颈套类型与创伤患者颈脊髓损伤发生率的关系

Q3 Nursing

Air Medical Journal Pub Date : 2025-07-10 DOI:10.1016/j.amj.2025.06.015

Matthew R. Shaw MPH, FP-C, CCP-C , Joseph Liu DO , Nicholas Segel DO , Michael Hudson MD , Iv Godzdanker MD , Zachary Lyman EdD, FP-C , Tricia Miedema MD , Holly Tallman MD , Joshua B. Gaither MD

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引用次数: 0

摘要

目的院前如何对颈椎进行最佳固定存在争议。刚性颈套一直被认为是预防和护理疑似颈脊髓损伤（c-SCI）患者的标准护理。最近，由于患者的耐受性较好，软c型领开始取代刚性领。本研究的目的是通过评估刚性c-collar与软c-collar固定患者中c-SCI的发生率来比较这两种装置的安全性。方法回顾性分析为提高质量而收集的资料。所有可能有c-SCI的病例均被纳入。排除缺少医院国际疾病分类代码或急诊医疗服务神经系统检查文件的病例。主要终点是出院时的c-SCI诊断。次要结果是c-SCI高危人群中c-SCI的患病率。完成描述性和卡方分析来比较队列。结果在882例可能的c-SCI患者中，267例采用刚性项圈，615例采用软项圈。硬领组和软领组的中位年龄分别为36岁（24.5-53岁）和39岁（24-58岁），男性占54%（134岁），男性占64%（313岁）。硬颈圈组c-SCI发生率为0.8%，软颈圈组为1.5% （P = 0.460）。在紧急医疗服务中发现神经功能缺损的病例中，硬颈（2/ 29,6.9%）与软颈（5/ 87,5.7%）组的c-SCI发生率无差异（P = 0.833）。结论：在这项有限的回顾性研究中，使用刚性和软型c-collar固定的患者在c-SCI发生率上没有统计学上的显著差异。需要进一步的调查来确定硬颈圈和软颈圈是否提供相同的保护。

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Association Between Collar Type and Incidence of Cervical Spinal Cord Injury in Trauma Patients

Objective

Debate exists on how to best immobilize the cervical spine in the prehospital setting. Rigid cervical collars have been considered the standard of care for both the prevention and care of patients with suspected cervical spinal cord injury (c-SCI). Recently, soft c-collars have begun replacing rigid collars as they are better tolerated by patients. The aim of this study was to compare the safety of these 2 devices by evaluating the prevalence of c-SCI in patients immobilized with a rigid c-collar with those in a soft c-collar.

Methods

A retrospective review of data collected for the purpose of quality improvement was conducted. All cases with possible c-SCI were included. Cases with missing hospital International Classification of Disease code or documentation of emergency medical service neurologic examination were excluded. The primary outcome was c-SCI diagnosis at hospital discharge. A secondary outcome was the prevalence of c-SCI among those at high risk for c-SCI. Descriptive and chi-square analyses were completed to compare the cohorts.

Results

Of 882 patients with possible c-SCI, 267 were placed in a rigid collar and 615 in soft collars. Respectively, of those in the rigid and soft collar groups, the median age was 36 (interquartile range 24.5-53) years and 39 (interquartile range 24-58) years, and 54% (134) versus 64% (313) were male. Incidence of c-SCI was 0.8% in the rigid c-collar versus 1.5% in the soft collar group (P = .460). Among those cases with neurologic deficit noted by emergency medical services, there was no difference in incidence of c-SCI in the rigid (2/29, 6.9%) versus the soft (5/87, 5.7%) collar groups (P = .833).

Conclusion

In this limited retrospective review, no statistically significant difference in the rates of c-SCI was observed between patients who were immobilized using a rigid versus soft c-collar. Additional investigation is needed to determine whether rigid and soft c-collars provide equal protection.

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来源期刊

Air Medical Journal Nursing-Emergency Nursing

CiteScore

1.20

自引率

0.00%

发文量

112

审稿时长

69 days

期刊介绍： Air Medical Journal is the official journal of the five leading air medical transport associations in the United States. AMJ is the premier provider of information for the medical transport industry, addressing the unique concerns of medical transport physicians, nurses, pilots, paramedics, emergency medical technicians, communication specialists, and program administrators. The journal contains practical how-to articles, debates on controversial industry issues, legislative updates, case studies, and peer-reviewed original research articles covering all aspects of the medical transport profession.