Management Protocols for Spinal Injuries in Adult Patients: A Clinical Guideline

Abstract

Background: This research aimed to elucidate and establish management recommendations for patients with spinal cord injuries, tailored to the characteristics of Iranian society, through an exploratory mixed-methods study. Materials and Methods: The present study was executed in three phases. The initial phase was conducted to identify and elucidate the principal recommendations for the management of spinal cord injuries, comprising two sub-phases: a systematic review and a qualitative guided study. In the second stage, management recommendations were developed by integrating the findings from the first stage, and in the third stage, the clinical guide was prioritized and validated through two rounds of the Delphi method. Results: During the initial phase of the study (qualitative-review phase), 781 codes were derived from interviews with specialists in emergency medicine and neurosurgery, which were subsequently consolidated into six categories. During the second phase of the study, which involved the preparation of the primary draft, a review of pertinent texts was conducted, and researchers assessed 23 chosen clinical guidelines. In the third phase of the study (combination), the findings from the preceding two phases were integrated, and the questionnaire developed by 27 relevant experts was evaluated, culminating in the creation of the final clinical guide. Conclusion: This clinical guide, encompassing six categories—Pre-hospital, Immobilization, Diagnostic Imaging, Pain Management, Medication Recommendations, and Surgical Intervention—has been developed and compiled for the utilization of physicians in the emergency departments of hospitals in Iran.