title: The prehospital management of suspected spinal cord injury: an update.
abstract: BACKGROUND
  Spinal cord injury (SCI) is a serious condition that may lead to long-term disabilities placing financial and social burden on patients and their families, as well as their communities. Spinal immobilization has been considered the standard prehospital care for suspected SCI patients. However, there is a lack of consensus on its beneficial impact on patients' outcome.
  
  
  OBJECTIVE
  This paper reviews the current literature on the epidemiology of traumatic SCI and the practice of prehospital spinal immobilization.
  
  
  METHODS
  A search of literature was undertaken utilizing the online databases Ovid Medline, PubMed, CINAHL, and the Cochrane Library. The search included English language publications from January 2000 through November 2012.
  
  
  RESULTS
  The reported annual incidence of SCI ranges from 12.7 to 52.2 per 1 million and occurs more commonly among males than females. Motor vehicle collisions (MVCs) are the major reported causes of traumatic SCI among young and middle-aged patients, and falls are the major reported causes among patients older than 55. There is little evidence regarding the relationship between prehospital spinal immobilization and patient neurological outcomes. However, early patient transfer (8-24 hours) to spinal care units and effective resuscitation have been demonstrated to lead to better neurological outcomes.
  
  
  CONCLUSIONS
  This review reaffirms the need for further research to validate the advantages, disadvantages, and the effects of spinal immobilization on patients' neurological outcomes.
authors.affiliation: 1Department of Community Emergency Health and Paramedic Practice,Monash University Melbourne,Victoria,Australia.
authors.forename: Ala'a O
authors.initials: AO
authors.lastname: Oteir
authors.affiliation: 2Ambulance Victoria,Melbourne,Victoria,Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Smith
authors.affiliation: 1Department of Community Emergency Health and Paramedic Practice,Monash University Melbourne,Victoria,Australia.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Jennings
authors.affiliation: 3Department of Epidemiology and Preventive Medicine,Monash University,Melbourne,Victoria,Australia.
authors.forename: Johannes U
authors.initials: JU
authors.lastname: Stoelwinder
mesh_terms: D004632:Emergency Medical Services / Q000592:standards*; D004638:Emergency Treatment / Q000592:standards*; D005260:Female; D006801:Humans; D007103:Immobilization; D015994:Incidence; D008297:Male; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000628:therapy*