Stabilization of the spine in the trauma victim - integrative review
Abstract
Goal: To identify harmful effects caused by the stabilization of the vertebral column in a trauma victim and in trauma situations without indication for stabilization of the spine in the prehospital.
Method: It was perform an integrative literature review guided by research questions: is there a scientific evidence of harmful effects on trauma victims caused by spinal stabilization in prehospital care? and are there situations of trauma with no indication for stabilization of the spine?
Results: We have performed a Boolean search in the electronic bases Cochrane Library and Pubmed and through the EBSCOhost engine in the databases CINAHL Plus, MEDLINE, MedicLatina, SPORTDiscus, PsycARTICLES, PsycBOOKS, Psychology and Behavioral Sciences Collection, Academic Search Complete. Twelve articles were obtained and after applying the inclusion and exclusion criteria, the sample was five articles.
Conclusions: Harmful effects of spinal stabilization on the victim of trauma related to airway management, pain, discomfort and pressure injuries are described.
Situations of penetrating trauma with unstable circulation and victims with gunshot injuries to the head do not require stabilization of the spine.
Recommendations to support the prehospital decision regarding stabilization of the spine were collected.
It is crucial for the improvement of prehospital care to integrate an individualized approach of the victim that refers to its clinical state and mechanism of injury.
Downloads
References
Kreinest, M., Gliwitzky, B., Schüler, S., Grützner, P. A., & Münzberg, M. Development of a new Emergency Medicine Spinal Immobilization Protocol for trauma patients and a test of applicability by German emergency care providers. Scandinavian journal of trauma, resuscitation and emergency medicine [internet]. 2016 [acesso em 2018 Dez 20];24(1), 71. Disponível em:
https://sjtrem.biomedcentral.com/articles/10.1186/s13049-016-0267-7
Catarino R., Ribeiro H., Valente M. Emergências de Trauma: Manual TAS.1.ed. Lisboa: Instituto de Emergência Médica; 2012. Disponível em:
https://www.inem.pt/wp-content/uploads/2017/06/Emerg%C3%AAncias-Trauma.pdf
Connor, D., Greaves, I., Porter, K., & Bloch, M. Pre-hospital spinal immobilisation: an initial consensus statement. Emerg Med J. [internet]. 2013 [acesso em 2018 Dez 23]; 30(12), 1067-1069. Disponível em:
http://dx.doi.org/10.1136/emermed-2013-203207
Hauswald, M., & Braude, D. Spinal immobilization in trauma patients: is it really necessary?. Current Opinion in Critical Care.[internet]. 2002 [acesso em 2018 Dez 20]; 8(6), 566-570. Disponível em:
Sundstrøm, T., Asbjørnsen, H., Habiba, S., Sunde, G. A., & Wester, K. Prehospital use of cervical collars in trauma patients: a critical review. Journal of neurotrauma. [internet]. 2014 [acesso em 2018 Dez 23]; 31(6), 531-540. Disponível em:
https://www.liebertpub.com/doi/pdf/10.1089/neu.2013.3094
Souza, M., Silva, M., Carvalho, R. Revisão integrativa: o que é e como fazer. Einstein. [internet]. 2010 [acesso em 2018 Dez 20]; 8, 102-106. Disponível em:
http://www.scielo.br/pdf/eins/v8n1/pt_1679-4508-eins-8-1-0102
da Costa Santos, C. M., de Mattos Pimenta, C. A., & Nobre, M. R. C. A estratégia PICO para a construção da pergunta de pesquisa e busca de evidências. Revista Latino-Americana de Enfermagem. [internet]. 2007 [acesso em 2018 Dez 23]; 15(3), 508-511. Disponível em:
http://www.scielo.br/pdf/rlae/v15n3/pt_v15n3a23
BVS. Descritores em Ciências da Saúde [internet]. São Paulo: Biblioteca Virtual em Saúde; 2018 Dez [citado em 2018 Dez 16]. Disponível em:http://decs.bvs.br/
NCBI. MeSH [internet]. Bethesda: National Center for Biotechology Information; 1999 Set 1 [citado em 2018 Dez 16]. Disponível em: https://www.ncbi.nlm.nih.gov/mesh
Melnyk, B. M. & Fineout-Overholt, E. Evidence-based practice in nursing & healthcare: A guide to best practice.2.ed. London: Lippincott Williams & Wilkins; 2011. Disponível em:
