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 ,Revised 1 March 2005 ,Accepted 1 March 2005.

References 

  1. Sekhon LHS, Fehlings MG. Epidemiology, demographics, and pathophysiology of acute spinal cord injury. Spine. 2001;26(Suppl):S2–S12
  2. Surkin J, Gilbert BJ, Harkey HL, Sniezek J, Currier M. Spinal cord injury in Mississippi. Findings and Evaluation, 1992–1994. Spine. 2000;25:716–721
  3. Thurman DJ, Burnett CL, Jeppson L, Beaudoin DE, Sniezek JE. Surveillance of spinal cord injuries in Utah, USA. Paraplegia. 1994;32:665–669
  4. Sonntag VK, Douglas RA. Management of spinal cord trauma. Neurosurg Clin N Am. 1990;1:729–750
  5. Domeier RM, Evans RW, Swor RA, Rivera-Rivera EJ, Frederiksen SM. Prehospital clinical findings associated with spinal injury. Prehosp Emerg Care. 1997;1:11–15
  6. Belanger E, Levi AD. The acute and chronic management of spinal cord injury. J Am Colleg Surg. 2000;190:603–618
  7. Michael DB, Guyot DR, Darmody WR. Coincidence of head and cervical spine injury. J Neurotrauma. 1989;6:177–189
  8. Stevens RD, Bhardwaj A, Kirsch JR, Mirski MA. Critical care and perioperative management in traumatic spinal cord injury. J Neurosurg Anesthesiol. 2003;15:215–229
  9. Chiles BW, Cooper PR. Acute spinal injury. N Engl J Med. 1996;334:514–520
  10. Holly LT, Kelly DF, Counelis GJ, Blinman T, McArthur DL, Cryer HG. Cervical spine trauma associated with moderate and severe head injury: incidence, risk factors, and injury characteristics. J Neurosurg. 2002;96:285–291
  11. Bernhard M, Helm M, Aul A, Gries A. Preclinic management of multiple trauma. Anaesthesist. 2004;53:887–904
  12. Hodgetts TJ, Smith J. Essential role of prehospital care in the optimal outcome from major trauma. Emerg Med. 2000;12:103–111
  13. Biewener A, Aschenbrenner U, Rammelt S, Grass R, Zwipp H. Impact of helicopter transport and hospital level on mortality of polytrauma patients. J Trauma. 2004;56:94–98
  14. Carvell JE, Grundy DJ. Complications of spinal surgery in acute spinal cord injury. Paraplegia. 1994;32:389–395
  15. Devivo MJ, Kartus PL, Stover SL, Dine PR. Benefits of early admission to an organised spinal cord injury system. Paraplegia. 1990;28:545–555
  16. Dyson-Hudson TA, Stein AB. Acute management of traumatic cervical spinal cord injuries. Mt Sinai J Med. 1999;66:170–178
  17. De Latorre F, Nolan J, Robertson C, Chamberlain D, Baskett P. European resuscitation council guidelines 2000 for adult advanced life support. A statement from the advanced life support working group and approved by the executive committee of the European resuscitation council. Resuscitation. 2001;48:211–221
  18. Podolsky S, Baraff LJ, Simon RR, Hoffman JR, Larmon B, Ablon W. Efficacy of cervical spine immobilization methods. J Trauma. 1983;23:461–465
  19. The Section on Disorders of the Spine and peripheral nerves of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons. Guidelines for management of acute cervical spinal injuries. Chapter 1. Cervical spine immobilization before admission to the hospital. Neurosurgery. 2002;50(Suppl):S7–S17
  20. Velmahos GC, Toutouzas K, Chan L, et al. Intubation after cervical spinal cord injury: to be done selectively or routinely?. Am Surg. 2003;69:891–894
  21. Mansel JK, Norman JR. Respiratory complications and management of spinal cord injuries. Chest. 1990;97:1446–1452
  22. McLeod AD, Calder I. Spinal cord injury and direct laryngoscopy—the legends lives on. Br J Anaesth. 2000;84:705–709
  23. Muckart DJ, Bhagwanjee S, van der Merwe R. Spinal cord injury as a result of endotracheal intubation in patients with undiagnosed cervical spine fractures. Anesthesiology. 1997;87:418–420
  24. Davis BD, Fowler R, Kupas DF, Ropollo LP. Role of rapid sequence induction in the prehospital setting: helpful or harmful?. Curr Opin Crit Care. 2002;8:571–577
  25. Raw DA, Beattie JK, Hunter JM. Anaesthesia for spinal surgery in adults. Br J Anaesth. 2003;91:886–904
  26. Holley J, Jorden R. Airway management in patients with unstable cervical spine fractures. Ann Emerg Med. 1989;18:1237–1239
