Ulus Travma Acil Cerrahi Derg. 2023; 29(2): 255-258 | DOI: 10.14744/tjtes.2021.56055

Sebebi belirsiz travma nedenli servikal omurga yaralanmasýna baðlý hastane dýþý kardiyak arrest: Ýki olgunun incelenmesi

Hosub Chung¹, Duk Hee Lee¹, Keon Kim², Yoon Hee Choi¹, Sung Jin Bae^3
1Ewha Womans Üniversitesi Týp Fakültesi, Mokdong Hastanesi, Acil Týp Bölümü, Güney Kore
²Acil Týp Bölümü, Ewha Womans Üniversitesi Týp Fakültesi, Seul Hastanesi, Seul-Güney Kore
³Chung-Ang Üniversite Hastanesi, Acil Týp Bölümü, Seul-Güney Kore

Servikal omurilik yaralanmasý, travma hastalarýnda iyi bilinen bir kardiyak arrest nedenidir. Travmadan kesin olarak þüphelenilmedikçe, acil saðlýk hizmetleri ekipleri hastane öncesi aþamada servikal immobilizasyon olmadan resüsitasyon gerçekleþtirir. Ýleri kardiyovasküler yaþam desteði (Advanced cardiovascular life support-ACLS) sýrasýnda, servikal immobilizasyon ile entübasyon hava yoluna eriþimde zorluða neden olur, bu nedenle hasta açýk bir travma vakasý olmadýkça immobilizasyon yapýlmaz. Açýk bir travma olmadan meydana gelen servikal kýrýklar nedeniyle hastane dýþý kardiyak arrest (Out-of-hospital cardiac arrest-OHCA) olan iki hastayý sunuyoruz. Bu vakalarda, önceden var olan servikal omurga lezyonlarý ek olarak bilgilendirildi ve servikal omurga kýrýklarýnýn tanýmlanmasý gecikti. Acil týp doktorlarý, OHCA ile baþvuran bir hastada travma olasýlýðý belirsiz olduðunda servikal omurga yaralanmasýný ihmal etme eðilimindedir. Bu vakalar, doktorlarý minör travma olgularýnda bile servikal yaralanma olasýlýðýný düþünmeye sevk edebilir. Servikal spinal yaralanma olasýlýðý varsa görüntüleme geciktirilmemeli ve ardýndan uygun tedavi uygulanmalýdýr.

Anahtar Kelimeler: Hastane dýþý kardiyak arrest, servikal vertebra; spinal yaralanma.

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Out-of-hospital cardiac arrest due to cervical spine injury by uncertain trauma: A study of two cases

Hosub Chung¹, Duk Hee Lee¹, Keon Kim², Yoon Hee Choi¹, Sung Jin Bae^3
1Department of Emergency Medicine, Ewha Womans University Mokdong Hospital, College of Medicine, South Korea
²Department of Emergency Medicine, Ewha Womans University Seoul Hospital, College of Medicine, South Korea
³Department of Emergency Medicine, Chung-Ang University Hospital, Seoul-South Korea

Cervical spinal cord injury is a well-known cause of cardiac arrest in trauma victims. Unless trauma is definitively suspected, emergency medical services teams perform resuscitation in the pre-hospital stage without cervical spine immobilization. During advanced cardiovascular life support (ACLS), intubation with cervical spinal immobilization causes difficulty in accessing the airway, thus, immobilization tends to not be performed, unless the patient is a clear case of trauma. We report two patients with out-of-hospital cardiac arrests (OHCA) due to cervical fractures that have occurred without clear trauma. In these cases, pre-existing cervical spine lesions was additional informed and identification of the cervical spine fractures was delayed. Emergency medical physicians tend to neglect cervical spine injury when the likelihood of trauma is unclear in a patient presenting with OHCA. These cases urge physicians to consider the possibility of cervical spinal injuries, even in cases of minor trauma. If there is a possibility of cervical spinal injury, imaging should not be delayed and should be followed by appropriate treatment.

Keywords: Cervical vertebrae, out of hospital cardiac arrest, spinal injury.

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