[Shock trauma room management of spinal injuries in the framework of multiple trauma. A systematic review of the literature].
Injuries to the spine are often part of life-threatening multiple trauma. In this review diagnostics and emergency room management were investigated in order to formulate effective recommendations for the emergency strategy. Clinical trials were systematically collected (MEDLINE, Cochrane, and hand searches) and classified into evidence levels (1 to 5 according to the Oxford system). The patient's history and clinical symptoms have low rates for specificity and positive predictive value, whereas their negative predictive value and sensitivity are high between 90 and 100%, respectively. CT imaging reaches higher rates for sensitivity, specificity, and positive and negative predictive values in comparison to conventional radiographic series. The patient's history should be asked and clinical investigation should be done in any case. Imaging diagnostics preferably as multislice spiral CT should be performed after stabilization of the patient's general condition and before admission to the intensive care unit.
Woltmann
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Berufsgenossenschaftliche Unfallklinik, Murnau. Woltmann@bgu-murnau.de
Bühren
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D002986:Clinical Trials as Topic; D015897:Comorbidity; D003422:Critical Care / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine; D006801:Humans; D009104:Multiple Trauma / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D010818:Practice Patterns, Physicians'; D018570:Risk Assessment / Q000379:methods* / Q000706:statistics & numerical data; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D014193:Trauma Centers / Q000706:statistics & numerical data