Pre-Hospital Treatment Recommendations for patients with suspected spinal cord injury (SCI)
These recommendations are inspired by the imperative to better use the first golden hour(s) after spinal cord injury in order to protect spinal cord tissue in a high-risk sport scenario offering formidable options for preemptive care. Feasibility is particularly high in case the medical team is already on-site, with immediate access to the patient. The proposed recommendations take a consequent (neuro-) protective approach. The recommendations can be understood as an additional option of SCI care focusing on the pre-hospital phase. Every patient has the freedom to reject this additional option.
Rationale: The recommendations summarize pragmatic options, which are supported by undisputed pathophysiological evidence derived from published peer-reviewed research including replicated results from experimental SCI models, observational human SCI studies and studies investigating different but related paradigms of human CNS injury, such as ischemic brain injury. Of note, available and integrated human data is of correlative but not causative nature. In addition, the recommendations respect treatment principles, which have reached guideline status for hospital care already and extend them to the preclinical phase (e.g. prevention of hypotensive episodes). These recommendations have been compiled considering for active sport athletes.
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