Re: Solumedrol for SCI

[Ken Lawson-Williams <Macgyver@FlightMedicMail.com>]

>Hey gang;
>I need a bit of input from you guys on Solumedrol therapy for Spinal >Cord Injury on scene responses.

You might want to do a bit more research. Apparantly, according to some of our local trauma centre MD's (University of Alberta Hospital in Edmonton Canada), there are recent studies that show NO improvement in outcomes with solu-medrol therapy. So ends the official word. 

HOWEVER I have been unable to determine the inclusiuon criteria, sampole size, start of loading dose times etc as the still haven't provided the publication dates etc. My gut feeling is that they are including all cases where solumedrol protocols were used, no matter when stated - and no matter if given prophylactically or only upon altered sensory/motor neural function assesment confirmnation.

Having said all that, ground units in Alberta have been using it x 10 years and I have personally had 3 patients (all of whom had altered neural findings and significant mechanism) recover with excellent (although not perfect) outcomes. Also 7 with no post-incident sequale (but who's to say if that was the protocol or the lack of actual injury/swelling as our protocol did not require neural deficits, only mechanism). 

The ground transport times involved were simelar to those your program has - in the 35 to 60 minute range, so approx 60 - 90 minutes post injury (estimated average). My current fixed wing program in Yellowknife NWT Canada uses both mechanism and neural findings, and can reach patient within the 3 hour timeframe about 70% of the time, 6 hour within 25%, and over 6 hours account for 5% (primary responses to native communities with no MD's as well as gold and diamond mines in the high arctic).

KLW 


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