Wilderness Medical Society Clinical Practice Guidelines for Spinal Cord Protection: 2024 Update

Seth C. Hawkins, Jason Williams, Brad L. Bennett, Arthur A. Islas, Robert Quinn
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Abstract

The Wilderness Medical Society reconvened an expert panel to update best practice guidelines for spinal cord protection during trauma management. This panel, with membership updated in 2023, was charged with the development of evidence-based guidelines for management of the injured or potentially injured spine in wilderness environments. Recommendations are made regarding several parameters related to spinal cord protection. These recommendations are graded based on the quality of supporting evidence and balance the benefits and risks/burdens for each parameter according to American College of Chest Physicians methodology. Key recommendations include the concept that interventions should be goal-oriented (spinal cord/column protection in the context of overall patient and provider safety) rather than technique-oriented (immobilization). An evidence-based, goal-oriented approach excludes the immobilization of suspected spinal injuries via rigid collars or backboards.
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荒野医学会脊髓保护临床实践指南:2024 年更新版
荒野医学会重新召集了一个专家小组,以更新创伤处理过程中脊髓保护的最佳实践指南。该专家小组的成员将于 2023 年更新,负责为野外环境中受伤或可能受伤的脊柱管理制定循证指南。该指南就脊髓保护的几个相关参数提出了建议。这些建议根据支持证据的质量进行分级,并按照美国胸科医师学会的方法平衡每个参数的益处和风险/负担。主要建议包括以下概念:干预措施应以目标为导向(在患者和提供者整体安全的前提下保护脊髓/脊柱),而不是以技术为导向(固定)。以证据为基础、以目标为导向的方法排除了通过硬质颈圈或背板对疑似脊柱损伤进行固定的做法。
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