Öz
Giriş: Travma tahtası kullanımı major travma olgularının stabilizasyonu için geniş ölçüde kabul edilmiş bir uygulamadır. Travma tahtası kullanımına bağlı oluşan rahatsızlık hissi ve bası ağrısı sık karşılaşılan komplikasyonlardandır. Bu çalışmamızdaki amacımız travma tahtası kullanımına bağlı oluşan rahatsızlık hissi ve bası ağrısının azaltılmasıdır.
Bulgular: Gönüllülerin DTT ve STT üzerinde VAS karşılaştırmasında tüm sorgulama dakikalarında genel ağrının ve oksipital bölge, skapular bölge ve sakral bölgelerdeki ağrının DTT üzerindeyken istatistiksel olarak anlamlı düzeyde azaldığı saptanmıştır. DTT ve STT üzerindeyken oluşan basınçlar karşılaştırıldığında; oksipital bölge ve skapular bölgelerde kapiller dolum basıncının üzerinde basıya uğrayan alanlar arasında istatistiksel fark bulunmamakla beraber, olumlu bir sonuç olarak DTT üzerindeyken sakral bölgede kapiller dolum basıncının altında basıya uğrayan alan oranının anlamlı düzeyde yüksek olduğu saptanmıştır.
Sonuç: Travma tahtası üzerinde transfer sırasında ve travma tahtası üzerinde bekleme süresinin uzaması nedeniyle oluşacak basınç açısında biraz daha geliştirilmeye ihtiyaç duyulmakla beraber bası ağrılarının azaltılmasında kullanmış olduğumuz DTT’nın önemli fayda sağladığı ortaya konmuştur.
Anahtar Kelimeler
Kaynakça
- White CC, Domeier RM, Millin MG; Standards and Clinical Practice Committee, National Association of EMS Physicians. EMS spinal precautions and the use of the long backboard – resource document to the position statement of the National Association of EMS Physicians and the American College of Surgeons Committee on Trauma. Prehosp Emerg Care. 2014 Apr-Jun;18(2):306-14. doi: 10.3109/10903127.2014.884197. Epub 2014 Feb 21.
- Rimel R., Winn R., Rice P., Butler A., Edlich R., Buck R., Jane J.. Prehospital treatment of the patient with spinal cord injuries. EMT J 1979:51-4.
- National Association of EMS Physicians and American College of Surgeons Committee on Trauma. January 15, 2013 Position Statement: EMS Spinal Precautions and the Use of the Long Backboard
- Lerner B, Moscati R. Duration of patient immobilization in the ED. Am J Emerg Med 2000;18 (1):28-30.
- March J, Ausband S, Brown L. Changes in physical examination caused by use of spinal immobilization. Prehosp Emerg Care. 2002;6:421–4.
- Cordell WH, Hollingsworth JC, Olinger ML, Stroman SJ, Nelson DR. Pain and tissue-interface pressure during spine-board immobilization. Ann Emerg Med 1995;26:31–6
- Kwan I, Bunn F. Effects of prehospital spinal immobilization: a systematic review of randomized trials on healthy subject. Prehospital Disaster Med 2005;20:47–53.
- Bauer D, Kowalski R. Effect of spinal immobilization devices on pulmonary function in the healthy, nonsmoking man. Ann Emerg Med 1988;17: 915–8.
- Berg G, Nyberg S, Harrison P, Baumchen J, Gurss E, Hennes E. Near-infrared spectroscopy measurement of sacral tissue oxygen saturation in healthy volun- teers immobilized on rigid spine boards. Prehosp Emerg Care 2010;14: 419–24.
- Ay D, Aktaş C, Yeşilyurt S, Sarıkaya S, Cetin A, Ozdoğan ES. Effects of spinal immobilization devices on pulmonary function in healthy volunteer individuals.Ulus Travma Acil Cerrahi Derg. 2011 Mar;17(2):103-7.
- Lerner EB, Billittier AJ, Moscati RM. The effects of neutral positioning with and without padding on spinal immobilization of healthy subjects. Prehosp Emerg Care. 1998;2:112–6.
- Sheerin F, de Frein R. The occipital and sacral pressures experienced by healthy volunteers under spinal immobilization: a trial of three surfaces. J Emerg Nurs 2007;33(5):447-50.
