Osteosynthesis and Trauma Care 2003; 11(4): 162-165
DOI: 10.1055/s-2003-44855
Original Article

© Georg Thieme Verlag Stuttgart · New York

Preclinical Treatment of Spinal Injuries from a Trauma Surgery Perspective - The Austrian Model

C. Fialka1 , C. Sebök 1 , G. Oberleitner1 , P. Kemetzhofer2 , O. Kwasny2 , V. Vécsei1
  • 1Universitätsklinik für Unfallchirurgie Wien (University Clinic for Trauma Surgery Vienna), Austria
  • 2Abteilung für Unfallchirurgie, AKH Linz (Department for Trauma Surgery), Austria
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Publikationsverlauf

Publikationsdatum:
23. Februar 2004 (online)

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Abstract

Background: Due to the lack of relevant data regarding the efficiency and effect of preclinical treatment of spinal injuries, there is a distinct lack of specific guidelines within this field. Although rescue methods are to some extent regulated by guidelines, there is a lack of specific guidelines regarding subsequent medication therapies and other further measures. This representative study is intended to generate recommendations with regard to the treatment of patients with spinal injuries, based on the practised procedures in Austria.
Methods: The current status of the treatment provided to spinal injury patients with regard to rescue methods, auxiliary devices, documentation, extent of volume substitution and medication used was documented by means of a representative survey of all trauma surgery hospitals or clinics that treat spinal injuries in Austria (representative participation of 97.0 %).
Results: Auxiliary devices such as vacuum mattresses and external spine stabilising devices are used in 93.6 %, i. e. 92.1 % of all cases. Intravenous access is applied in 95.2 % of cases; oxygen is administered in 68.3 %. Opiates (74.6 %) and ketamine (23.8 %) are most frequently used for sedation and as analgesics. Neuroprotective therapy, by means of administrating cortisone, is initiated preclinically in 74.6 % of cases.
Conclusion: Careful rescue, the use of splinting devices, and fast transportation in conjunction with continuous volume substitution are vital prerequisites for successful treatment. A rough neural examination is sufficient for assessing neurological function during the preclinical phase. Cortisone therapy may be initiated preclinically, if neurological deficits are suspected.