Emergency Live | 10 Steps to perform a Correct Spinal Immobilization of a Trauma Patient image 4 — Mgbapu ihe mberede: ntinye nke isi immobilizer na nke olu akwa cervical

Usoro cervical na spinal immobilization: nyocha

By Cristiano Antonino On Feb 24, 2023

Usoro mgbochi nke cervical na spinal: Ndị ọrụ nlekọta ahụike mberede (EMS) na-anọgide na-abụ ndị na-ahụ maka nlekọta nke ọtụtụ ihe mberede na-adịghị n'ụlọ ọgwụ, gụnyere ọnọdụ trauma.

Ntuziaka ATLS (nkwado ndụ trauma dị elu), nke e mepụtara na 1980s, na-anọgide na-abụ ụkpụrụ ọla edo maka nyochaa na ịkwado nlekọta nke mmerụ ahụ na-eyi ndụ egwu n'ụzọ ezi uche dị na ya na nke ọma, ọ bụ ezie na ọ dịla anya enwere arụmụka siri ike banyere ụzọ ndị ahụ. nke iji enyemaka a.

Ịkwụsị ọkpụkpụ azụ abụrụla akụkụ dị mkpa nke nkuzi, na mgbakwunye na ihe nkedo pelvic na splint maka ọkpụkpụ ọkpụkpụ dị ogologo.

Ụdị ahụike dị iche iche ngwá emebela iji mee ka ịdị irè na ịdị mfe nke ngwa ngwa, yana ikwe ka mgbanwe na ohere dị mkpa maka njikwa ụgbọ elu na usoro ndị ọzọ.

A na-ekpebi mkpa ọ dị ime ka ọkpụkpụ azụ azụ site na ọnọdụ na nyocha onye ọrịa.

Ndị na-agbatị agbatị, bọọdụ azụ azụ, ndị na-eku ume ọkụ, oche mgbapụ: AKWỤKWỌ SPENCER N'AKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWASỊ

Tụlee immobilisation spinal mgbe usoro nke mmerụ ahụ na-emepụta nnukwu index nke enyo maka isi, n'olu ma ọ bụ mmerụ azụ azụ

Ọnọdụ uche adịghị mma na ụkọ akwara ozi bụkwa ihe na-egosi na ekwesịrị ịtụle imegharị ọkpụkpụ azụ.[1][2][3][4]

Nkuzi ATLS ọdịnala maka ịgbatị azụ azụ kwesịrị ekwesị nke onye ọrịa nọ n'ọnọdụ nnukwu mmerụ ahụ bụ ihe siri ike dabara adaba nke ọma. olu akwa nwere ihe mgbochi na teepu iji chekwaa spain cervical, yana bọọdụ azụ iji chebe ọkpụkpụ azụ ndị ọzọ.

The Ngwa mwepụ nke Kendrick na-enye ohere ka a na-echebe ọkpụkpụ azụ na onye ahụ merụrụ ahụ na-anọdụ ala n'oge a na-ewepụ ngwa ngwa site na ụgbọ ala ma ọ bụ n'ọnọdụ ndị ọzọ ebe a na-ejedebe ohere iji kwe ka iji azụ azụ zuru ezu.

Otú ọ dị, ngwaọrụ a na-achọ ka ndị ọrụ nnapụta na-akpachapụ anya iji gbochie mmegharị ahụ nke cervical site na iji nchịkọta inline ruo mgbe mgbakọ [5].

Mbipụta nke iri nke ntuziaka ATLS na nkwupụta nkwenye nke American College of Emergency Physicians (ACEP), American College of Surgeons Committee on Trauma (ACS-COT), na National Association of EMS Physicians (NAEMSP) na-ekwu na, na ikpe nke penetrating trauma ọ dịghị ihe na-egosi maka mmachi nke spinal ije [10], n'ikwekọ na a retrospective ọmụmụ si American Trauma Database nke gosiri a dị nnọọ ala ọnụ ọgụgụ nke spinal ọnyà na-adịghị akwụsi ike na-achọ ịwa ahụ na ọnọdụ nke penetrating trauma. Ọmụmụ ihe ahụ gosikwara na ọnụ ọgụgụ ndị ọrịa a ga-agwọta iji nweta uru nwere ike ịdị elu karịa ọnụ ọgụgụ ndị ọrịa a ga-agwọta iji nweta mmerụ ahụ, 6/1032.

Otú ọ dị, n'ihe banyere nnukwu mmerụ ahụ na-adịghị mma, a na-anọgide na-egosipụta ihe mgbochi n'ọnọdụ ndị a:

Low GCS ma ọ bụ ihe akaebe nke mmanya na-egbu egbu na ọgwụ ọjọọ
Ọkpụkpụ dị n'etiti ma ọ bụ azụ cervical dị nro
Nrụrụ spinal doro anya
Ọnụnọ nke ọnyá ndị ọzọ na-adọpụ uche

Nkwanye maka mmachi dị irè na-aga n'ihu na-abụ olu olu cervical na-echebe ọkpụkpụ azụ zuru oke, nke a ga-ewepụ ozugbo enwere ike.