  27. Sawin PD, Todd MM, Traynelis VC, et al. Cervical spine motion with direct laryngoscopy and orotracheal intubation. An in vivo cinefluoroscopic study of subjects without cervical abnormality. Anesthesiology. 1996;85:26–36
  28. Lennarson PJ, Smith D, Todd MM, et al. Segmental cervical spine motion during orotracheal intubation of the intact and injured spine with and without external stabilization. J Neurosurg. 2000;92(2 Suppl):201–206
  29. Gerling MC, Davis DP, Hamilton RS, et al. Effects of cervical spine immobilization technique and laryngoscope blade selection on an unstable cervical spine in a cadaver model of intubation. Ann Emerg Med. 2000;36:293–300
  30. Nolan JP, Parr MJA. Aspects of resuscitation in trauma. Br J Anaesth. 1997;79:226–240
  31. Majernick TG, Bieniek R, Houston JB, Hughes HG. Cervical spine movement during orotracheal intubation. Ann Emerg Med. 1986;15:417–420
  32. Kihara S, Watanabe S, Brimacombe J, et al. Segmental cervical spine movement with the intubating laryngeal mask during manual in-line stabilization in patients with cervical pathology undergoing cervical spine surgery. Anesth Analg. 2000;91:195–200
  33. Keller C, Brimacombe J, Keller K. Pressures exerted against the cervical vertebrae by the standard and intubating laryngeal mask airways: a randomized, controlled, cross-over study in fresh cadavers. Anesth Analg. 1999;89:1296–1300
  34. The Section on Disorders of the Spine and peripheral nerves of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons. Guidelines for management of acute cervical spinal injuries. Chapter 8. Blood pressure management after acute spinal cord injury. Neurosurgery. 2002;50(Suppl):S58–S62
  35. Vale FL, Burns J, Jackson AB, Hadley MN. Combined medical and surgical treatment after acute spinal cord injury: results of a prospective pilot study to assess the merits of aggressive medical resuscitation and blood pressure management. J Neurosurg. 1997;87:239–246
  36. Chesnut RM, Marshall SB, Piek J, Blunt BA, Klauber MR, Marshall LF. Early and late systemic hypotension as a frequent and fundamental source of cerebral ischemia following severe brain injury in the Traumatic Coma Data Bank. Acta Neurochir Suppl (Wien). 1993;59:121–125
  37. Lenz C, Rebel A, Waschke KF. Infusion therapy in neuro-anaesthesia. Anästhesiol Intensivmed. 1997;3:120–134
  38. Dieterich HJ. Colloids in intensive care. Anaesthesist. 2001;50:54–68
  39. Kreimeier U, Messmer K. Small-volume resuscitation: from experimental evidence to clinical routine. Advantages and disadvantages of hypertonic solutions. Acta Anaesthesiol Scand. 2002;46:625–638
  40. Vassar MJ, Perry CA, Gannaway WL, Holcroft JW. 7.5% sodium chloride/dextran for resuscitation of trauma patients undergoing helicopter transport. Arch Surg. 1991;126:1065–1072
  41. Cooper DJ, Myles PS, McDermott FT, et al. Prehospital hypertonic saline resuscitation of patients with hypotension and severe traumatic brain injury—a randomized controlled trial. JAMA. 2004;291:1350–1357
  42. Lewis RJ. Prehospital care of the multiply injured patient—the challenge of figuring out what works. JAMA. 2004;291:1382–1384
  43. Legos JJ, Gritman KR, Tuma RF, Young WF. Coadministration of methylprednisolone with hypertonic saline solution improves overall neurological function and survival rates in a chronic model of spine cord injury. Neurosurgery. 2001;49:1427–1433
  44. Spera PA, Arfors KE, Vasthare US, Tuma RF, Young WF. Effect of hypertonic saline on leukocyte activity after spinal cord injury. Spine. 1998;23:2444–2448
  45. Spera PA, Vasthare US, Tuma RF, Young WF. The effects of hypertonic saline on spinal cord blood flow following compression injury. Acta Neurochir (Wien). 2000;142:811–817
  46. Toni D, De Michele M, Fiorelli M, et al. Influence of hyperglycaemia on infarct size and clinical outcome of acute ischemic stroke patients with intracranial arterial occlusion. J Neurol Sci. 1994;123:129–133
