Zeitbedarf für die präklinische Ganzkörperimmobilisation bei Schwerverletzten

Ein Vergleich von Spineboard und Schaufeltrage/Vakuummatratze

Vacuum mattress or long spine board: which method of spinal stabilisation in trauma patients is more time consuming? A simulation study.

von Martin Riffelmann geb. Segref
Dissertation
Datum der mündl. Prüfung:2022-11-24
Erschienen:2022-11-24
Betreuer:PD Dr. Markus Roessler
Gutachter:PD Dr. Markus Roessler
Gutachter:PD Dr. Lukas Weiser
Zum Verlinken/Zitieren: http://dx.doi.org/10.53846/goediss-9581

 

 

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Name:Riffelmann Dissertation ohne CV Version eDiss.pdf
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Description:Dissertation

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Zusammenfassung

Englisch

Background: Spinal stabilisation is recommended for prehospital trauma treatment. In Germany, vacuum mattresses are traditionally used for spinal stabilisation, whereas in anglo-american countries, long spine boards are preferred. While it is recommended that the on-scene time is as short as possible, even less than 10 minutes for unstable patients, spinal stabilisation is a time-consuming procedure. For this reason, the time needed for spinal stabilisation may prevent the on-scene time from being brief. The aim of this simulation study was to compare the time required for spinal stabilisation between a scoop stretcher in conjunction with a vacuum mattress and a long spine board. Methods: Medical personnel of different professions were asked to perform spinal immobilizations with both methods. A total of 172 volunteers were immobilized under ideal conditions as well as under realistic conditions. A vacuum mattress was used for 78 spinal stabilisations, and a long spinal board was used for 94. The duration of the procedures were measured by video analysis. Results: Under ideal conditions, spinal stabilisation on a vacuum mattress and a spine board required 254.4 s (95 % CI 235.6-273.2 s) and 83.4 s (95 % CI 77.5-89.3 s), respectively (p < 0.01). Under realistic conditions, the vacuum mattress and spine board required 358.3 s (95 % CI 316.0-400.6 s) and 112.6 s (95 % CI 102.6-122.6 s), respectively (p < 0.01). Conclusions: Spinal stabilisation for trauma patients is significantly more time consuming on a vacuum mattress than on a long spine board. Considering that the prehospital time of EMS should not exceed 60 minutes and the on-scene time should not exceed 30 minutes or even 10 minutes if the patient is in extremis, based on our results, spinal stabilisation on a vacuum mattress may consume more than 20 % of the recommended on-scene time. In contrast, stabilisation on a spine board requires only one third of the time required for that on a vacuum mattress. We conclude that a long spine board may be feasible for spinal stabilisation for critical trauma patients with timesensitive life threatening ABCDE-problems to ensure the shortest possible on-scene time for prehospital trauma treatment, not least if a patient has to be rescued from an open or inaccessible terrain, especially that with uneven overgrown land.
Keywords: Vacuum mattress; Spinal stabilisation; Long spine board; Prehospital trauma treatment
 
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