Nke a bụ n'ihi ihe ize ndụ nke mmerụ ahụ dị iche iche.

Otú ọ dị, n'ime ọnụ ọgụgụ ụmụaka, ihe ize ndụ nke mmerụ ahụ dị iche iche dị ala ma ya mere ọ bụ naanị nlezianya anya nke spine cervical ma ọ bụghị nlezianya zuru oke ka a na-egosi (ọ gwụla ma ihe ịrịba ama ma ọ bụ ihe mgbaàmà nke mmerụ ahụ ndị ọzọ dị).

Imobilization cervical na olu ike siri ike na onye ọrịa ụmụaka

olu mgbu
Mgbanwe nke neurology nke akụkụ ahụ adịghị akọwa ya site na trauma ụkwụ
Muscle spasm nke olu (torticollis)
GCS dị ala
Ahụhụ nwere nnukwu ihe ize ndụ (dịka ihe mberede ụgbọ ala nwere ike dị elu, mmerụ ahụ hyperextension nke olu na nnukwu mmerụ ahụ dị elu)

Mpaghara nchegbu

A na-enwewanye ihe akaebe na nchegbu ubi ahụ ịlụ emela ka ojiji nke usoro ịgbatị azụ azụ n'ụzọ gabigara ókè yana na ụfọdụ ndị ọrịa nwere ike nọrọ n'ihe ize ndụ[7][8][9][10].

Nsogbu nwere ike ime ka ọkpụkpụ azụ azụ:

Ahụ erughị ala na Nsogbu maka onye ọrịa[11].
Ịgbatị oge tupu ụlọ ọgwụ na-enwe ike igbu oge nke nyocha na ọgwụgwọ dị mkpa, yana itinye aka na ntinye aka ndị ọzọ[11].
Mgbochi iku ume site na eriri, yana arụ ọrụ iku ume ka njọ na ọnọdụ dị elu ma e jiri ya tụnyere ọnọdụ ziri ezi. Nke a dị mkpa karịsịa n'ọnọdụ nke trauma thoracic, ma ọ bụ nke na-adịghị mma ma ọ bụ ịbanye[12][13] Ihe isi ike na intubation[14].
Okwu nke ndị ọrịa nwere spondylitis ankylosing ma ọ bụ nrụrụ ọkpụkpụ azụ dị adị, ebe enwere ike ịkpata mmerụ ahụ n'ezie site n'ịmanye onye ọrịa ka ọ kwekọọ n'ọnọdụ a kara aka nke akwa akwa cervical na azụ azụ[15].

Nlebanya ọhụrụ nke akwụkwọ Scandinavian, nke a na-eme iji nyochaa ihe akaebe dị maka mmachi nke ọkpụkpụ azụ [16], na-enye nghọta bara uru nke ukwuu n'iji atụnyere usoro nkwụsi ike nke azụ azụ na mbụ na nyocha nke ike ihe akaebe.

Olu akwa siri ike

A na-eji olu olu siri ike mee ihe kemgbe etiti afọ 1960 dị ka usoro nke nkwụsi ike nke spine cervical, nke nwere ihe akaebe dị ala na-akwado mmetụta dị mma na nsonaazụ akwara nke ụbụrụ cervical, na-enwe mmetụta ọjọọ n'ihi mmụba dị ukwuu na nrụgide intracranial na dysphagia [17].

Akụkọ ahụ na-atụkwa aro na onye na-amụ anya na onye na-akwado ya na-enwe mgbagwoju anya nke ahụ kpatara mmerụ ahụ agaghị enwe mgbanwe dị ịrịba ama, dịka ekwuru na nchọpụta cadaver nke nwara nyochaa mmetụta nke mmerụ ahụ.

Akụkọ ahụ na-atụ aro imezi ihe ize ndụ na uru nke ịwa ahụ a.

Agbanyeghị, otu American Association of Neurological Surgeons na-aga n'ihu na-atụ aro olu olu siri ike dị ka ụzọ isi mee ka spain cervical kwụsie ike na ọnọdụ ụlọ ọgwụ tupu ụlọ ọgwụ[18].

bọọdụ siri ike: Kedu mgbe a na-eji ogologo bọọdụ azụ azụ?

A na-eji ogologo bọọdụ azụ azụ azụ nke izizi yana akwa akwa, ihe mgbochi na eriri iji nweta mbelata nke ọkpụkpụ azụ.

Enwere ike imebi, karịsịa ọnya nrụgide na sacrum, [19] [20] egosila ugbu a, karịsịa n'ihe gbasara mmerụ ahụ na-enweghị mmetụta nchebe.

