Backboard versus mattress splint immobilization: A comparison of symptoms generated

Chan, Ding Cheng; Goldberg, Richard M.; Mason, Jennifer; Chan, Linda S.

doi:10.1016/0736-4679(96)00034-0

Cited by 61 publications

(41 citation statements)

References 12 publications

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“…In general, a vacuum mattresses is associated with 30%-85% reduced motion compared to a spine board in simulated experiments, 16,17 and provide for more patient comfort. 12,18 The two main methods of transferring a patient onto a stable surface are the log roll (LR) and the lift-and slide. Although the lift-and-slide results in less motion compared to the LR [19][20][21][22][23] , the current standard of care in the paramedic context is to transfer a patient onto a spine board using a standard LR technique 9 conducted with 1-3 assistants depending on availability.…”

Section: Introductionmentioning

confidence: 99%

Cervical Spine Motion during Transfer and Stabilization Techniques

Shrier¹,

Boissy²,

Lebel³

et al. 2014

Prehospital Emergency Care

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Objectives: To compare paramedics' ability to minimize cervical spine motion during patient transfer onto a vacuum mattress with two stabilization techniques (Head Squeeze vs. Trap Squeeze) and two transfer methods (log roll with one assistant (LR 2 ) vs. 3 assistants (LR 4 )).Methods: We used a cross-over design to minimize bias. Each lead paramedic performed 10 LR 2 transfers and 10 LR 4 transfers . For each of the 10 LR 2 and 10 LR 4 transfers, the lead paramedic stabilized the cervical spine using the Head Squeeze technique five times and the Trap Squeeze technique five times. We randomized the order of the stabilization techniques and LR 2 / LR 4 across lead paramedics to avoid a practice or fatigue effect with repeated trials. We measured relative cervical spine motion between the head and trunk using Inertial Measurement Units placed on the forehead and sternum.Results: On average, total motion was 3.9° less with three assistants compared to one assistant (p=0.0002), and 2.8° less with the Trap Squeeze compared to the Head Squeeze (p=0.002). There was no interaction between the transfer method and stabilization technique. When examining specific motions in the six directions, the Trap Squeeze generally produced less lateral flexion and rotation motion but allowed more extension. Examining within paramedic differences, some paramedics were clearly more proficient with the Trap Squeeze technique and others were clearly more proficient with the Head Squeeze technique.Conclusion: Paramedics performing a log roll with three assistants created less motion compared to a log roll with only one assistant, and using the Trap Squeeze stabilization technique resulted in less motion than the Head Squeeze technique. However, the clinical relevance of the magnitude remains unclear. However, large individual differences suggest future paramedic training should incorporate both best evidence practice as well as recognition that there may be individual differences between paramedics.

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Section: Introductionmentioning

confidence: 99%

Cervical Spine Motion during Transfer and Stabilization Techniques

Shrier¹,

Boissy²,

Lebel³

et al. 2014

Prehospital Emergency Care

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“…127,[159][160][161][162][163][164][165][166] Additionally, discomfort, pain, and related stress responses are not an insignificant problem and can be a confounding factor in initial patient assessment and trauma management. [167][168][169][170][171][172] Patients that have received spinal immobilization are more likely to proceed to radiological examinations to ''clear the neck.'' 13,171,173 This is concerning, in light of the accumulating evidence on the unfavorable radiation effects of computed tomography (CT) scanning, [174][175][176] especially in children.…”

mentioning

confidence: 99%

Prehospital Use of Cervical Collars in Trauma Patients: A Critical Review

Sundstrøm

Asbjørnsen

Habiba

et al. 2014

Journal of Neurotrauma

148

115

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The cervical collar has been routinely used for trauma patients for more than 30 years and is a hallmark of state-of-the-art prehospital trauma care. However, the existing evidence for this practice is limited: Randomized, controlled trials are largely missing, and there are uncertain effects on mortality, neurological injury, and spinal stability. Even more concerning, there is a growing body of evidence and opinion against the use of collars. It has been argued that collars cause more harm than good, and that we should simply stop using them. In this critical review, we discuss the pros and cons of collar use in trauma patients and reflect on how we can move our clinical practice forward. Conclusively, we propose a safe, effective strategy for prehospital spinal immobilization that does not include routine use of collars.

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“…43 In a study comparing backboards with vacuum mattress-splints, there were fewer complaints of occipital and lumbosacral pain in the group immobilised using the vacuum mattress-splint. 45 Two studies also showed that the use of unpadded spinal boards increased board-tissue interface pressure. 41,44 • During placement on a spinal board: -Lift-and-slide technique had less C-spine motion than log roll -In cooperative patients, little difference in C-spine motion between head squeeze and trap squeeze -In confused patients, head squeeze results in more C-spine motion than trap squeeze Hamilton et al 33 Extrapolated data/Poor Neutral Prospective, nonrandomised, crossover study…”

Section: Effect Of Spinal Immobilisation On Decreasing Pain or Improvmentioning

confidence: 97%

“…[41][42][43][44][45] All studies presented extrapolated data from adult volunteers. [41][42][43][44][45] Four were of fair [41][42][43][44] and one was of poor 45 methodological quality. All opposed the use of spinal immobilisation to decrease pain or improve comfort.…”

Section: Effect Of Spinal Immobilisation On Decreasing Pain or Improvmentioning

confidence: 99%