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C-spine immobilation

James M Tatum, Nicolas Melo, Ara Ko, Navpreet K Dhillon, Eric J T Smith, Dorothy A Yim, Galinos Barmparas, Eric J Ley
BACKGROUND: Spinal motion restriction (SMR) after traumatic injury has been a mainstay of prehospital trauma care for more than 3 decades. Recent guidelines recommend a selective approach with cervical spine clearance in the field when criteria are met. MATERIALS AND METHODS: In January 2014, the Department of Health Services of the City of Los Angeles, California, implemented revised guidelines for cervical SMR after blunt mechanism trauma. Adult patients (aged ≥18 y) with an initial Glasgow Coma Scale (GCS) score of ≥13 presented to a single level I trauma center after blunt mechanism trauma over the following 1-y period were retrospectively reviewed...
May 1, 2017: Journal of Surgical Research
Michael M McDowell, Ozgur Dede, Patrick Bosch, Elizabeth C Tyler-Kabara
OBJECTIVES: The objective of the present study is to report a case of campomelic dysplasia illustrating the absence of cervical and thoracic pedicles. This report reiterates the importance of this clinical peculiarity in the setting of spine instrumentation. MATERIALS AND METHODS: A 10-year-old female patient with campomelic dysplasia presented with progressive kyphoscoliosis and signs of neural compromise. Imaging studies confirmed thoracic level stenosis and demonstrated absence of multiple pedicles in cervical and thoracic spine...
April 26, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Marcin Madziala, Jacek Smereka, Marek Dabrowski, Steve Leung, Kurt Ruetzler, Lukasz Szarpak
Emergency airway management in children is generally considered to be challenging, and endotracheal intubation requires a high level of personal skills and experience. Immobilization of the cervical spine is indicated in all patients with the risk of any cervical spine injury but significantly aggravates endotracheal intubation. The best airway device in this setting has not been established yet, although the use of videolaryngoscopes is generally promising. Seventy-five moderately experienced paramedics of the Emergency Medical Service of Poland performed endotracheal intubations in a pediatric manikin in three airway scenarios: (A) normal airway, (B) manual in-line cervical immobilization, and (C) cervical immobilization using a Patriot cervical extrication collar and using two airway techniques: (1) McGrath videolaryngoscope and (2) Macintosh blade in a randomized sequence...
June 2017: European Journal of Pediatrics
N Reyhan, E Goksu, A Kaplan, A Senfer, H Sevil
No abstract text is available yet for this article.
March 10, 2017: American Journal of Emergency Medicine
Jacek Smereka, Jerzy R Ladny, Amanda Naylor, Kurt Ruetzler, Lukasz Szarpak
INTRODUCTION: The aim of this study was to compare C-MAC videolaryngoscopy with direct laryngoscopy for intubation in simulated cervical spine immobilization conditions. METHODS: The study was designed as a prospective randomized crossover manikin trial. 70 paramedics with <5years of medical experience participated in the study. The paramedics attempted to intubate manikins in 3 airway scenarios: normal airway without cervical immobilization (Scenario A); manual inline cervical immobilization (Scenario B); cervical immobilization using cervical extraction collar (Scenario C)...
March 16, 2017: American Journal of Emergency Medicine
Enrico Pola, G Autore, V M Formica, V Pambianco, D Colangelo, R Cauda, M Fantoni
PURPOSE: Pyogenic spondylodiscitis (PS) is still burdened by a high rate of orthopedic and neurological complications. Despite the rising incidence, the choice of a proper orthopedic treatment is often delayed by the lack of clinical data. The aim of this study was to propose a clinical-radiological classification of pyogenic spondylodiscitis to define a standard treatment algorithm. METHODS: Based on data from 250 patients treated from 2008 to 2015, a clinical-radiological classification of pyogenic spondylodiscitis was developed...
March 21, 2017: European Spine Journal
Dhanyasi Shravanalakshmi, Prasanna U Bidkar, K Narmadalakshmi, Suman Lata, Sandeep K Mishra, S Adinarayanan
BACKGROUND: Glottic visualization can be difficult with cervical immobilization in patients with cervical spine injury. Indirect laryngoscopes may provide better glottic visualization in these groups of patients. Hence, we compared King Vision videolaryngoscope, C-MAC videolaryngoscope for endotracheal intubation in patients with proven/suspected cervical spine injury. METHODS: After standard induction of anesthesia, 135 patients were randomized into three groups: group C (conventional C-MAC videolaryngoscope), group K (King Vision videolaryngoscope), and group D (D blade C-MAC videolaryngoscope)...
