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Three Part Question

In [an unconscious patient who has survived an attempted hanging] does [the prophylactic administration of steroids] lead to [improvement in neurological outcome]

Clinical Scenario

A 12 year old boy is brought in unconscious following an attempted hanging. CT of his brain and cervical spine are normal. There is no clinical evidence of a spinal cord injury. You wonder if giving steroids will improve his neurological outcome

Search Strategy

[exp Asphyxia/ or exp Neck Injuries/ or exp Suicide/ or hanging.mp or strangulation.mp or hang$.mp or strang$.mp] and [exp Steroids/ or steroid.mp or exp Prednisolone/ or prednisolone.mp or exp Dexamethasone/ or exp dexamethasone.mp or exp Methylprednisolone/ or methylprednisolone.mp] limit to Human and English
Medline 1966 to first June Week 4 2008

Search Outcome

577 papers were found none of which answered the clinical question

Clinical Bottom Line

There is no evidence for or against the use of steroids in this situation. Local guidance should be followed