RETROSPECTIVE EVALUATION OF SPINAL IMMOBILIZATION IN TRAUMA PATIENTS IN PREHOSPITAL EMERGENCY MEDICAL SERVICES- NEW CONTRIBUTIONS TO SELECTIVE CRITERIA

Authors : Lütfi Mert Güler, Ali Ekşi

Pages : 293-310

Doi:10.54409/hod.1561721

View : 81 | Download : 98

Publication Date : 2025-12-28

Article Type : Research Paper

Abstract :Objective: The study aims to retrospectively evaluate the application of spinal immobilization in trauma patients within prehospital emergency medical services (PH-EMS) and to critically examine the need for refining selective criteria for its implementation. Methods: This retrospective cohort study was conducted on trauma patients who received PH-EMS between January 1, 2019, and December 31, 2022, in a province of Turkey. Data were systematically extracted from medical records and statistical analysis was performed using SPSS version 26.0. The Wilcoxon signed-rank test was applied for paired comparisons of continuous variables, while the Chi-square test was employed to evaluate the distribution of categorical variables between independent groups. A significance level of p<0.05 was set. Results: The cohort comprised 7,860 trauma patients. Spinal immobilization was performed in 36.2% of cases, of which 13.0% were diagnosed with spinal cord injuries (SCI). However, 25.2% of patients who were ultimately diagnosed with SCI in the largest hospital in province emergency department had not received spinal immobilization during the prehospital phase. Notably, SCI occurred in 9.5% of occupational accidents, 7.6% of traffic-related trauma, 17.6% of patients classified as red triage, and 13.7% of those with a Glasgow Coma Scale (GCS) score ≤14. Conclusions: While spinal immobilization is implemented in a considerable proportion of trauma patients, there remains a critical gap in its application, particularly in cases with confirmed SCI. The findings highlight the urgent need to establish evidence-based, selective criteria for spinal immobilization, especially for high-risk groups such as patients with low GCS scores and those involved in occupational accidents. Further research is required to develop a protocol that integrates clinical factors, trauma mechanisms, and triage classification to optimize spinal immobilization practices.
Keywords : Hastane Öncesi, Travma, İmmobilizasyon, Omurilik yaralanması

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