  47. Longstreth WT, Inui TS. High blood glucose level on hospital admission and poor neurological recovery after cardiac arrest. Ann Neurol. 1984;15:59–63
  48. Rovlias A, Kotsou S. The influence of hyperglycemia on neurological outcome in patients with severe head injury. Neurosurgery. 2000;46:335–342
  49. Van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in the critically ill patients. N Engl J Med. 2001;345:1359–1367
  50. Green BA, Kahn T, Klose KJ. A comparative study of steroid therapy in acute experimental spinal cord injury. Surg Neurol. 1980;13:91–97
  51. Eidelberg E, Staten E, Watkins CJ, Smith JS. Treatment of experimental spinal cord injury in ferrets. Surg Neurol. 1976;6:243–246
  52. Bracken MB, Collins WF, Freeman DF, et al. Efficacy of methylprednisolone in acute spinal cord injury. JAMA. 1984;251:45–52
  53. Bracken MB, Shepared MJ, Hellebrand KG, et al. Methylprednisolone and neurological function 1 year after spinal cord injury. Results of the National Acute Spinal Cord Injury Study. J Neurosurg. 1985;63:704–713
  54. Himmelseher S, Büttner J, Baethmann A, Piek J, Unterberg AW. Management of acute spinal cord injury with corticosteroids. Anästhesiol Intensivmed. 1999;10:716–726
  55. Bracken MB, Shepard MJ, Collins WF, et al. A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal cord injury. Results of the National Acute Spinal Cord Injury Study. N Engl J Med. 1990;322:1405–1411
  56. Bracken MB, Shepard MJ, Collins WF, et al. Methylprednisolone or naloxone treatment after acute spinal cord injury: 1-year follow-up data. Results of the second National Acute Spinal Cord Injury Study. J Neurosurg. 1992;76:23–31
  57. Nesathurai S. Steroids and spinal cord injury: revisiting the NASCIS 2 and NASCIS 3 trials. J Trauma. 1998;45:1088–1093
  58. Colemann WP, Benzel D, Cahill DW, et al. A critical appraisal of the reporting of the national acute spinal cord injury studies (II and III) of methylprednisolone in acute spinal cord injury. J Spinal Disord. 2000;13:185–199
  59. Bracken MB, Shepard MJ, Holford TR, et al. Administration of methylprednisolone for 24 or 48h or tirilazad mesylate for 48h in the treatment of acute spinal cord injury. Results of the Third National Acute Spinal Cord Injury Randomized Controlled Trial. National Acute Spinal Cord Injury Study. JAMA. 1997;28(277):1597–1604
  60. Bracken MB, Shepard MJ, Holford TR, et al. Methylprednisolone or tirilazad mesylate administration after acute spinal cord injury: 1-year follow up. Results of the third National Acute Spinal Cord Injury Randomized Controlled Trial. J Neurosurg. 1998;89:699–706
  61. Hulbert RJ, Moulton RJ. Why do you prescribe methylprednisolone for acute spinal cord injury? A Canadian perspective and position statement. Can J Neurol Sci. 2002;29:236–239
  62. Short D. Is the role of steroids in acute spinal cord injury now resolved?. Curr Opin Neurol. 2001;14:759–763
  63. The Section on Disorders of the Spine and peripheral nerves of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons. Guidelines for management of acute cervical spinal injuries. Chapter 9. Pharmacological therapy after acute cervical spinal cord injury. Neurosurgery. 2002;50:S63–S72
  64. Bledsoe BE, Wesley AK, Salomone JP for the National Association of EMS Physicians and Clinical Practice Committee. High-dose steroids for acute spinal cord injury in emergency medical services. Prehosp Emerg Care. 2004;8:313–316
  65. CRASH Trial Collaborators. Effect of intravenous corticosteroids on death within 14 days in 10008 adults with clinically significant head injury (MRC CRASH trial): randomised placebo-controlled trial. Lancet. 2004;364:1321–1328
  66. Sauerland S, Maegele M. A CRASH landing in severe head injury. Lancet. 2004;364:1291–1292
  67. Jones L, Bagnall A. Spinal injuries centres (SICs) for acute traumatic spinal cord injury. Cochrane Database Syst Rev. 2004;18:CD004442

 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

Article Tools

* Image Usage & Resolution