Prehospital stabilization of the cervical spine for penetrating injuries of the neck - is it necessary?

The purpose of this study was to assess the specific indications, benefits and risks associated with cervical spine stabilization during pre-hospital care of penetrating neck injuries. We retrospectively reviewed hospital cha rts and autopsy reports of 44 military casualties in Israel with a penetrat ing neck injury during a period of 4.5 years. A review of the literature wa s also carried out. In eight of 36 hospitalized casualties (22%) a life-thr eatening sign was diagnosed in the exposed neck - large or expanding haemat oma, or subcutaneous emphysema. Surgical stabilization of the cervical spin e was not performed for any of the casualties. It was concluded that life t hreatening complications due to penetrating neck injury are common and may be overlooked if the neck is covered by a stabilization device. It is extre mely rare for a penetrating injury to result in an unstable cervical spine. New management guidelines concerning pre-hospital stabilization are sugges ted. (C) 2000 Elsevier Science Ltd. All rights reserved.