Does prehospital spinal immobilization influence in hospital decision to obtain imaging after trauma?

Injury ◽  
2020 ◽  
Vol 51 (4) ◽  
pp. 935-941
Author(s):  
Joseph Drain ◽  
Eleanor S. Wilson ◽  
Timothy A. Moore ◽  
Heather A. Vallier
1996 ◽  
Vol 14 (4) ◽  
pp. 369-372 ◽  
Author(s):  
David R Johnson ◽  
Mark Hauswald ◽  
Cy Stockhoff

2008 ◽  
Vol 23 (6) ◽  
pp. 530-536 ◽  
Author(s):  
Colin J. Ireland ◽  
Kathryn M. Zeitz ◽  
Franklin H.G. Bridgewater

AbstractIntroduction:Research on skill acquisition and retention in the prehospital setting has focused primarily on resuscitation and defibrillation. Investigation into other first aid skills is required in order to validate practices and support training regimes. No studies have investigated competency using an extrication cervical collar for cervical spine immobilization.Objective:This study was conducted to confirm that a group of first responders could acquire and maintain competency in the application of an extrication cervical collar over a 12-month period.Methods:Participants attended a standardized training session that addressed the theory of application of an extrication cervical collar followed by hands-on practice. The training was presented by the same instructor and covered the nine key elements necessary in order to be deemed competent in extraction cervical collar application. Following the practical session, the competency of the participants was assessed. Participants were requested not to practice the skill during the 12-month period. Following the 12-month period, their skills were re-assessed by the same assessor.Results:Of the 64 subjects who participated in the study, 100% were competent after the initial first assessment. Forty-one participants (64%) were available for the second assessment (12 months later); of these, 25 (61%) maintained competence.Conclusions:Although the sample size was small, this research demonstrates that first responders are able to acquire competence in applying an extrication cervical collar. However, skill retention in the absence of usage or re-training is poor. Larger studies should be conducted to validate these results. In addition, there is a need for research on the clinical practice and outcomes associated with spinal immobilization in the prehospital setting.


2018 ◽  
Vol 53 (8) ◽  
pp. 752-755
Author(s):  
Francis X. Feld

Since the early 1970s, initial management of patients with suspected spinal injuries has involved the use of a cervical collar and long spine board for full immobilization, which was thought to prevent additional injury to the cervical spine. Despite a growing body of literature demonstrating the detrimental effects and questionable efficacy of spinal immobilization, the practice continued until 2013, when the National Association of EMS Physicians issued a position statement calling for a reduction in the use of spinal immobilization and a shift to spinal-motion restriction. This article examines the literature that prompted the change in spinal-injury management and the virtual elimination of the long spine board as a tool for transport.


2019 ◽  
Vol 11 (2) ◽  
pp. 53-56
Author(s):  
Darryl Conway ◽  
Ellen K. Payne ◽  
Edward Strapp ◽  
James R. Scifers

2008 ◽  
Vol 43 (1) ◽  
pp. 6-13 ◽  
Author(s):  
Gianluca Del Rossi ◽  
Mary Beth H. Horodyski ◽  
Bryan P. Conrad ◽  
Christian P. Di Paola ◽  
Matthew J. Di Paola ◽  
...  

Abstract Context: To achieve full spinal immobilization during on-the-field management of an actual or potential spinal injury, rescuers transfer and secure patients to a long spine board. Several techniques can be used to facilitate this patient transfer. Objective: To compare spinal segment motion of cadavers during the execution of the 6-plus–person (6+) lift, lift-and-slide (LS), and logroll (LR) spine-board transfer techniques. Design: Crossover study. Setting: Laboratory. Patients or Other Participants: Eight medical professionals (1 woman, 7 men) with 5 to 32 years of experience were enlisted to help carry out the transfer techniques. In addition, test conditions were performed on 5 fresh cadavers (3 males, 2 females) with a mean age of 86.2 ± 11.4 years. Main Outcomes Measure(s): Three-dimensional angular and linear motions initially were recorded during execution of transfer techniques, initially using cadavers with intact spines and then after C5-C6 spinal segment destabilization. The mean maximal linear displacement and angular motion obtained and calculated from the 3 trials for each test condition were included in the statistical analysis. Results: Flexion-extension angular motion, as well as anteroposterior and distraction-compression linear motion, did not vary between the LR and either the 6+ lift or LS. Compared with the execution of the 6+ lift and LS, the execution of the LR generated significantly more axial rotation (P  =  .008 and .001, respectively), more lateral flexion (P  =  .005 and .003, respectively), and more medial-lateral translation (P  =  .003 and .004, respectively). Conclusions: A small amount of spinal motion is inevitable when executing spine-board transfer techniques; however, the execution of the 6+ lift or LS appears to minimize the extent of motion generated across a globally unstable spinal segment.


2013 ◽  
Vol 45 (4) ◽  
pp. e117-e125 ◽  
Author(s):  
Andrew J. Bouland ◽  
J. Lee Jenkins ◽  
Matthew J. Levy

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