2017: Surgical Neurology International
C D Shank, B C Walters, M N Hadley
Acute traumatic spinal cord injury (SCI) is a devastating disease process affecting tens of thousands of people across the USA each year. Despite the increase in primary prevention measures, such as educational programs, motor vehicle speed limits, automobile running lights, and safety technology that includes automobile passive restraint systems and airbags, SCIs continue to carry substantial permanent morbidity and mortality. Medical measures implemented following the initial injury are designed to limit secondary insult to the spinal cord and to stabilize the spinal column in an attempt to decrease devastating sequelae...
2017: Handbook of Clinical Neurology
O Gonschorek, S Hauck, T Weiß, V Bühren
INTRODUCTION: There is still no general consensus about the management of osteoporotic vertebral fractures. Recommendations depend on type of fracture, grade of instability, bone quality, and general conditions of the patient. Spontaneous fractures may be considered to be treated different compared to cases with high-velocity trauma. METHODS: According to the DVO, patients without trauma should first be treated conservatively. However, there is no more strict time protocol of 3 or 6 week conservative treatment before operations may be indicated...
February 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Pawel Gawlowski, Jacek Smereka, Marcin Madziala, Lukasz Szarpak, Michael Frass, Oliver Robak
INTRODUCTION: Endotracheal intubation (ETI) using a Macintosh laryngoscope (MAC) requires the head to be positioned in a modified Jackson position, slightly reclined and elevated. Intubation of trauma patients with an injured neck or spine is therefore difficult, since the neck usually cannot be turned or is already immobilized in order to prevent further injury. The iGEL supraglottic airway seems optimal for such conditions due to its blind insertion without the need of a modified Jackson position...
March 2017: American Journal of Emergency Medicine
Sanoara Mazid, Baila S Hall, Shannon C Odell, Khalifa Stafford, Andreina D Dyer, Tracey A Van Kempen, Jane Selegean, Bruce S McEwen, Elizabeth M Waters, Teresa A Milner
Drug addiction requires associative learning processes that critically involve hippocampal circuits, including the opioid system. We recently found that acute and chronic stress, important regulators of addictive processes, affect hippocampal opioid levels and mu opioid receptor trafficking in a sexually dimorphic manner. Here, we examined whether acute and chronic stress similarly alters the levels and trafficking of hippocampal delta opioid receptors (DORs). Immediately after acute immobilization stress (AIS) or one-day after chronic immobilization stress (CIS), the brains of adult female and male rats were perfusion-fixed with aldehydes...
December 2016: Neurobiology of Stress
Eugene Kim, Byung-Gun Kim, Young-Jin Lim, Young-Tae Jeon, Jung-Won Hwang, Seo-Yun Lee, Hee-Pyoung Park
BACKGROUND: Positioning of a lightwand in the midline of the oral cavity can be challenging in patients with cervical immobilization. Direct laryngoscopy may permit the lightwand tip to more easily access the glottic opening. We tested our hypothesis that a laryngoscope-assisted lightwand technique allows more successful endotracheal intubation than does a conventional lightwand approach. METHODS: A total of 162 patients requiring cervical immobilization during intubation for cervical spine surgery were allocated randomly to 2 groups...
October 11, 2016: Anesthesia and Analgesia
M Kreinest, S Goller, G Rauch, B Gliwitzky, C Frank, S Matschke, C G Wölfl, M Münzberg
BACKGROUND: The application of cervical collars is a standard procedure in emergency care of trauma patients. It is often observed that the application of cervical collars is performed incorrectly, which may lead to reduced immobilization of the cervical spine. OBJECTIVES: The objective of this study was to analyze the practical skills of professional emergency care providers concerning the application of cervical collars. MATERIALS AND METHODS: Emergency care professionals (n = 104) were asked to apply a cervical collar to a training doll...
June 29, 2016: Der Unfallchirurg
A Völker, S Schubert, C-E Heyde
BACKGROUND: Spondylodiscitis in children is rare. The condition has an incidence of 2 to 4 % of all infectious skeletal diseases in children. AIM: Aim of the article is the presentation of epidemiology, the clinical signs, radiological findings as well the treatment options of non-specific and specific spondylodiscitis in children. METHODS: The available literature was reviewed. RESULTS: Non-specific spondylodiscitis in children is caused by haematogenous spread of pathogens...