- Uysal, A.: Bası Yaraları, Editör: Ali Haydar Şahinoğlu; Özel Yoğun Bakım Sorunları ve Tedavileri, Türkiye Klinikleri Yayınevi, Ankara, 1992, s.827-32.
- Lyder C. H. Pressure ulcer prevention and management. JAMA, 2003; 289(2), 223-6.
- Ahn H.,Singh J., Nathens, MacDonald R.D., Travers A., Tallon J., Fehlings M.G., Yee A.. Pre-hospital care management of a potential spinal cord injured patient: a systematic review of the literature and evidence-based guidelines. Journal of neurotrauma, 2011; 28(8), 1341-1361.
- Jonsson A, Lindén M, Lindgren M, Malmqvist LA, Bäcklund Y. Evaluation of antidecubitus mattresses. Med Biol Eng Comput 2005; 43(5): 541-7
- Dini V, Bertone M, Romanelli M. Prevention and management of pressure ulcers. Dermatol Ther 2006; 19 (6):356-64.
- Çizmeci O, Emekli U. Bası Yaraları. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi. Cilt: 45, Sayı: 4,1999.
- Beğer T. Yoğun Bakımda Dekübit Ülserleri: Risk Faktörleri ve Önlenmesi, Yoğun Bakım Dergisi, Cilt: 4, Sayı:4, Ankara, 2004, s.244-53.
- European Pressure Ulcer Advisory Panel. Guidelines on treatment of pressure ulcers. EPUAP Review 1999; 1 (2), 31–3.
- Edlich R. F., Mason S. S., Vissers R. J., Gubler K. D., Thacker J. G., Pharr P., Anderson M., Long III W.B. Revolutionary advances in enhancing patient comfort on patients transported on a backboard. The American journal of emergency medicine 2011; 29(2), 181-6.
- Hemmes B, Poeze M, Brink P. R. Reduced tissue-interface pressure and increased comfort on a newly developed soft-layered long spineboard. Journal of Trauma and Acute Care Surgery 2010; 68(3), 593-8.
Öz
Introduction:
The use of
backboard is a widely-accepted practice for the stabilization of major trauma
cases. Discomfort and pressure pain due to the use of backboard are common
complications. In this study, we aimed to reduce the discomfort and pressure pain
due to the use of backboard.
Materials
and methods: The study
was carried out with 20 healthy volunteers. In the first stage, the volunteers
were placed in the supine position for 5 minutes on the standard backboard(STB)
and on the supported backboard(SUB). The pressures in the occipital, scapular,
and sacral regions were measured while lying on an STB and an SUB. In the
second stage, the volunteers were placed in the supine position on an STB or an
SUB as two episodes of 60 minutes. Visual Analog Scale(VAS) was used for
evaluation of the pain at 10,15,30,45 and 60th minutes.
Results:
When the VAS
scores while lying on an STB and an SUB were compared in the volunteers,
general pain and pain in the occipital, scapular, and sacral regions were found
to be statistically significantly decreased at all minutes while lying on an
SUB. When the pressures while lying on an STB and an SUB were compared in the
volunteers, there was no statistically significant difference between the areas
exposed to the pressure above the capillary filling pressure in the occipital
and scapular regions. However, as a positive result, the area exposed to the
pressure below the capillary filling pressure in the sacral region while lying
on an SUB was found to be high at a statistically significant level.
Conclusion:Although it is needed to be slightly improved in terms
of the pressure due to lengthened transport time and lengthened waiting time on
a backboard, the SUB, which we used to reduce pressure pain, was demonstrated
to provide significant benefits.
Kaynakça
- White CC, Domeier RM, Millin MG; Standards and Clinical Practice Committee, National Association of EMS Physicians. EMS spinal precautions and the use of the long backboard – resource document to the position statement of the National Association of EMS Physicians and the American College of Surgeons Committee on Trauma. Prehosp Emerg Care. 2014 Apr-Jun;18(2):306-14. doi: 10.3109/10903127.2014.884197. Epub 2014 Feb 21.
