在颈部支撑中使用带枕骨延伸的颈圈的意外后果--英国最大的三级脊柱转诊中心的快照评估。

N. Patel , A. Rajabian , J. George
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引用次数: 0

摘要

介绍:上颈椎骨折是老年人常见的低能量外伤。这些损伤的死亡率很高,与髋部骨折患者类似。影响临床治疗效果的一个关键因素是伤后 12 周内的有效治疗。本研究旨在评估医护人员对护理此类患者的理解程度:在英国最大的脊柱专科转诊中心(索尔福德皇家基金会信托,SRFT)进行了为期一天的调查,评估医护人员对 "带枕骨伸展项圈 "这一术语的理解,方法是要求医护人员在观看戴有项圈的模型在各种不同颈部位置的临床图片时识别颈部的安全位置。然后对参与者进行人口统计学调查,包括职业、级别、脊柱/研究生经历、英语是否为母语以及他们对 "枕骨伸展项圈 "一词的理解:102 名参与者接受了访谈,结果显示近一半(45.1%)的参与者认为颈部过度伸展是保守治疗的安全姿势,只有 37.3% 的参与者认为中性姿势是令人满意的。对于那些选择中性安全颈椎对位的人来说,唯一的积极预测因素是参与者是否有5年以上的脊柱治疗经验(p = 0.0006),或者他们是否理解 "项圈与枕骨伸展 "一词是指项圈部分(p = 0.000013)而非颈部位置:可能由于脊柱专科缺乏培训和理解,非脊柱中心对脊柱损伤的处理通常很糟糕。这项研究表明,与转诊医院明确沟通如何对高颈椎损伤患者进行保守治疗对改善临床疗效非常重要。
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Unintended consequences of using collars with occipital extensions in neck support – Snapshot assessment at the largest tertiary spinal referral centre in the UK

Introduction

Upper cervical spine fractures are commonplace in the elderly following low energy trauma. These injuries carry high mortality rates, similar to patients sustaining hip fractures. A key aspect affecting clinical outcome is effective management in the first 12 weeks following injury. This study aims to assess the understanding of healthcare staff that may be required to care for such patients.

Materials and methods

A survey was carried out over a single day at the UK's largest Spine Specialist referral centre (Salford Royal Foundation Trust, SRFT) assessing the understanding of healthcare staff of the term, ‘Collar with occipital extension’, by asking staff to identify the safe position of the neck when looking at clinical images of a model in a collar in various different neck positions. The participants demographics were then taken, including profession, grade, spinal/post graduate experience, if English is their first language and their understanding of the term ‘Collar with occipital extension’.

Results

102 participants were interviewed and the results showed almost half (45.1%) of participants selecting an incorrect hyperextended neck to be a safe position for conservative treatment and only 37.3% selecting the neutral position as satisfactory. The only positive predictors identified for those selective the neutral safe cervical spine alignment was if participants had >5 years of previous spinal experience (p = 0.0006) or if they understood the term ‘Collar with occipital extension’ to be describing the collar component (p = 0.000013) and not neck position.

Conclusion

Management of spinal injuries are classically poorly managed in non-spinal centres, possibly due to the lack of training and understanding within the spinal speciality. This study shows the importance of clearly communicating with referring hospitals exactly how to conservatively manage patients with high cervical injuries to best improve clinical outcome.

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CiteScore
2.60
自引率
14.30%
发文量
34
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