Analysis of cervical spine immobilization during patient transport in emergency medical services

Nolte, Philip-Christian; Uzun, Davut D.; Häske, David; Weerts, Jeronimo; Münzberg, Matthias; Rittmann, Adrian; Grützner, Paul Alfred; Kreinest, Michael

doi:10.1007/s00068-019-01143-z

Cited by 21 publications

(19 citation statements)

References 27 publications

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“…Minimal immobilization is recommended only if the patient is unstable (e.g., shock). 24 Similar data were reported by Rahmatalla et al 25 noting the long spine board and vacuum matters combined with the cervical collar as the most effective.…”

Section: ) Patient Transportationsupporting

confidence: 76%

“…It is recommended that long spine boards be used only during patient transportation, and every effort should be made to remove patients from spine boards without unnecessary delay. 15 Nolte et al 24 conducted a biomechanical analysis of immobilization techniques performed in a standardized setting. The authors' primary analysis endpoint was the cervical range of motion of a participant immobilized using a spine board with or without a cervical collar, a vacuum mattress with or without a cervical collar, and a minimal immobilization technique using an ambulance cot and pillows.…”

Section: ) Patient Transportationmentioning

confidence: 99%

“…The vacuum mattress was analyzed in 2 settings -straight and inclined (30°). Nolte et al 24 concluded that the best spinal motion restriction during transportation is achieved using the spine board, and it should be used if the distance to the trauma center is short. The patient is better transported on a vacuum mattress with a cervical collar and head blocks to avoid pain and possible ulcers when longer.…”

Section: ) Patient Transportationmentioning

confidence: 99%

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Early Management of Cervical Spine Trauma: WFNS Spine Committee Recommendations

et al. 2020

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Section: ) Patient Transportationsupporting

confidence: 76%

Section: ) Patient Transportationmentioning

confidence: 99%

Section: ) Patient Transportationmentioning

confidence: 99%

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Early Management of Cervical Spine Trauma: WFNS Spine Committee Recommendations

et al. 2020

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“…In the present study, the remaining flexion and the remaining lateral bending of the immobilized cervical spine were measured with a wireless human motion tracker system (Xsens Technologies, Enschede, Netherlands). Compared to other methods, this measurement method with a motion tracker has been proven 25 – 27 and guarantees exact measurement results 28 . The endpoints of the measurements were maximal flexion and maximal lateral bending.…”

Section: Methodsmentioning

confidence: 99%

Analysis of remaining motion using one innovative upper airway opening cervical collar and two traditional cervical collars

Jung

Ehrlich-Treuenstätt

Keil

et al. 2021

Sci Rep

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The aim of this study was to compare the remaining motion of an immobilized cervical spine using an innovative cervical collar as well as two traditional cervical collars. The study was performed on eight fresh human cadavers. The cervical spine was immobilized with one innovative (Lubo Airway Collar) and two traditional cervical collars (Stifneck and Perfit ACE). The flexion and lateral bending of the cervical spine were measured using a wireless motion tracker (Xsens). With the Weinman Lubo Airway Collar attached, the mean remaining flexion was 20.0 ± 9.0°. The mean remaining flexion was lowest with the Laerdal Stifneck (13.1 ± 6.6°) or Ambu Perfit ACE (10.8 ± 5.8°) applied. Compared to that of the innovative Weinmann Lubo Airway Collar, the remaining cervical spine flexion was significantly decreased with the Ambu Perfit ACE. There was no significant difference in lateral bending between the three examined collars. The most effective immobilization of the cervical spine was achieved when traditional cervical collars were implemented. However, all tested cervical collars showed remaining motion of the cervical spine. Thus, alternative immobilization techniques should be considered.

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“…Cervical collars are generally used to restrict movement whenever spinal motion restriction is indicated and its application is possible. The best form of spinal motion restriction uses a spine board, head blocks and immobilisation straps with and without a cervical collar [23]. However, evidence not only shows the benefits of spinal immobilisation but also reports adverse effects such as raised intracranial pressure, pain and discomfort, pressure ulcers, difficulties in airway management, restriction of respiration and dural sac compression [24][25][26][27][28][29][30][31][32].…”

Section: Why Are Cervical Collars Recommended or Not?mentioning

confidence: 99%

Evidence for the use of spinal collars in stabilising spinal injuries in the pre-hospital setting in trauma patients: a systematic review

Hawkridge

Ahmed

2020

Eur J Trauma Emerg Surg

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Purpose Spinal collars were introduced in 1967 into the management of spinal trauma care as it was thought that this technique of immobilisation would prevent any further neurological or spinal damage in high-risk patients. The aim of this systematic review was to determine whether the use of spinal collars in the pre-hospital trauma patient was recommended by published literature. Methods A systematic search of the literature was conducted between 1990 and 2020, screening PubMed, Medline, Science Direct and Google Scholar. The consequent findings were then qualitatively synthesised with the aim of effectively evaluating the evidence to resolve the discrepancy between current practice and literature. Results Of the nine eligible studies, six deemed that spinal collars should not be used in pre-hospital trauma patients with the remaining three reporting uncertainty if spinal collars were best practice. Our results suggest that there is a discrepancy between current guidance and practice in that although the guidelines recommend the use of spinal collars in the pre-hospital setting the majority of the studies were against the use of spinal collars. Importantly, none of the studies reported any benefits of spinal collars. Conclusion Our study shows a disparity between current guidelines and the published literature and warrants further direct research to obtain a more comprehensive view of the use of spinal collars in a pre-hospital setting.

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Analysis of cervical spine immobilization during patient transport in emergency medical services

Cited by 21 publications

References 27 publications

Early Management of Cervical Spine Trauma: WFNS Spine Committee Recommendations

Early Management of Cervical Spine Trauma: WFNS Spine Committee Recommendations

Analysis of remaining motion using one innovative upper airway opening cervical collar and two traditional cervical collars

Evidence for the use of spinal collars in stabilising spinal injuries in the pre-hospital setting in trauma patients: a systematic review

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