The ITLS Editorial Board has just released three position papers on current topics in prehospital care:
• Long Backboard Use for Spinal Mo- tion Restriction of the Trauma Pa- tient
• Role of TXA in Management of Traumatic Hemorrhage in the Field
• Needle Decompression for Tension Pneumothorax
The documents are authored and re- viewed by the Editorial Board and update ITLS’s recommendations on the topics.
The abstracts for each position paper ap- pear below, and the full, evidence-based position
papers can be downloaded
’s Current Thinking section. New video introductions to the position papers will be available shortly!
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Abstract - Spinal Motion Restriction of the Trauma Patient This is the official current thinking of International Trauma Life Support (ITLS) regarding pre-hospital use of Spinal Mo- tion Restriction (SMR) and the use of the long spine board and other rigid motion restriction devices. It is the position of International Trauma Life Support that:
1. Spinal motion restriction (SMR) is not indicated in every trauma pa- tient.
2. The long spine board and other rigid devices are primarily extrication de- vices designed to move a patient to a transport stretcher. Having the patient remain on the board for pro- longed periods can produce discom- fort, pressure sores and respiratory compromise.
3. In order to minimize these negative occurrences, patients should be re- moved from the long spine board as soon as it is safe and practical to do so.
4. Maintenance of in-line spinal align- ment when moving the patient and appropriately securing them to the transport stretcher remain impor- tant components of SMR.
5. SMR should be applied appropriate- ly to those patients who have indica- tors that they may have sustained or are at high risk for spinal injuries, or who cannot be adequately assessed clinically for the presence of such injuries. Providers should apply the appropriate guideline in these situa- tions and apply a rigid cervical collar and other rigid devices as clinically
6. Spinal Motion Restriction onto a long board is not indicated in pene- trating wounds of the torso, head or neck unless there is clinical evidence of a spinal injury.
Abstract - Role of TXA In Manage- ment of Traumatic Hemorrhage In The Field This is the official current thinking of International Trauma Life Support (ITLS) with regard to the role of TXA in man- agement of traumatic hemorrhage in the pre-hospital setting. It is the position of International Trauma Life Support that:
1. There is sufficient evidence to sup- port the use of TXA in the manage- ment of traumatic hemorrhage in adult trauma patients.
2. ITLS supports the use of TXA in the acute management of trau- matic hemorrhagic shock within the framework of established system medical oversight and protocols.
3. Use of TXA is recommended in con- junction with initial resuscitation and control of external bleeding. Early TXA administration should be considered following airway stabili- zation, control of external bleeding, and initial volume resuscitation.
4. The use of TXA should be consid- ered during the early stages of re- suscitation and transport. Current research demonstrates TXA is most effective if given within 3 hours of the injury and may be detrimental if given after that time.
Continued on Page 2 International Trauma Life Support 3000 Woodcreek Drive, Suite 200 Downers Grove, IL 60515 888.495.IT
LS 630.495.6442 www.itrauma.org
Improving Trauma Care Worldwide Winter 2005
ITLS Publishes Position Papers on SMR, TXA, Needle Decompression
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