PDF(Pubmed)
Abstract：
Severe traumatic damage to the brain-to-body signaling bundle that results in bruising and a partial or total tear of the spinal cord is known as a spinal cord injury (SCI). SCI may develop at the time of an event or after. It can also develop while handling the patient and can worsen during the transportation of the patient. So prehospital care is crucial to prevent or minimize SCI. Prehospital care involves examining the patient, immobilizing the cervical spine (C-spine), providing cardiovascular support (keeping the mean arterial blood pressure over 85 mmHg), and carefully managing the airway (possibly intubating the patient using manual in-line stabilization (MILS)). Methylprednisolone (MPS) and other pharmacological treatments have not been shown to offer clinically meaningful and essential benefits for people with SCI. The therapeutic use of MPS in patients with SCI in the prehospital context is no longer supported. Additionally, whether or not pharmaceutical drugs will be effective in therapeutic hypothermia is unknown. When performing endotracheal intubation on these patients, the potential for C-spine damage is always considered. During intubation, the MILS approach significantly reduces C-spine movement. The MILS method, however, can potentially restrict mouth opening and result in subpar laryngoscopic vision. These issues can be handled using the recently developed video laryngoscope, such as Airtraq laryngoscope and AirWay Scope (AWS). Compared to a direct laryngoscope, the AWS and Airtraq laryngoscope reduced the improvement of intubation conditions and the acceleration of tracheal intubation through the occiput-C1 and C2-C4 levels of the C-spine extension movement.
摘要：
导致脊髓瘀伤和部分或全部撕裂的脑-体信号束的严重创伤性损伤被称为脊髓损伤(SCI)。SCI可能在事件发生时或之后发展。它还可以在处理患者时发展并且可以在患者的运输期间恶化。因此，院前护理对于预防或减少SCI至关重要。院前护理包括检查病人，固定颈椎（C-脊柱），提供心血管支持（保持平均动脉血压超过85mmHg），并仔细管理气道（可能使用手动在线稳定（MILS）对患者进行插管）。甲基强的松龙（MPS）和其他药物治疗尚未显示出对SCI患者具有临床意义和基本益处。MPS在院前SCI患者中的治疗用途不再得到支持。此外,药物在治疗性低温中是否有效尚不清楚。对这些患者进行气管插管时，C-脊柱损伤的可能性始终被考虑。插管时,MILS方法显著减少C-脊柱运动。MILS方法，然而,可能会限制张口并导致喉镜视力低下。这些问题可以使用最近开发的视频喉镜来处理，例如Airtraq喉镜和AirWayScope(AWS)。与直接喉镜相比，AWS和Airtraq喉镜通过C脊柱伸展运动的枕骨C1和C2-C4水平降低了插管条件的改善和气管插管的加速。
