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Confirmation of suboptimal protocols in spinal immobilisation?
BACKGROUND: Spinal immobilisation during extrication of patients in road traffic collisions is routinely used despite the lack of evidence for this practice. In a previous proof of concept study (n=1), we recorded up to four times more cervical spine movement during extrication using conventional te...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717352/ https://www.ncbi.nlm.nih.gov/pubmed/26362582 http://dx.doi.org/10.1136/emermed-2014-204553 |
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author | Dixon, Mark O'Halloran, Joseph Hannigan, Ailish Keenan, Scott Cummins, Niamh M |
author_facet | Dixon, Mark O'Halloran, Joseph Hannigan, Ailish Keenan, Scott Cummins, Niamh M |
author_sort | Dixon, Mark |
collection | PubMed |
description | BACKGROUND: Spinal immobilisation during extrication of patients in road traffic collisions is routinely used despite the lack of evidence for this practice. In a previous proof of concept study (n=1), we recorded up to four times more cervical spine movement during extrication using conventional techniques than self-controlled extrication. OBJECTIVE: The objective of this study was to establish, using biomechanical analysis which technique provides the minimal deviation of the cervical spine from the neutral in-line position during extrication from a vehicle in a larger sample of variable age, height and mass. METHODS: A crew of two paramedics and four fire-fighters extricated 16 immobilised participants from a vehicle using six techniques for each participant. Participants were marked with biomechanical sensors and relative movement between the sensors was captured via high-speed infrared motion analysis cameras. A three-dimensional mathematical model was developed and a repeated-measures analysis of variance was used to compare movement across extrication techniques. RESULTS: Controlled self-extrication without a collar resulted in a mean movement of 13.33° from the neutral in-line position of the cervical spine compared to a mean movement of 18.84° during one of the equipment-aided extrications. Two equipment-aided techniques had significantly higher movement (p<0.05) than other techniques. Both height (p=0.003) and mass (p=0.02) of the participants were significant independent predictors of movement. CONCLUSIONS: These data support the findings of the proof of concept study, for haemodynamically stable patients controlled self-extrication causes less movement of the cervical spine than extrications performed using traditional prehospital rescue equipment. |
format | Online Article Text |
id | pubmed-4717352 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-47173522016-01-28 Confirmation of suboptimal protocols in spinal immobilisation? Dixon, Mark O'Halloran, Joseph Hannigan, Ailish Keenan, Scott Cummins, Niamh M Emerg Med J Original Article BACKGROUND: Spinal immobilisation during extrication of patients in road traffic collisions is routinely used despite the lack of evidence for this practice. In a previous proof of concept study (n=1), we recorded up to four times more cervical spine movement during extrication using conventional techniques than self-controlled extrication. OBJECTIVE: The objective of this study was to establish, using biomechanical analysis which technique provides the minimal deviation of the cervical spine from the neutral in-line position during extrication from a vehicle in a larger sample of variable age, height and mass. METHODS: A crew of two paramedics and four fire-fighters extricated 16 immobilised participants from a vehicle using six techniques for each participant. Participants were marked with biomechanical sensors and relative movement between the sensors was captured via high-speed infrared motion analysis cameras. A three-dimensional mathematical model was developed and a repeated-measures analysis of variance was used to compare movement across extrication techniques. RESULTS: Controlled self-extrication without a collar resulted in a mean movement of 13.33° from the neutral in-line position of the cervical spine compared to a mean movement of 18.84° during one of the equipment-aided extrications. Two equipment-aided techniques had significantly higher movement (p<0.05) than other techniques. Both height (p=0.003) and mass (p=0.02) of the participants were significant independent predictors of movement. CONCLUSIONS: These data support the findings of the proof of concept study, for haemodynamically stable patients controlled self-extrication causes less movement of the cervical spine than extrications performed using traditional prehospital rescue equipment. BMJ Publishing Group 2015-12 2015-09-11 /pmc/articles/PMC4717352/ /pubmed/26362582 http://dx.doi.org/10.1136/emermed-2014-204553 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Original Article Dixon, Mark O'Halloran, Joseph Hannigan, Ailish Keenan, Scott Cummins, Niamh M Confirmation of suboptimal protocols in spinal immobilisation? |
title | Confirmation of suboptimal protocols in spinal immobilisation? |
title_full | Confirmation of suboptimal protocols in spinal immobilisation? |
title_fullStr | Confirmation of suboptimal protocols in spinal immobilisation? |
title_full_unstemmed | Confirmation of suboptimal protocols in spinal immobilisation? |
title_short | Confirmation of suboptimal protocols in spinal immobilisation? |
title_sort | confirmation of suboptimal protocols in spinal immobilisation? |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717352/ https://www.ncbi.nlm.nih.gov/pubmed/26362582 http://dx.doi.org/10.1136/emermed-2014-204553 |
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