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Titre : | The Use of Clinical Cervical Spine Clearance in Trauma Patients: A Literature Review (2018) |
Auteurs : | Sandra Larson ; Andrew U. Delnat ; Jill Moore |
Type de document : | Article |
Dans : | Journal of Emergency Nursing (Vol. 44, n° 4, July 2018) |
Article en page(s) : | p. 368-374 |
Note générale : | DOI: https://doi.org/10.1016/j.jen.2017.10.013 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Rachis ; Revue de la littérature ; Traumatismes de la moelle épinière |
Mots-clés: | Collier cervical |
Résumé : |
Introduction
Five million patients in America are placed in spinal immobilization annually, with only 1% to 2% of these patients suffering from an unstable cervical spine injury. Prehospital agencies are employing selective and limited immobilization practices, but there is concern that this practice misses cervical spine injuries and therefore possibly predisposes patients to worsening injuries. Methods A systematic review was conducted that examined literature from the last 5 years that reviewed cervical spine immobilization application and/or clearance in alert trauma patients. Results Prehospital selective immobilization protocols and bedside clinical clearance examinations are becoming more commonplace, with few missed injuries or poor outcomes. Prehospital providers can evaluate patients in the field safely to assess who needs or does not need cervical collars; similar criteria can be used in the emergency department. Harm from cervical collars is increasingly documented, with concerns that risks exceed possible benefits. Discussion The literature suggests that alert trauma patients can be cleared from cervical spine immobilization safely through a structured algorithm in either the prehospital or ED setting. The evidence is primarily observational. Thus, many providers who fear missing cervical injuries may be reluctant to follow the recommendations despite few or no published cases of sudden deterioration from missed cervical spine injuries. Image 1 |
Disponible en ligne : | Non |
Exemplaires (1)
Cote | Support | Localisation | Section | Disponibilité |
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REV | Périodique papier | Woluwe | Espace revues | Consultation sur place uniquement Exclu du prêt |