Emergency medical care at the prehospital stage and outcome prediction for concomitant injuries with spine-and-spinal cord trauma as their component
Introduction. Concomitant injuries with spine-and-spinal cord trauma as their component have long become not only a medical problem but also a social one. In case of multiple and concomitant injuries the diagnosis of the spine traumas in the injured persons should not have the character of confirmation, but that of possible injury exclusion. Purpose. To evaluate the severity, prognosis and outcomes, as well as to analyze the details of providing medical care for spine-and-spinal cord trauma in miners at the prehospital stage. Materials and methods. The outcomes of treatment were analyzed in 146 injured miners with spine-spinal cord trauma. Mean age of the injured persons was 37.7±0.8 years. 12 (8.2 %) injured persons had isolated injuries, 21 (14.4 %) - multiple injuries, and 113 (77.4 %) - concomitant ones. Spine-and-spinal cord trauma was dominant in 67 cases (45.9 %). The physicians of resuscitation-antishock groups of the State Paramilitary Mountain-Rescue Service rendered medical care at the prehospital stage. Results. There were no fatal outcomes at the prehospital stage. The death of injured persons was observed in eight (8) cases (5.5 %) in a medical institution. Severe concomitant injuries of the chest, abdomen, pelvis were observed in six (6) patients; the spine trauma with spinal cord injury prevailed in two cases. Conclusion. It is advisable to use an integrated predictor in order to identify the severity and prognosis of trauma outcomes at the prehospital stage, and numerical scoring of trauma shock genicity should be used to highlight the dominant injury.