Cervical Spine Motion During Vehicle Extrication of Healthy Volunteers

Gabrieli, Alberto; Nardello, Francesca; Geronazzo, Michele; Marchetti, Pierpaolo; Liberto, Alessandro; Arcozzi, Daniele; Polati, Enrico; Cesari, Paola; Zamparo, Paola

doi:10.1080/10903127.2019.1695298

Cited by 10 publications

(16 citation statements)

References 33 publications

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“…Data from a total of 392 extrications were successfully collected for analysis (98% data capture success rate). Seven of the ten participants were female, with a mean age across all of the participants of 39 years (range 21-59) and BMI of 25.1 (range [19][20][21][22][23][24][25][26][27][28][29].…”

Section: Resultsmentioning

confidence: 99%

“…Engsberg et al did not provide instructions to their participants [ 33 ]. Gabreli et al compared the use of instructions provided in video and verbal explanatory format prior to the subjects (all young men less than 30 years of age) attempting self-extrication – they found that instructions reduced movement in the sagittal (AP) plane (other movements were not tested / analysed) at the cervical spine [ 24 ]. No previous studies have considered movement at the lumbar spine.…”

Section: Discussionmentioning

confidence: 99%

“…Previous researchers have concluded that self-extrication is associated with smaller movements at the cervical spine than other methods of extrication, which normally involve being physically lifted from the vehicle by rescue service personnel on to a board or a scoop [ 23 , 24 ]. Trapped casualties have an excess mortality, and many of the injuries they suffer are time critical [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…to allow facial packing in maxillofacial injury) [19][20][21][22]. These conflicting analyses suggest that the optimal role of cervical collars as an extrication device remains unclear, particularly in the setting of self-extrication [23][24][25].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The role of cervical collars and verbal instructions in minimising spinal movement during self-extrication following a motor vehicle collision - a biomechanical study using healthy volunteers

Nutbeam

Fenwick

May

et al. 2021

Scand J Trauma Resusc Emerg Med

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Background Motor vehicle collisions account for 1.3 million deaths and 50 million serious injuries worldwide each year. However, the majority of people involved in such incidents are uninjured or have injuries which do not prevent them exiting the vehicle. Self-extrication is the process by which a casualty is instructed to leave their vehicle and completes this with minimal or no assistance. Self-extrication may offer a number of patient and system-wide benefits. The efficacy of routine cervical collar application for this group is unclear and previous studies have demonstrated inconsistent results. It is unknown whether scripted instructions given to casualties on how to exit the vehicle would offer any additional utility. The aim of this study was to evaluate the effect of cervical collars and instructions on spinal movements during self-extrication from a vehicle, using novel motion tracking technology. Methods Biomechanical data on extrications were collected using Inertial Measurement Units on 10 healthy volunteers. The different extrication types examined were: i) No instructions and no cervical collar, ii) No instructions, with cervical collar, iii) With instructions and no collar, and iv) With instructions and with collar. Measurements were recorded at the cervical and lumbar spine, and in the anteroposterior (AP) and lateral (LAT) planes. Total movement, mean, standard deviation and confidence intervals are reported for each extrication type. Results Data were recorded for 392 extrications. The smallest cervical spine movements were recorded when a collar was applied and no instructions were given: mean 6.9 mm AP and 4.4 mm LAT. This also produced the smallest movements at the lumbar spine with a mean of 122 mm AP and 72.5 mm LAT. The largest overall movements were seen in the cervical spine AP when no instructions and no collar were used (28.3 mm). For cervical spine lateral movements, no collar but with instructions produced the greatest movement (18.5 mm). For the lumbar spine, the greatest movement was recorded when instructions were given and no collar was used (153.5 mm AP, 101.1 mm LAT). Conclusions Across all participants, the most frequently occurring extrication method associated with the least movement was no instructions, with a cervical collar in situ.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The role of cervical collars and verbal instructions in minimising spinal movement during self-extrication following a motor vehicle collision - a biomechanical study using healthy volunteers

Nutbeam

Fenwick

May

et al. 2021

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

show abstract

“…Rescue service teaching recommends that casualties in the assisted or medical groups receive a traditional extrication method, as it is understood that these result in less spinal movement than other techniques [11]. Recently these principles have been challenged; with a number of small biomechanical studies demonstrating that self-extrication may cause less movement than more traditional extrication techniques [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Assessing Spinal Movement During Four Extrication Methods: A Biomechanical Study using Healthy Volunteers

Nutbeam

Fenwick

May

et al. 2021

Preprint

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BackgroundMotor vehicle collisions are a common cause of death and serious injury. Many casualties will remain in their vehicle following a collision. Trapped patients have more injuries and are more likely to die than their untrapped counterparts. Current extrication methods are time consuming and have a focus on movement minimisation and mitigation. The optimal extrication strategy and the effect this extrication method has on spinal movement is unknown. The aim of this study was to evaluate the movement at the cervical and lumbar spine for four commonly utilised extrication techniques. MethodsBiomechanical data was collected using inertial Measurement Units on 6 healthy volunteers. The extrication types examined were: roof removal, b-post rip, rapid removal and self-extrication. Measurements were recorded at the cervical and lumbar spine, and in the anteroposterior (AP) and lateral (LAT) planes. Total movement (travel), maximal movement, mean, standard deviation and confidence intervals are reported for each extrication type.ResultsData from a total of 230 extrications were collected for analysis. The smallest maximal and total movement (travel) were seen when the volunteer self-extricated (AP max = 2.6mm, travel 4.9mm). The largest maximal movement and travel were seen in rapid extrication extricated (AP max = 6.21mm, travel 20.51 mm). The differences between self-extrication and all other methods were significant (p<0.001), small non-significant differences existed between roof removal, b-post rip and rapid removal.Self-extrication was significantly quicker than the other extrication methods (mean 6.4s).ConclusionsIn healthy volunteers, self-extrication is associated with the smallest spinal movement and the fastest time to complete extrication. Rapid, B-post rip and roof off extrication types are all associated with similar movements and time to extrication in prepared vehicles.

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Evaluating a novel, low-cost technique for cervical-spine immobilization for application in resource-limited LMICs: a non-inferiority trial

et al. 2022

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Cervical Spine Motion During Vehicle Extrication of Healthy Volunteers

Cited by 10 publications

References 33 publications

The role of cervical collars and verbal instructions in minimising spinal movement during self-extrication following a motor vehicle collision - a biomechanical study using healthy volunteers

The role of cervical collars and verbal instructions in minimising spinal movement during self-extrication following a motor vehicle collision - a biomechanical study using healthy volunteers

Assessing Spinal Movement During Four Extrication Methods: A Biomechanical Study using Healthy Volunteers

Evaluating a novel, low-cost technique for cervical-spine immobilization for application in resource-limited LMICs: a non-inferiority trial

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