ʻO ka spinal immobilization kekahi o nā mākau maikaʻi loa e pono ai ka ʻenehana lapaʻau pilikia. No nā makahiki he nui i kēia manawa, ua hoʻokuʻu ʻia nā poʻe āpau i loaʻa i ka ʻeha a, no ke ʻano o ka pōʻino, e like me nā ʻōlelo a ke technician, pono e hoʻokaʻawale i ka spinal cord.

ʻO kēia nā makahiki i kūpono a noʻonoʻo i ka noʻonoʻo ʻana i ka mea i loaʻa i kahi pōʻino o ka nui o ka nui, e like me ka hāʻule ʻana mai ke kiʻekiʻe, kahi ulia kaʻa a i ʻole kekahi hanana like, pono e hoʻoneʻe ʻia no ka mea aia ka pilikia o ka ʻeha o ke kuamoʻo. ka mea e pale aku ai kakou ma na koina a pau.

Hoʻopili kēia i ka poʻe immobilizing ʻaʻole i loaʻa i nā hōʻailona o ka ʻeha o kēlā me kēia ʻano, ʻaʻole hoʻi 'ā'ī eha.

Ma keʻano he kūlana maʻamau, e hoʻokuʻu mākou i ka mea i komo i kahi ulia pōpilikia, i ka mea i komo i kahi kūlana e hiki ai ke hopena i ka haʻi kuamoʻo a iʻole kaʻeha o ke kuamoʻo.

NA PAPA SPINAL OI? E KIPA I KA SPENCER BOOTH MA EMERGENCY EXPO

Nā hopena o ka nui o ka spinal immobilization:

ʻO kēia ka mea i hoʻopiha ai nā halemai i nā poʻe i hōʻeha ʻia e hele ana ma ka puka me ke kaula ʻāʻī, i hoʻopaʻa ʻole ʻia ma kahi papa a i ʻole ka moena moena, ka mea i hāʻule i ka ʻōnaehana holoʻokoʻa.

Koke, ka lumi kūikawā Ua hoʻomaka nā limahana lapaʻau e hoʻomaopopo i ka hoʻopaʻa nui ʻana e hōʻino ana i ka keʻena pilikia o ka haukapila.

Ua alakaʻi kēia i ka hoʻomohala ʻana i kahi ʻano o nā protocols e hoʻoholo ai inā ua hoʻokō ka poʻe maʻi e hele ana ma ka puka o ka lumi ulia pōpilikia i nā koina e hana i nā ʻenehana radiological e hoʻoholo ai inā loaʻa iā lākou nā haʻi kuamoʻo.

ʻO ka immobilization spinal: Ua kūkulu ʻia ʻelua mau protocols nui, ʻo ka Nexus Low Risk Criteria (NLC) a me ka Canadian C-Spine Rule (CCR)

Ua ʻimi ʻo Nexus a me ka protocol Kanada e hoʻokaʻawale i nā poʻe maʻi i hoʻokō ʻole i nā koina no ka hoʻāʻo ʻana i ka radiology diagnostic no ka mea ʻaʻole i loaʻa i kā lākou maʻi maʻi i kahi kānalua kumu o ka spinal cord a i ʻole spinal cord.

Ua hele koke kēia mau pae hoʻohālikelike mai ka pae hoʻokipa halemai, kokoke wale nō no ka radiology, i hoʻohana ʻia i ka lāʻau lapaʻau ma waho o ka haukapila e hoʻoholo ai i nā mea maʻi e hoʻokuʻu ʻia ma ke alanui a ʻaʻole pono.

Aia kekahi mau koi kikoʻī ʻē aʻe no nā ulia pōpilikia ma waho o ka haukapila, e like me nā pae hoʻohālike PHTLS, nā mea a pau e pili ana i nā pae ʻepekema nui e pili ana i ka noiʻi helu a i ʻole ka hoʻokolohua kanaka.

