Patients with gunshot wounds to the head do not require cervical spine immobilization and evaluation.
نویسندگان
چکیده
OBJECTIVE The purpose of this study was to determine the incidence of indirect spinal column injury in patients sustaining gunshot wounds to the head. METHODS A retrospective review of patient records and autopsy reports was conducted of patients admitted with gunshot wounds to the head between July of 1990 and September of 1995 were included. Those with gunshot wounds to the neck and those who were dead on arrival were excluded. RESULTS A total of 215 patients were included in the study. Cervical spine clearance in 202 patients (93%) was determined either clinically, radiographically, or by review of postmortem results. No patients sustained indirect (blast or fall-related) spinal column injury. Three patients had direct spinal injury from bullet passage that were apparent from bullet trajectory. More intubation attempts occurred in patients with cervical spine immobilization (49 attempts in 34 patients with immobilization versus five attempts in four patients without cervical spine immobilization, p = 0.008). CONCLUSIONS Indirect spinal injury does not occur in patients with gunshot wounds to the head. Airway management was compromised by cervical spine immobilization. Protocols mandating cervical spine immobilization after a gunshot wound to the head are unnecessary and may complicate airway management.
منابع مشابه
C-spine injury associated with gunshot wounds to the head: retrospective study and literature review.
OBJECTIVE To determine the incidence of C-spine injury (CSI) associated with gunshot wounds (GSWs) to the head. METHODS A retrospective chart review including patients with GSWs to the head and excluding those with penetrating facial/neck trauma was performed. Cervical clearance was by clinical/radiologic criteria in survivors, and autopsy in nonsurvivors. A MEDLINE literature search was perf...
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متن کاملGunshot wounds to the spine.
BACKGROUND CONTEXT The incidence of violent crimes has risen over the past decade. With it, gunshot injuries have become increasingly more common in the civilian population. Among the most devastating injuries are gunshot wounds to the spine. PURPOSE The purpose of this article is to provide a thorough review of the pathomechanics, diagnosis and treatment of gunshot wounds to the spine. STU...
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ورودعنوان ژورنال:
- The Journal of trauma
دوره 44 5 شماره
صفحات -
تاریخ انتشار 1998