Campos, C. J. G. Método de análise de conteúdo: ferramenta para a análise de dados qualitativos no campo da saúde. Revista brasileira de enfermagem.[internet]. 2004 [acesso em 2018 Dez 14]; 57(5):611-4. Disponível em: http://www.scielo.br/pdf/reben/v57n5/a19v57n5
Hemmes, B., Brink, P. R., & Poeze, M. Effects of unconsciousness during spinal immobilization on tissue-interface pressures: a randomized controlled trial comparing a standard rigid spineboard with a newly developed soft-layered long spineboard. Injury. [internet]. 2014 [acesso em 2018 Dez 20]; 45(11), 1741-1746. Disponível em:
Kornhall, D. K., Jørgensen, J. J., Brommeland, T., Hyldmo, P. K., Asbjørnsen, H., Dolven, T., ... & Jeppesen, E. The Norwegian guidelines for the prehospital management of adult trauma patients with potential spinal injury. Scandinavian journal of trauma, resuscitation and emergency medicine. [internet]. 2017 [acesso em 2018 Dez 20]; 25(1), 2. Disponível em:
https://sjtrem.biomedcentral.com/articles/10.1186/s13049-016-0345-x
Sundstrøm, T., Asbjørnsen, H., Habiba, S., Sunde, G. A., & Wester, K. Prehospital use of cervical collars in trauma patients: a critical review. Journal of neurotrauma. [internet]. 2014 [acesso em 2018 Dez 20]; 31(6), 531-540. Disponível em:https://www.liebertpub.com/doi/pdf/10.1089/neu.2013.3094
American College of Surgeons Committee on Trauma. Advanced Trauma Life Support (ATLS) Student Course Manual. 9.ed. Chicago: American College of Surgeons; 2012.
Prehospital Trauma Life Support Committee of The National Association of Emergency Medical Technicians in Cooperation with The Committee on Trauma of The American College of Suregons. Prehospital Trauma Life Support (PHTLS). 7.ed. Burlington, MA: Jones & Bartlett Learning; 2010.
Ala'a, O. O., Jennings, P. A., Smith, K., & Stoelwinder, J. Should suspected cervical spinal cord injuries be immobilised? A systematic review protocol. Injury prevention. [internet]. 2014 [acesso em 2018 Dez 21]; 20(3), e5-e5. Disponível em:http://dx.doi.org/10.1136/injuryprev-2013-041080
Kreinest, M., Gliwitzky, B., Schüler, S., Grützner, P. A., & Münzberg, M. Development of a new Emergency Medicine Spinal Immobilization Protocol for trauma patients and a test of applicability by German emergency care providers. Scandinavian journal of trauma, resuscitation and emergency medicine. [internet]. 2016 [acesso em 2018 Dez 21]; 24(1), 71. Disponível em:
https://sjtrem.biomedcentral.com/articles/10.1186/s13049-016-0267-7
Hauswald, M. A re-conceptualisation of acute spinal care. Emerg Med J. [internet]. 2013 [acesso em 2018 Dez 21]; 30(9), 720-723. Disponível em:
The works published in this magazine are subject to the following terms:
1. The Publications Service of the University of Murcia (the publisher) preserves the copyright of the published works, and encourages and allows the reuse of the works under the license for use stated in point 2.
© Servicio de Publicaciones, Universidad de Murcia, 2011 (© Publications Service, University of Murcia, 2011)
2. The works are published in the electronic edition of the journal under Creative Commons Reconocimiento-NoComercial-SinObraDerivada 3.0 España(texto legal) “ a Attribution-NonCommercial-NoDerivatives 3.0 Spain license (legal text)”. They can be copied, used, broadcasted, transmitted and publicly displayed, provided that: i) the authorship and original source of their publication (journal, publisher and URL) are cited; (ii) are not used for commercial purposes; iii) the existence and specifications of this license is mentioned.
3. Conditions of self-archiving. Authors are allowed and encouraged to electronically disseminate the pre-print (pre-reviewed ) and / or post-print (reviewed and accepted for publication) versions of their works prior to publication, as it ensures a wider circulation and dissemination which may lead to a possible increase in its mention and a higher scope among the academic community. RoMEO color: green.
