Cervical Spine Injury · Neuroprotection · Neurotrauma · Scandinavian Guidelines · Thoracolumbar Spine Injury

New Danish Guidelines on Spinal Stabilisation in Trauma

Our Danish colleagues have recently issued updated guidelines on spinal stabilisation of adult trauma patients (open-access in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine). As expected, the evidence base is fairly limited as robust randomised studies on this topic are rare and often hard to conduct. The group does provide a strong recommendation against immobilising patients with penetrating neck injuries. This is hardly very contentious, but needs stating nonetheless. In the more hotly disputed “cervical collar or not for blunt trauma” debate the group weighs in and offers a weak recommendation against indiscriminately employing rigid collars and spine-boards on stable patients. For many clinicians, including this one, this nuancing of trauma-immobilisation dogma is a welcome development. The provision of an algorithm for clinical management of patients with suspected spinal trauma may prove very useful for decision-making in the field. In essence, these guidelines offer prehospital carers more freedom to make their own clinical judgment on the degree of stabilisation required, very much in keeping with the Norwegian guidelines published in 2017.

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