Matraasi oghere dị nro na-enye elu dị nro nke na-echebe megide mmetụta nke ọnya nrụgide ma n'otu oge ahụ na-enye nkwado zuru oke mgbe ọ gbatịpụrụ n'elu ọkwa isi[16].

nkanka

Ihe mgbochi bụ akụkụ nke atụmatụ nchịkọta inline maka ịkwado ọkpụkpụ azụ ma yie ka ọ dị irè mgbe ị na-eke onye ọrịa ahụ n'ọkpụkpụ. osisi iji nweta ọ̀tụ̀tụ̀ ụfọdụ nke enweghị ike imegharị ahụ, na-enweghị abamuru agbakwunyere nke iji olu olu siri ike na ngwakọta [21].

Akwụsịnụ matraasi

N'iji matraasi na-ekpo ọkụ na-atụnyere naanị bọọdụ siri ike, matraasi na-enye ọtụtụ njikwa na obere mmegharị n'oge ngwa na ebuli karịa bọọdụ siri ike [22].

N'iburu n'uche ihe ize ndụ nke ọnya nrụgide, matraasi ahụ yiri ka ọ na-enye nhọrọ ka mma maka njem ndị ọrịa.

Ịhapụ ọkpụkpụ azụ: mgbanwe nke spinal na cervical immobilization

Usoro NEXUS: onye anya, onye na-adịghị egbu egbu na-enweghị mmerụ ahụ na-adọpụ uche nwere obere ohere nke mmerụ ahụ na enweghị esemokwu etiti na nhụjuanya akwara.

Nke a na-egosi na ọ bụ ngwa nyocha nwere mmetụta nke nwere mmetụta nke 99% yana uru amụma na-adịghị mma nke 99.8%[23].

Otú ọ dị, nchọpụta nchọpụta ndị ọzọ na-atụ aro na onye na-amụ anya nke nwere mmerụ ahụ nke ụbụrụ cervical ga-anwa ime ka ọkpụkpụ azụ dị ike nakwa na ọnụnọ nke ọnya na-adọpụ uche (ewezuga thorax) adịghị emetụta nsonaazụ nke nyocha ụlọ ọgwụ nke spine cervical na ya mere, Enwere ike ikpochapụ ọkpụkpụ azụ n'ụlọ ọgwụ na-enweghị foto ọzọ[24]. Ọmụmụ ihe ndị ọzọ na-atụ aro otu nsonaazụ ahụ maka spine thoracolumbar [25] [24].

RADIO ndị ọrụ napụta n'ụwa? Gaa leta EMS RADIO BOOTH na ngosi ihe mberede

Clinical mkpa

Ọ bụ ezie na a na-emezi ọkpụkpụ azụ azụ tupu ụlọ ọgwụ ruo ọtụtụ iri afọ, data dị ugbu a na-egosi na ọ bụghị ndị ọrịa niile kwesịrị imegharị ahụ.

Ugbu a National Association of Emergency Physicians USA na American College of Surgeons Committee on Trauma na-atụ aro obere ngwa nke nkwụsị azụ azụ.

Ntuziaka ọhụrụ ndị a na-egosi na ọnụ ọgụgụ ndị ọrịa nwere ike irite uru site na nkwụsịtụ dị ntakịrị

Kọmiti ahụ gara n'ihu kwupụta na ekwesịrị iji nlezianya jiri ihe mgbochi azụ azụ n'oge njem, n'ihi na n'ọnọdụ ụfọdụ ihe ize ndụ ha nwere ike ịkarị uru ha.

Ọzọkwa, n'ime ndị ọrịa nwere mmerụ ahụ na-abanye n'ime ahụ na enweghị ntụpọ akwara ozi doro anya, a naghị atụ aro iji mgbochi azụ azụ.

Na USA, onye na-ahụ maka EMS ga-eji acumen nke ụlọ ọgwụ tupu ya ekpebi iji bọọdụ spinal.[26]

N'ikpeazụ, ọkpụkpụ azụ na-ejikọta ya na mgbu azụ, mgbu olu ma mee ka ọ sie ike ịme usoro ụfọdụ, gụnyere ihe oyiyi.

Ejikọtakwara mkpụgharị azụ azụ na ihe isi ike iku ume, karịsịa mgbe a na-etinye nnukwu eriri n'ime obi.

Ọ bụ ezie na ọtụtụ òtù EMS dị na US anabatala ụkpụrụ nduzi ọhụrụ ndị a na nkwụsị azụ azụ, nke a abụghị ihe zuru ụwa ọnụ.

Ụfọdụ sistemu EMS na-atụ egwu ịgba akwụkwọ ma ọ bụrụ na ha emeghị ka ndị ọrịa ghara imegharị ahụ.

Ndị ọrịa kwesịrị ịmegharị ahụ na ọkpụkpụ azụ gụnyere ihe ndị a:

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masịrị trauma
mgbu azụ azụ
ndị ọrịa nwere ọkwa mmụọ gbanwere
adịghị ike akwara
nrụrụ anatomical doro anya nke kọlụm azụ azụ
Nnukwu mmerụ ahụ dị elu na onye ọrịa na-aṅụ ọgwụ ọjọọ, mmanya.

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