Emergency transportation in the event of acute spinal cord lesion
1974; Springer Nature; Volume: 12; Issue: 1 Linguagem: Inglês
10.1038/sc.1974.6
ISSN1476-5624
Autores Tópico(s)Trauma and Emergency Care Studies
ResumoDISTRICT hospitals are often inadequately equipped and understaffed to deal efficiently with acute spinal injury cases.All too often patients develop pressure sores, respiratory insufficiency and serious urinary infections during the first few days after hospitalisation.Early complications can be prevented if all aCllte cases are immediately transferred to a specialised SCI Centre where first-class intensive care and appropriate treatment are immediately available.We all know that rapid and precise assessment of the level and type of lesion is of paramount importance if the patient is to benefit from optimal therapy and to have a chance for possible functional improvement.Data received at the emergency desk is often fragmentary and insufficient.We therefore make it a rule that all victims with acute spinal injury should be considered and treated as having potential involvement of the cord.Emergency transport should be both smooth and rapid.However, one must keep in mind that the quickest is not necessarily the best.In our mountainous regions, evacuation of the injured by ambulance is often impractical and time consuming.During week-ends, heavy traffic on main highways is likely to block easy access to the scene of the accident.This creates distressing situations both for the patient and the rescue-squad.On several occasions we have registered delays •of up to 4 and 5 hours.In the presence of life-threatening lesions the situation may rapidly become dramatic (Robertson & Tonge, 1968).These various considerations clearly stress the need for an efficient, nation wide rescue system.Entirely new standards have now been adopted in accordance with data compiled in other countries such as Germany, France and the United States, both during peace and war (Pilisbury, 1957;Engelmann, 1962; Kliesch, 1962; Salvacnac, 1963; Ahnfeld, 1969).Since 1965 we strongly insisted that all SCI patients should immediately be sent to one of the country's paraplegic centres.Swiss Air Rescue (SRC) has been extremely helpful in organising the patient's initial transfer under optimal conditions.'Acute spinal injury' is classified as top-urgent and always given priority assistance (von Ballmoos, 1971).Since 1965, SRC, still a private organisa tion, is officially affiliated to the Swiss Red Cross.Aircraft carrying the sign of RSC may land and take off without restriction on all civilian and most military airports in Europe, Northern Africa and the Middle East.In many of these regions, adequate facilities for proper care of acute paraplegics are missing.This largely justifies the expenses involved in long-distance rescue flights.The SRC squadron comprises of 25 helicopters of the type Bell-47, Bell-206 Jet Ranger, Alouette 315 Lama, Alouette III and Sikorsky S-58 T. These aircraft are all especially equipped with up-to-date first-aid material.On the regular check-list of over 300 items, figure a VISICARD-8 ECG-monitoring unit, a DEFI-CARD defibrillator, an AMBU respirator, a large display of surgical 12/1-C
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