- Rimel R., Winn R., Rice P., Butler A., Edlich R., Buck R., Jane J.. Prehospital treatment of the patient with spinal cord injuries. EMT J 1979:51-4.
- National Association of EMS Physicians and American College of Surgeons Committee on Trauma. January 15, 2013 Position Statement: EMS Spinal Precautions and the Use of the Long Backboard
- Lerner B, Moscati R. Duration of patient immobilization in the ED. Am J Emerg Med 2000;18 (1):28-30.
- March J, Ausband S, Brown L. Changes in physical examination caused by use of spinal immobilization. Prehosp Emerg Care. 2002;6:421–4.
- Cordell WH, Hollingsworth JC, Olinger ML, Stroman SJ, Nelson DR. Pain and tissue-interface pressure during spine-board immobilization. Ann Emerg Med 1995;26:31–6
- Kwan I, Bunn F. Effects of prehospital spinal immobilization: a systematic review of randomized trials on healthy subject. Prehospital Disaster Med 2005;20:47–53.
- Bauer D, Kowalski R. Effect of spinal immobilization devices on pulmonary function in the healthy, nonsmoking man. Ann Emerg Med 1988;17: 915–8.
- Berg G, Nyberg S, Harrison P, Baumchen J, Gurss E, Hennes E. Near-infrared spectroscopy measurement of sacral tissue oxygen saturation in healthy volun- teers immobilized on rigid spine boards. Prehosp Emerg Care 2010;14: 419–24.
- Ay D, Aktaş C, Yeşilyurt S, Sarıkaya S, Cetin A, Ozdoğan ES. Effects of spinal immobilization devices on pulmonary function in healthy volunteer individuals.Ulus Travma Acil Cerrahi Derg. 2011 Mar;17(2):103-7.
- Lerner EB, Billittier AJ, Moscati RM. The effects of neutral positioning with and without padding on spinal immobilization of healthy subjects. Prehosp Emerg Care. 1998;2:112–6.
- Sheerin F, de Frein R. The occipital and sacral pressures experienced by healthy volunteers under spinal immobilization: a trial of three surfaces. J Emerg Nurs 2007;33(5):447-50.
- Uysal, A.: Bası Yaraları, Editör: Ali Haydar Şahinoğlu; Özel Yoğun Bakım Sorunları ve Tedavileri, Türkiye Klinikleri Yayınevi, Ankara, 1992, s.827-32.
- Lyder C. H. Pressure ulcer prevention and management. JAMA, 2003; 289(2), 223-6.
- Ahn H.,Singh J., Nathens, MacDonald R.D., Travers A., Tallon J., Fehlings M.G., Yee A.. Pre-hospital care management of a potential spinal cord injured patient: a systematic review of the literature and evidence-based guidelines. Journal of neurotrauma, 2011; 28(8), 1341-1361.
- Jonsson A, Lindén M, Lindgren M, Malmqvist LA, Bäcklund Y. Evaluation of antidecubitus mattresses. Med Biol Eng Comput 2005; 43(5): 541-7
- Dini V, Bertone M, Romanelli M. Prevention and management of pressure ulcers. Dermatol Ther 2006; 19 (6):356-64.
- Çizmeci O, Emekli U. Bası Yaraları. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi. Cilt: 45, Sayı: 4,1999.
- Beğer T. Yoğun Bakımda Dekübit Ülserleri: Risk Faktörleri ve Önlenmesi, Yoğun Bakım Dergisi, Cilt: 4, Sayı:4, Ankara, 2004, s.244-53.
- European Pressure Ulcer Advisory Panel. Guidelines on treatment of pressure ulcers. EPUAP Review 1999; 1 (2), 31–3.
- Edlich R. F., Mason S. S., Vissers R. J., Gubler K. D., Thacker J. G., Pharr P., Anderson M., Long III W.B. Revolutionary advances in enhancing patient comfort on patients transported on a backboard. The American journal of emergency medicine 2011; 29(2), 181-6.
- Hemmes B, Poeze M, Brink P. R. Reduced tissue-interface pressure and increased comfort on a newly developed soft-layered long spineboard. Journal of Trauma and Acute Care Surgery 2010; 68(3), 593-8.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Orijinal Çalışma |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Mart 2019 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 2 Sayı: 1 |
