| dc.description.abstract | Background: In 2015, the National Protocol Ambulance version 7 (LPA7) revised to version 8 (LPA8). The patient profile, including criteria to assess which patient is suspected of having spinal injury, was too strict in LPA7. Therefore, the patient profile in LPA8 includes less strict criteria. It is unclear whether criteria in LPA8 indicate the correct patients suspected of having spinal injury. Moreover, complications occurred after using spinal immobilization methods and devices in LPA7. Therefore, other methods and devices are included in LPA8.
Objectives: To describe the patient profile according to LPA7 and the diagnosis of spinal (cord) injury in trauma patients with suspected spinal injury admitted to the trauma room of the emergency department and to evaluate used spinal immobilization methods and devices as applied by paramedics according to the LPA8.
Methods: During observations at the trauma room of the emergency department, a questionnaire, designed by the researcher, was completed by the researcher or trauma nurses for adult trauma patients admitted to an academic hospital. Results All 31 patients included, met ≥1 criteria in LPA7. In five patients, not immobilized during transport, spinal injury was not present. Patients were immobilized lying or half-sitting with devices as the backboard, vacuum mattress, stretcher, head blocks and/or a C-collar. For 24 patients, extra devices were applied at the emergency department.
Conclusion: Although all patients met ≥1 criteria in LPA7, not every patient was immobilized during transport. Spinal injury was not present in patients without immobilization. Moreover, varying immobilization methods are used and discrepancies in immobilization between the pre-hospital and hospital phase are showed.
Implications of key findings: Discrepancies between the pre-hospital and hospital phase should be reduced to prevent confusion between health care professionals. Moreover, research according to specificity and sensitivity of criteria inLPA8 is recommended. | |
