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Is there enough evidence to support the reversal of standard trauma care for patients who have been suspended?
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Cooke, Matthew (Professor of clinical systems design), Fisher, Joanne D. and Brown, S. N. (2008) Is there enough evidence to support the reversal of standard trauma care for patients who have been suspended? Annals of Emergency Medicine, Vol.51 (No.4). p. 538. doi:10.1016/j.annemergmed.2008.01.192 ISSN 0196-0644.
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Official URL: http://dx.doi.org/10.1016/j.annemergmed.2008.01.19...
Abstract
The effects of being suspended motionless in an upright position is commonly termed suspension trauma. It has been reported that following rescue some patients are at risk of immediate sudden death from a cardiac arrest when they are laid flat. Although there is little evidence into the causes of this condition a number of authors have written guidelines for the care of these patients and whilst opinions differ, this quote from the UK Health and Safety Executive represents the majority view: “Important! The casuality must never be laid down after being rescued from the suspended position, not even in the recovery position.” This advice is clear, yet it is counter to the conventional approach to trauma care and creates difficulty for transportation and subsequent care if taken literately. It is hypothesised that lying patients down results in a sudden return of pooled blood to the heart resulting in a cardiac arrest, yet this could be explained by other mechanisms which are not related to lying patients down but could result in sudden death, for example, the release of potassium resulting from ischemic areas (e.g. after femoral vessel compression by a safety harness), similar to the mechanism in crush injury. The response of the UK ambulance service as to what guidance to issue to paramedics must be measured. In order to support this decision process a systematic review was undertaken.
| Item Type: | Journal Article | ||||
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| Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Traumatology, Emergency medicine, Systematic reviews (Medical research) | ||||
| Journal or Publication Title: | Annals of Emergency Medicine | ||||
| Publisher: | Mosby, Inc. | ||||
| ISSN: | 0196-0644 | ||||
| Official Date: | April 2008 | ||||
| Dates: |
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| Volume: | Vol.51 | ||||
| Number: | No.4 | ||||
| Number of Pages: | 1 | ||||
| Page Range: | p. 538 | ||||
| DOI: | 10.1016/j.annemergmed.2008.01.192 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access | ||||
| Description: | Policy statement |
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| Version or Related Resource: | Presented at 12th International Conference on Emergency Medicine, San Francisco, C.A., April 03-04, 2008. |
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