Acute Management of Spinal Cord Injury in Out-of-hospital and Emergency Department Settings

Spinal cord injury (SCI) is a devastating neurological disorder that is estimated to affect approximately 1000 patients each year in the Republic of Turkey. With this review, we aim to update the recent evidence related to the acute management of patients with SCI in out-of-hospital and emergency department settings. We performed a literature review of publications in the English language and indexed in PubMed, ScienceDirect and Scopus using the following search terms: spinal cord injury and acute management, spinal cord injury and immobilisation, spinal cord injury and transfer, spinal cord injury and transport, spinal cord injury and airway management, spinal cord injury and haemodynamic management, spinal cord injury and steroid. We also reviewed the recent international guidelines. This review reports the immobilisation of patients with SCI and management strategies relevant to their transfer, airway management in cervical SCI, haemodynamic management and methylprednisolone use. The patient's spinal alignment should be maintained with appropriate techniques for sufficient immobilisation to ease safe extrication and transport. Patients with acute SCI should be promptly and carefully transported from the place of injury to the nearest specialist SCI facility.