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Rekommendationer och risker vid prehospital helkroppsimmobilisering av misstänkt spinal skada: En litteraturgranskning
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
2016 (Swedish)Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
Abstract [sv]

Bakgrund

Idag används olika medicinsktekniska produkter för helkroppsimmobilisering vid misstanke

om spinal skada prehospitalt. Valet av immobiliseringsutrustning som skall användas görs av

ansvarig sjuksköterska på plats. Den vanligaste utrustningen är ryggbräda, vaccummadrass,

Kendric Extration Device (KED-väst) och nackkrage. Då utbildningen Pre Hospital Trauma

Life Support (PHTLS) varit en del av specialistutbildningen för ambulanssjuksköterskor

under en längre period har det funnits lite anledning till att ifrågasätta

helkroppsimmobilisering och dess utrustning. All immobiliseringsutrustning klassificeras

under klass 1 av Läkemedelsverket, vilket kan innebära att få vetenskapliga studier har gjorts

för att utvärdera immobilieringsutrustning. Patientsäkerhetslagen ska efterlevas vad gäller

vetenskaplig och beprövad metod i omvårdnaden av patienter med misstänkt spinal skada.

Syfte

Att genom en litteraturgranskning undersöka rekommendationer och eventuella risker med

helkroppsimmobilisering vid misstanke av spinal skada prehospitalt utifrån patientsäkerhet

och ett historiskt perspektiv.

Metod

Studien genomförs som litteraturgranskning med artikelgranskning och ett retrospektivt,

deskriptivt perspektiv.

Resultat

Forskning rekommenderade helkroppsimmobilisering på traumapatienter där det fanns

misstanke om spinal skada. Behandlingsriklinjerna följde nuvarande

forskningsrekommendationer. Forskningskvaliten hade blivit bättre över tid och resultaten

hade ökat i trovärdighet. Flera forskare påvisade risker med helkroppsimmobilisering.

Riskerna var relaterade till dagens immobiliseringsutrustning. Ett antal alternativ till dagens

immobiliseringsutrusning fanns beskrivna, men användes inte och var inte omnämnda i

behandlingsriktlinjer.

Slutsats

Forskning rekommenderar helkroppsimmobilisering på traumapatienter där det finns

misstanke om spinal skada. Immobiliseringutrustning har bevisligen flera risker för patienter,

vilka orsakar allvarliga konsekvenser för hälsan. En lågt sittande ryggskada kanske inte

behöver helkroppsimmobiliseras. Det kanske räcker med halvkroppsimmobilisering för vissa

patienter.

Abstract [en]

Background

Today, there are various medical devices for full body immobilisation in cases of suspected

spinal injury prehospital. The choice of immobilisation devices to be used is the charge

nurse’s on site. The most common equipment is back board, vaccummadrass, Kendric

extraction Device (KED - West) and cervical collar. Because When training Pre Hospital

Trauma Life Support (PHTLS) has been part of the specialist training of ambulance nurses

over a longer period , there has been little reason to question full body immobilisation and its

equipment . All immobilisation devices classified under Class 1 of the Medical Product

Agency (MPA) , which may mean that few scientific studies have been done to evaluate

immobilisation devices. The Patient Safety Act must be complied with in terms of scientific

and proven method in the care of patients with suspected spinal injury.

Aim

Through a literature review examining recommendations and possible risks of full body

immobilisation on suspicion of spinal injury pre-hospital based on patient safety and a

historical perspective.

Method

The study is conducted as a literature review with the article review and a retrospective,

descriptive perspective.

Result

Research recommended full body immobilisation on trauma patients where there was

suspicion of spinal injury. Treatment guidelines followed the current research

recommendations. The research quality had improved over time and results in increased

credibility. Several researchers demonstrated the risks of full body immobilisation. The risks

were related to today's immobilisation devices. A number of alternatives to current

immobilisation devices was described, but was not used and was not mentioned in the

treatment guidelines.

Conclusion

Research recommends full body immobilisation of trauma patients where there is a suspected

spinal injury. Immobilisation devices has proven more risks for patients , which cause serious

health consequences. A low sitting back injury may not need full body immobilisation. It

might suffice with a half body immobilisation for some patients.

Place, publisher, year, edition, pages
2016. , 47 p.
Keyword [en]
Patient safety, Prehospital, Immobilization, SCI (spinal cord injury), Trauma
Keyword [sv]
Patientsäkerhet, Prehospital, Immobilisation, Spinal Skada, Trauma
National Category
Nursing
Identifiers
URN: urn:nbn:se:uu:diva-295823OAI: oai:DiVA.org:uu-295823DiVA: diva2:935033
Subject / course
Caring Sciences
Educational program
Freestanding course
Supervisors
Examiners
Available from: 2016-06-10 Created: 2016-06-09 Last updated: 2016-06-10Bibliographically approved

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