Spinal Care during Sea Rescue: HUKM experience Ismail MS, Azhar AA, A.Khaldun, Shalimar A, Muszaphar SS. Dept of Emergency Medicine HUKM
Introduction• Spinal injury NOT common but very devastating.• The higher the injury level the worse will be the outcome• Most victims are in their prime time• Significant loss of work-force to family and community and the nation
Spine injuries• Incidence : 40 per million (US) : 15 per million (UK)• In Malaysia: Incidence 19.8 per 1000 MVA victims had spinal injuries• 57.89% involve the cervical spine• SCI was only 5.3%• Mean age : 29.7 years old• Age peak: 20-24 male 25-29 female• Majority : Male
• Spinal care is very important• Should receive utmost attentionDuring primary survey & resuscitationSpinal immobilization > spinal clearanceRegardless of the situation
Important reminders• Early diagnosis is essential, prompt Mx planning for spinal & spinal cord injuries- reduce the morbidity & mortality• Early stages- life-saving procedures takes priority.• Movement of non-immobilized pts with unrecognized, unstable vertebral injuries put the spinal cord at high risk. TOTAL SPINAL IMMOBILIZATION• medical & legal consequences.
The sea rescue• Sea condition was quite rough• Wind was 35 knots• Waves was between 1.5- 2.0 m
In the sea• Condition slight different• Waves- much stronger• Wind quite strong• Helicopter downdraft was quite powerful• Getting to the victim is more further away• Technique remained the same
Conclusion• Spinal care in aquatic injuries should receive equal emphasis just like their counterpart on land injuries• Spinal care technique should be taught to all rescuer whether it is on land or water.• Spinal care (immobilization) technique can and should be applied to all indicated patients.
Thank you for your kind attention Terima kasih