Resuscitation
Volume 66, Issue 2 , Pages 127-139, August 2005

Spinal cord injury (SCI)—Prehospital management☆

  • Michael Bernhard

      Affiliations

    • Department of Anesthesiology, University of Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany
    • Corresponding Author InformationCorresponding authors. Tel.: +49 6221 56 6110; fax: +49 6221 56 5345.
    • ,
  • André Gries

      Affiliations

    • Department of Anesthesiology, University of Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany
    • ,
  • Paul Kremer

      Affiliations

    • Department of Neurosurgery, University of Heidelberg, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany
    • ,
  • Bernd W. Böttiger

      Affiliations

    • Department of Anesthesiology, University of Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany
    • Corresponding Author InformationCorresponding authors. Tel.: +49 6221 56 6110; fax: +49 6221 56 5345.

Received 8 April 2004; received in revised form 1 March 2005; accepted 1 March 2005.

Abstract 

Up to 20,000 patients annually suffer from spinal cord injury (SCI) and 20% of these die before being admitted to the hospital in the United States as well as in the European Union. Prehospital management of SCI is of critical importance since 25% of SCI damage may occur or be aggravated after the initial event. Prehospital management includes examination of the patient, spinal immobilisation, careful airway management (intubation, if indicated, using manual in-line stabilisation), and cardiovascular support (maintenance of mean arterial blood pressure above 90mmHg) and blood glucose levels within the normal range. It is still not known whether additional specific therapy is useful. Studies have not demonstrated convincingly that methylprednisolone (MPS) or other pharmacological agents really have clinically significant and important benefits for patients suffering from SCI. Recently published statements from the United States also do not support the therapeutic use of MPS in patients suffering from SCI in the prehospital setting any more. Moreover, at this stage, it is not known whether therapeutic hypothermia or any further pharmacological intervention has beneficial effects or not. Therefore, networks for clinical studies in SCI patients should be established, as a basic requirement for further improvement in outcome in such patients.

Keywords: Spinal cord injury, Emergency treatment, Fluid therapy, Blood pressure, Drug therapy

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 Presented in part at the Third International Interdisciplinary Congress “EuroNeuro 2002”, from 12–14 September 2002, in Munich, Germany by B.W. Böttiger.

☆ A Spanish translated version of the Abstract and Keywords of this article appears as Appendix at 10.1016/j.resuscitation.2005.03.005.

PII: S0300-9572(05)00155-3

doi:10.1016/j.resuscitation.2005.03.005

Resuscitation
Volume 66, Issue 2 , Pages 127-139, August 2005

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