Prehospital management of spinal cord injuries

Muñoz Castellano J

Prehospital management of spinal cord injury is of critical importance

since 25% of spinal cord injury damage may occur or be

aggravated after the initial event. Prehospital management includes

examination of the patient, spinal immobilisation, careful airway

management (intubation, if indicated, using manual in-line stabilisation),

and cardiovascular support. Studies have not demonstrated convincingly

that methylprednisolone or other pharmacological agents really

have clinically significant and important benefits for patients suffering

from spinal cord injury. Published statements also do not support the

therapeutic use of methylprednisolone in patients suffering from spinal

cord injury in the prehospital setting any more, although it is the only

treatment that has demostrated to improve the motor function if it is

used wthin the first 8 hours after the injury. Moreover, at this stage, it is

not known whether pharmacological intervention has beneficial effects

or not. Therefore, networks for clinical studies in spinal cord injury patients

should be established, as a basic requirement for further improvement

in outcome in such patients.

Muñoz Castellano J