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Erschienen in: Notfall +  Rettungsmedizin 1/2016

01.02.2016 | Konzepte – Stellungnahmen – Leitlinien

Präklinische Immobilisation der Wirbelsäule

Freund oder Feind des Traumapatienten?

verfasst von: Dr. Dr. M. Kreinest, B. Gliwitzky, S. Goller, M. Münzberg

Erschienen in: Notfall + Rettungsmedizin | Ausgabe 1/2016

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Zusammenfassung

Hintergrund und Fragestellung

Die Frage der notwendigen Immobilisation des Traumapatienten im Allgemeinen sowie die verschiedenen Durchführungen dieser Maßnahme im Speziellen werden in der wissenschaftlichen Literatur zunehmend kontrovers diskutiert. Des Weiteren zeigt sich auch in der täglichen Praxis der Notfallmedizin kein einheitliches Vorgehen. Ziel des vorliegenden Artikels ist es, einen Überblick über die exemplarisch ausgewählte Literatur zum Themenkomplex „Wirbelsäulen-Immobilisation des Traumapatienten“ zu geben und hieraus mögliche Handlungsempfehlungen abzuleiten.

Immobilisation beim Traumapatienten

Bei generell fehlender Evidenz für oder gegen eine Wirbelsäulen-Immobilisation finden sich in der Literatur zunehmend Hinweise, dass die alleinige Anlage einer Zervikalstütze keine ausreichende Immobilisation der Halswirbelsäule gewährleistet. Die geforderte Ganzkörper-Immobilisation des Traumapatienten kann allerdings auch mit erheblichen Komplikationen wie erschwertem Atemwegsmanagement oder Einschränkungen der Lungenfunktion einhergehen. Ferner kann auch die alleinige Anlage einer Zervikalstütze zur Steigerung des Hirndrucks führen. Die Indikationsstellung zur Wirbelsäulen-Immobilisation sollte deshalb differenziert anhand von Entscheidungshilfen, wie z. B. der Canadian C-Spine Rule, getroffen werden. Bei Patienten mit instabilen Kreislaufverhältnissen muss entschieden werden, ob der zügige Transport durch die Immobilisation verzögert werden kann. Liegt bei einem Traumapatienten ein symptomatisches schweres Schädel-Hirn-Trauma vor, sollte abgewogen werden, ob die Anlage einer Zervikalstütze zwingend erforderlich ist oder ob eine anderweitige Möglichkeit der Immobilisation besteht. Hier bietet die Vakuummatratze bessere Stabilität und mehr Komfort während der Ganzkörper-Immobilisation im Vergleich zum Spineboard.
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Metadaten
Titel
Präklinische Immobilisation der Wirbelsäule
Freund oder Feind des Traumapatienten?
verfasst von
Dr. Dr. M. Kreinest
B. Gliwitzky
S. Goller
M. Münzberg
Publikationsdatum
01.02.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Notfall + Rettungsmedizin / Ausgabe 1/2016
Print ISSN: 1434-6222
Elektronische ISSN: 1436-0578
DOI
https://doi.org/10.1007/s10049-015-0118-5

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