# Management Protocols for Spinal Injuries in Adult Patients: A Clinical Guideline: Management Recommendations for Patients with Spinal Cord Injuries

## TL;DR

This study created a clinical guideline for managing spinal injuries in Iranian hospitals, combining expert input and existing research.

## Contribution

A culturally tailored clinical guide for spinal cord injury management in Iran, validated through mixed methods and expert consensus.

## Key findings

- Six key categories for spinal injury management were identified and validated.
- The Delphi method confirmed the final clinical guide with input from 27 experts.
- The guide is intended for use in emergency departments across Iranian hospitals.

## Abstract

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.

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.

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.

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.