Spinal Immobilisation: A Literature Review
A review of the literature regarding spinal immobilisation has been undertaken using databases for PubMed, MEDLINE, CINAHL, OVID and Cochrane EBM. Reviews were electronically searched using the subject headings “spinal injuries”, “spinal immobilisation” and “management of spinal injuries”. The results generated by the search were limited to English language articles and reviewed for relevance to the topic. The aim of this literature review is to compare and contrast the views on spinal immobilisation and to achieve a better knowledge of evidence based practice.
According to Chiles and Cooper (1996) spinal injury should always be suspected in patients with severe systemic trauma, patients
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According to Vickery (2001) however, the spinal board is considered to be the gold standard for spinal immobilisation during the pre-hospital phase of trauma management. For some patients, effective spinal immobilisation is beneficial and can also be vital in preventing the devastating effects of cord damage however it has been suggested that for many the excessive use of this preventative measure may not be prudent or necessary. It has been estimated that over 50% of trauma patients with no complaint of neck or back pain were transported with full spinal immobilisation (McHugh & Taylor 1998). Inappropriate spinal immobilisation may lead to patients experiencing unnecessary pain, skin ulceration, aspiration and respiratory compromise, which in turn may lead to further unnecessary procedures, a longer hospital stay which then incurs increasing costs to the National Health Service (Kwan, Bunn & Roberts, 2001). Shooman & Rushambuza (2009) report that immobilisation is a crucial part of the management of a trauma patient. They believe that if the mechanism of injury is uncertain, the patient should remain immobilised until further imaging even if there are no symptoms of spinal instability after log rolling. However, in a recent study by Pandie, Shepherd & Lamont (2010) they concluded that on its own, standard
* Following a SCI, the first priority is often to help the patient develop as much possible strength in the
This assignment will present a reflective analysis of the examination, diagnosis, treatment and referral plan based on a simulated patient presenting with a minor injury. Potential diagnoses related to the mechanism of injury will discussed aligning the patient presentation with the literature to produce the most likely diagnosis. When this is established, a suggested treatment plan will be created in line with current guidance.
It is important to note that there are currently no invasive procedures that Paramedics are trained to do in the field to reduce ICP and early recognition and prompt transport to the nearest hospital with neurological capabilities is the definitive treatment for this type of injury. In our case study, the treating medics were limited in their options for treatment, mostly due to the inability to secure the airway due to the patient locking down his jaw. However they were able to suction some of the fluid and maintain an open airway through manual manipulation and cervical spinal
Spinal cord injury is a sudden and devastating event for patients. The injury can be extremely debilitating and it may require a significant alteration in lifestyle post injury. P.R. has sustained a relatively high level (C6) spinal cord injury, which makes him very limited functional capacity. He will go through grieving process followed by anger for the loss of function and independence. This may be especially difficult for P.R. because he is a young man in his thirties who sustained a debilitating injury in a foreign country without any support from family and friends. Spinal cord injury has left P.R. unable to move his entire lower extremities and trunk muscles. He is unable to do the most basic activities, such as feeding and bowel movement without the help of a caregiver. For a young man who was active and completely independent, it is very difficult to accept this reality. It should also be noted that most of the nursing staff are females, which further damages his male ego for having total dependence.
The spine is one of the most important structures in the human body. The spine is located in the dorsal cavity and consists of 24 bones, called vertebrae. These vertebrae play a crucial role in protected the body’s command center, the spinal cord. But what happens when a disorder prevents the spinal column from functioning correctly? Scoliosis is a musculoskeletal disorder that causes abnormal lateral curvature of the spine and it effects millions of people in the US per year. I have chosen this disorder because I am aspiring to become a chiropractor and scoliosis is a typical condition that chiropractors help treat on a daily basis.
Now that I have shared a brief overview of the spinal cord and some statistics about spinal cord injuries, we will look at the past research that has led to the treatments most commonly used today. In 1990, a steroid called dexamethasone was discovered in human trials to preserve some motor and sensory function if administered at high doses within 8 hours of injury. Surgery used to remove fluid, tissue, or bone fragments, or to stabilize fractured vertebrae by fusing bones or inserting hardware has also proven to be one of the most thorough measures to prevent further harm. I received both of these treatments after my accident, and they are the same that have been used for the past decade. Until recently, doctors had no way of limiting such disabilities, aside from stabilizing the cord to prevent added destruction, treating infections, and prescribing rehabilitative therapy to maximize any remaining capabilities.
Football is known as the most popular sport in America. But, little people know about the “Silent Killer.” Football injuries are all too common, one of which being Spinal Cord Injuries. Nobody understands how devastating Spinal Cord Injuries can actually be, until it’s too late.
This essay is not intended to criticize any emergency medical or hospital staff. I am writing this essay out of concern for patients who come into the emergency room that may have a jeopardized spinal cord resulting from an injury or suspected injury to their cervical spine. I am a certified emergency medical technician, farm-medic instructor and currently a medical diagnostic student doing clinicial's. In the United States each year there are approximately 10,000 reported cervical spine injuries that come into emergency rooms. Motor vehicle accidents account for approximately 45%, falls approximately 30%, the remaining 25% from sports and miscellaneous. Although only a small amount of
After researching about paraplegic and quadriplegic, it has been determined how they occur and in what parts of the body they affect. According to John Hopkins Medical, if a person suffers with paraplegic or quadriplegic, it is caused by damage to the spinal cord. To determine whether a person has a spinal injury, doctors will use clinical signs to help determine the severity of the injury. When the spinal cord has been injured, the patient might feel pain, and some disorders; such as motor or sensory. When this occurs, it allows the doctor to determine the cause of the injury, however; most spinal injuries are caused by traumatic accidents. The two
Spine injuries hurt a lot for example your spine can pop outback this up. 2-100,000 get spine injuries.
Five criteria must be met which includes authority, information, objectivity, ease of navigation and privacy and security policies. The website used for my research was www.christopherreeve.org. The website met the five criteria. Authority was displayed in several ways. The author, Judith Lubinsky is qualified as an expert in the spinal cord injury field. Judith is responsible for web production and social media for the website. The contact information and credentials for the author was clearly stated. Information is updated daily to keep readers informed of any changes. The information posted is accurate and appropriate for the intended audience. The author provides an unbiased comprehensive review of spinal cord injuries and management. The sponsor for the website is The Christopher and Dana Reeve Foundation. The source of funding does not have an impact on the information provided. The website provides easy navigation with reliable information, treatment options, clinical trials and ways to get involved. The website provided clear privacy and security
"Ambulatory spinal unloading" is the "new kid on the block" when it comes to treatment of acute and chronic low back pain. It is so new that many care givers are not yet fully aware of it.
The limited space within the vertebrae actually plays an important roll in spinal cord injury. Once the initial injury occurs the body, as with every other part of the body, tries to protect the injured area with swelling. But the swelling occurs within the small confines of the spinal column and causes further damage to the surrounding tissue. It has only recently been discovered how much of an impact this secondary damage has. One of the areas of crucial ongoing research is on what kind of window of opportunity medicine has in treating these types of injuries and still attaining the best recovery.
However the patient was immobilised with a cervical collar and extrication board and conveyed to the appropriate receiving hospital as Fisher J.D et al (2006) also states all patients should have initial immobilisation if the mechanism of injury suggests possible spinal injury.
Review what Dr. Notto and his team want you to understand about spinal decompression to help determine if it’s your ideal treatment: