ABSTRACT
Acute injury to the spine and spinal cord can occur both in isolation as also in the context of multiple injuries. Whereas a few decades ago, the cause of paraplegia was almost exclusively traumatic, the ratio of traumatic to non-traumatic causes in Germany is currently almost equivalent. In acute treatment of spinal cord injury, restoration and maintenance of vital functions, selective control of circulation parameters, and avoidance of positioning or transport-related additional damage are in the foreground. This article provides information on the guideline for emergency treatment of patients with acute injury of the spine and spinal cord in the preclinical phase.
Subject(s)
Cardiopulmonary Resuscitation/standards , Emergency Medical Services/standards , Immobilization/standards , Patient Positioning/standards , Spinal Cord Injuries/therapy , Transportation of Patients/standards , Germany , Humans , Patient Safety/standards , Practice Guidelines as Topic , Spinal Cord Injuries/diagnosisABSTRACT
With 2000 new cases/year in Germany spinal cord injury (SCI) is quantitatively less important for intensive care medicine than, e.g., sepsis. But, due to the consequences for the patient, the intricacy of treatment and the enormous costs, it is a significant clinical picture. Outside of specialized centers, routine experience with SCI is largely lacking, particularly in cases of tetraplegia. Dependent on the level of the paralysis, complications in the acute situation, the hospitalization and the rehabilitation are common and need intensive medical care. Lifelong mechanical ventilation is needed in some cases of cervical SCI, for which experience has since grown. New therapeutic options have become implemented (e.g., electrophrenic/diaphragm pacing), have a need to be examined, and extend lifespan in cases of SCI. As a result more patients have a chance for rehabilitation today than in previous decades."
Subject(s)
Critical Care/trends , Paralysis/diagnosis , Paralysis/therapy , Respiration, Artificial/trends , Spinal Cord Injuries/diagnosis , Spinal Cord Injuries/therapy , Spinal Cord Stimulation/trends , Germany , Humans , Paralysis/etiology , Spinal Cord Injuries/complicationsABSTRACT
We report on the case of a multiply injured 14-year-old girl with severe open brain trauma, prehospital cardiopulmonary rescuscitation and immediate decompressive craniectomy. Despite the extremely poor prognosis, a very good outcome has been achieved. We discuss the influence of the time management on the outcome.