June 2016: Der Orthopäde
Roya Yumul, Ofelia L Elvir-Lazo, Paul F White, Omar Durra, Alen Ternian, Richard Tamman, Robert Naruse, Hailu Ebba, Taizoon Yusufali, Robert Wong, Antonio Hernandez Conte, Shahbaz Farnad, Christine Pham, Ronald H Wender
STUDY OBJECTIVE: To compare the C-MAC video laryngoscope to the standard flexible fiberoptic scope (FFS) with an eye piece (but without a camera or a video screen) for intubation of patients undergoing cervical spine surgery with manual inline stabilization. The primary end point was the time to achieve successful tracheal intubation. Secondary end points included glottic view at intubation and number of intubation attempts. DESIGN: Prospective, randomized, single-blinded study...
June 2016: Journal of Clinical Anesthesia
Ahmet Yildirim, Hasan A Kiraz, İbrahim Ağaoğlu, Okhan Akdur
The aim of the this study is to evaluate the intubation success rates of emergency medical technicians using a Macintosh laryngoscope (ML), McCoy laryngoscope (MCL), and C MAC D-Blade (CMDB) video laryngoscope on manikin models with immobilized cervical spines. This randomized crossover study included 40 EMTs with at least 2 years' active service in ambulances. All participating technicians completed intubations in three scenarios-a normal airway model, a rigid cervical collar model, and a manual in-line cervical stabilization model-with three different laryngoscopes...
February 2017: Internal and Emergency Medicine
C Garcia-Keller, Y M Kupchik, C D Gipson, R M Brown, S Spencer, F Bollati, M A Esparza, D J Roberts-Wolfe, J A Heinsbroek, A-C Bobadilla, L M Cancela, P W Kalivas
There is substantial comorbidity between stress disorders and substance use disorders (SUDs), and acute stress augments the locomotor stimulant effect of cocaine in animal models. Here we endeavor to understand the neural underpinnings of comorbid stress disorders and drug use by determining whether the glutamatergic neuroadaptations that characterize cocaine self-administration are induced by acute stress. Rats were exposed to acute (2 h) immobilization stress, and 3 weeks later the nucleus accumbens core was examined for changes in glutamate transport, glutamate-mediated synaptic currents and dendritic spine morphology...
August 2016: Molecular Psychiatry
Yue Han, Qun Xia, Yong-cheng Hu, Ji-dong Zhang, Jie Lan, Xin-long Ma
The purpose of this article is to introduce and analyze the feasibility of simultaneously combined anterior-posterior approaches for subaxial cervical circumferential reconstruction in sitting position. A retrospective case review was performed for above surgery procedure. A 79-year-old man was confirmed subaxial cervical fracture and dislocation with facet locked by radiological examination, and the involved levels were C5-6. According to American Spinal Injury Association (ASIA) classification, the impairment scale was grade B...
November 2015: Orthopaedic Surgery
Ulrich Linsenmaier, Zsuszsanna Deak, Aina Krtakovska, Francesco Ruschi, Nora Kammer, Stefan Wirth, Maximilian Reiser, Lucas Geyer
OBJECTIVE: To evaluate whether straightening of the cervical spine (C-spine) alignment after trauma can be considered a significant multidetector CT (MDCT) finding. METHODS: 160 consecutive patients after C-spine trauma admitted to a Level 1 trauma centre received MDCT according to Canadian Cervical Spine Rule and National Emergency X-Radiography Utilization Study indication rule; subgroups with and without cervical collar immobilization (CCI +/-) were compared with a control group (n = 20) of non-traumatized patients...
2016: British Journal of Radiology
Atilla Kaplan, Erkan Göksu, Gunay Yıldız, Taylan Kılıç
BACKGROUND: Intubation is a fundamental skill in maintaining adequate oxygenation and ventilation of seriously ill patients. OBJECTIVES: To compare the C-MAC video laryngoscope and Bonfils intubation fiberscope with direct laryngoscopy in simulated easy and difficult airway scenarios. METHODS: This was a prospective, randomized-controlled cross-sectional study. Thirty emergency medicine residents attempted to intubate a manikin using four progressively more difficult airway settings (normal airway [scenario 1], cervical spine immobilization [scenario 2], cervical spine immobilization + tongue swelling scenario [scenario 3], and cervical spine immobilization + tongue swelling + limited jaw opening scenario [scenario 4]) with both the C-MAC video laryngoscope and the Bonfils intubation fiberscope and direct laryngoscope...
March 2016: Journal of Emergency Medicine
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