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Erschienen in: Notfall +  Rettungsmedizin 6/2016

01.09.2016 | Originalien

Untersuchung der Anwendbarkeit eines neuen Protokolls zur Immobilisation der Wirbelsäule

Indikationsstellung anhand des E.M.S. IMMO Protocol für erwachsene Traumapatienten

verfasst von: M. Kreinest, B. Gliwitzky, P. A. Grützner, Dr. M. Münzberg

Erschienen in: Notfall + Rettungsmedizin | Ausgabe 6/2016

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Zusammenfassung

Hintergrund

Die Immobilisation der Wirbelsäule generell und die Immobilisation der Halswirbelsäule im Speziellen sind Standard-Prozeduren in der präklinischen Behandlung von Traumapatienten seit mehreren Jahrzehnten. In der aktuellen Literatur werden zunehmend auch Nachteile der Wirbelsäulenimmobilisation beschrieben, weshalb eine differenzierte Indikationsstellung zur Immobilisation anhand von Entscheidungsregeln empfohlen wird. Die Anwendbarkeit vieler Entscheidungshilfen ist mit zahlreichen Einschränkungen versehen. Ein universell einsetzbares Protokoll zur Indikationsstellung der Wirbelsäulenimmobilisation, welches für alle erwachsenen Traumapatienten gilt und zudem den aktuellen Patientenzustand und die Verletzungsart berücksichtigt, existiert nach unseren Kenntnissen nicht.

Ziel der Arbeit

Ziel der vorliegenden Studie war die Entwicklung eines Protokolls zur Indikationsstellung der präklinischen Wirbelsäulenimmobilisation bei erwachsenen Traumapatienten sowie eine erste Testung des Protokolls bezüglich der unmittelbaren Anwendbarkeit durch Medizinstudenten anhand eines Fragebogens.

Material und Methoden

Es erfolgte eine umfangreiche Literaturrecherche. Basierend auf der aktuellen Literatur und den Leitlinien wurde das Emergency Medicine Spinal Immobilization Protocol (E.M.S. IMMO Protocol) für erwachsene Traumapatienten entworfen und bezüglich seiner unmittelbaren Anwendbarkeit mittels Fragebogen durch 86 Medizinstudenten getestet.

Ergebnisse

Es konnte ein Protokoll als Entscheidungshilfe bei der Indikationsstellung zur Wirbelsäulenimmobilisation formuliert und grafisch dargestellt werden. Fragen zur Kontrolle der korrekten Anwendung des E.M.S. IMMO Protocol durch Medizinstudenten wurden überwiegend richtig beantwortet. Die Ursache der Häufung falscher Antworten konnte durch ein direktes Feedback der Studenten evaluiert werden und liegt am ehesten außerhalb des Einflussbereichs des E.M.S. IMMO Protocol.

Diskussion

Mit dem E.M.S. IMMO Protocol wird eine Entscheidungshilfe für die Indikationsstellung zur Wirbelsäulenimmobilisation bei erwachsenen Traumapatienten bereitgestellt, welche, basierend auf dem Patientenzustand und dem Verletzungsmuster, eine differenzierte Entscheidung zur Immobilisation generell und zur Immobilisationsmethode im Speziellen erlaubt. Weiterführende Studien müssen die Sensitivität und die Spezifität des E.M.S. IMMO Protocol analysieren.
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Metadaten
Titel
Untersuchung der Anwendbarkeit eines neuen Protokolls zur Immobilisation der Wirbelsäule
Indikationsstellung anhand des E.M.S. IMMO Protocol für erwachsene Traumapatienten
verfasst von
M. Kreinest
B. Gliwitzky
P. A. Grützner
Dr. M. Münzberg
Publikationsdatum
01.09.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Notfall + Rettungsmedizin / Ausgabe 6/2016
Print ISSN: 1434-6222
Elektronische ISSN: 1436-0578
DOI
https://doi.org/10.1007/s10049-016-0154-9

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