Spinal cord injury (SCI) - Prehospital management

  • M. B
  • A. G
  • P. K
 et al. 
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Up to 20,000 patients annually suffer from spinal cord injury (SCI) and 20{{}{{}{}}{{}{%}{}}{{}{}}{}} of these die before being admitted to the hospital in the United States as well as in the European Union. Prehospital management of SCI is of critical importance since 25{{}{{}{}}{{}{%}{}}{{}{}}{}} of SCI damage may occur or be aggravated after the initial event. Prehospital management includes examination of the patient, spinal immobilisation, careful airway management (intubation, if indicated, using manual in-line stabilisation), and cardiovascular support (maintenance of mean arterial blood pressure above 90 mmHg) and blood glucose levels within the normal range. It is still not known whether additional specific therapy is useful. Studies have not demonstrated convincingly that methylprednisolone (MPS) or other pharmacological agents really have clinically significant and important benefits for patients suffering from SCI. Recently published statements from the United States also do not support the therapeutic use of MPS in patients suffering from SCI in the prehospital setting any more. Moreover, at this stage, it is not known whether therapeutic hypothermia or any further pharmacological intervention has beneficial effects or not. Therefore, networks for clinical studies in SCI patients should be established, as a basic requirement for further improvement in outcome in such patients. {{}{{}{}}{{}{©}{}}{{}{}}{}} 2005 Elsevier Ireland Ltd. All rights reserved.

Author-supplied keywords

  • Glasgow coma scale
  • airway
  • brain injury
  • brain ischemia
  • breathing
  • circulation
  • clinical trial
  • colloid
  • conference paper
  • crystalloid
  • drug efficacy
  • drug safety
  • emergency treatment
  • endotracheal intubation
  • ganglioside GM1
  • glucose
  • glucose blood level
  • hematemesis
  • human
  • hypertonic solution
  • hypotension
  • hypovolemic shock
  • hypoxia
  • immobilization
  • incidence
  • induced hypothermia
  • intubation
  • laryngeal mask
  • mean arterial pressure
  • melena
  • methylprednisolone
  • motor performance
  • naloxone
  • neurologic disease
  • oxygenation
  • pain
  • pathophysiology
  • patient care
  • patient mobility
  • physical examination
  • pneumonia
  • prevalence
  • priority journal
  • prognosis
  • pulse oximetry
  • respiratory arrest
  • respiratory failure
  • resuscitation
  • seizure
  • spinal cord injury
  • tirilazad
  • wound infection

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  • Bernhard M.

  • Gries A.

  • Kremer P.

  • Böttiger B.W.

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