ʻO kahi laʻana maʻamau ka hoʻokolohua kahi i hoʻopaʻa ʻole ʻia ai kahi hui o nā mea manawaleʻa no ka manawa lōʻihi, ma waena o ka hapalua hola a me ʻelua mau hola, a laila nīnau ʻia e pili ana i nā pilikia e hiki mai ana mai kēia lōʻihi. immobilisation.

A laila ua ʻike ʻia ʻo ka hoʻokau ʻole ʻana i ka mea maʻi i hoʻoulu ai i ka hopohopo a me ka ʻeha ma ka ʻāʻī a me ke kua i hiki ke mau no nā hola, a i kekahi mau mea hiki ke hana i nā ʻili ʻili ma nā wahi kākoʻo me ka papa.

No laila, ua ʻike ʻia nā alakaʻi e pili ana i nā hōʻike, e like me nā alakaʻi NICE 2 a i ʻole nā ​​mea like.

I ʻAukake 2018, ua hōʻea ka American College of Surgeons Committee on Trauma (ACS-COT), ka American College of Emergency Physicians (ECEP) a me ka Association of Emergency Medical Services Physicians (NAEMSP) i kahi kūlana hui i ka mea i kapa ʻia ʻo Spinal Motion. Ka palena (SMR) 3 .

I ka makahiki aʻe, ua ʻike ʻia kahi ʻatikala hoihoi ma ka Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine i kapa ʻia ʻo "New Clinical Guidelines on Spinal Motion Restriction. ʻO ka mea maʻi trauma makua: consensus and evidence base 4", i paʻi ʻia ma 19 ʻAukake 2019.

Hiki iā mākou ke hōʻuluʻulu i loko o kāna mau manaʻo koʻikoʻi ʻelima, ʻehā mau ʻōlelo hōʻike ʻepekema a me hoʻokahi algorithm:

• Aia nā hōʻike ʻepekema ikaika e kūʻē i ka hoʻohana ʻana i ka spinal stabilization i nā poʻe maʻi me ka trauma penetrating kaʻawale, ʻo ia hoʻi ʻaʻole pono e hana ʻia.
• ʻO ke kākoʻo ʻepekema no ka hoʻokuʻu ʻana i ka mea maʻi me kahi hale paʻa A B C D E me ka papa kuamoo a me ke kuamoo paakiki kola nāwaliwali, ʻaʻole i ʻōlelo ʻia e hana mau.
• ʻO ke kākoʻo ʻepekema no ka hoʻokuʻu ʻana i ka mea maʻi i loko o kahi moena ʻūhā no ka lawe ʻana he nāwaliwali, ʻo ia hoʻi, hiki ke hana ʻia akā ʻaʻole liʻiliʻi nā mea hōʻike e makemake ai.
• Hoʻohana ʻia ka hoʻohana ʻana i ka algorithm clinical.

KANAKA

1. García García, JJ Immobilizzazione cervicale selettiva basata sull'evidenza. Wahi TES 2014(3):1;6-9.
2. Linea guida NIZZA. Febbraio 2016. Trauma maggiore: erogazione del servizio. https://www.nice.org.uk/guidance/ng40/chapter/Recommendations
3. Peter E. Fischer, Debra G. Perina, Theodore R. Delbridge, Mary E. Fallat, Jeffrey P. Salomone, Jimm Dodd, Eileen M. Bulger & Mark L. Gestring (2018) Spinal Motion Restriction in the Trauma Patient - ​​​​Una dichiarazione di posizione comune, Assistenza preospedaliera di pilikia, 22:6, 659-661, DOI: 10.1080/10903127.2018.1481476. https://www.tandfonline.com/doi/full/10.1080/10903127.2018.1481476
4. Maschmann, Elisabeth Jeppesen, Monika Afzali Rubin a me Charlotte Barfod. ʻO ka laina e alakaʻi ai i ka cliniche sulla stabilizzazione spinale dei pazienti adulti con trauma: consenso and prove basate. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2019: (27):77. https://sjtrem.biomedcentral.com/articles/10.1186/s13049-019-0655-x

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Source:

Zona TES