No place for the rigid cervical collar in pre-hospital care

Rogers, Leigh

doi:10.12968/ippr.2017.7.1.12

Cited by 9 publications

(10 citation statements)

References 29 publications

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“…In case of an inconspicuous clinical examination and the presence of risk factors, immobilization does not seem to be superior to independent, pain-free relieving posture, although this does not preclude spinal injury [38][39][40][41]. Also, data show that the physical examination for possible spinal cord injury is not affected by the injury mechanism [31].…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and predictors of traumatic spine injury in severely injured patients: implications for emergency procedures

Häske

Lefering

Stock

et al. 2020

Eur J Trauma Emerg Surg

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Purpose This study aimed to identify the prevalence and predictors of spinal injuries that are suitable for immobilization. Methods Retrospective cohort study drawing from the multi-center database of the TraumaRegister DGU®, spinal injury patients ≥ 16 years of age who scored ≥ 3 on the Abbreviated Injury Scale (AIS) between 2009 and 2016 were enrolled. Results The mean age of the 145,833 patients enrolled was 52.7 ± 21.1 years. The hospital mortality rate was 13.9%, and the mean injury severity score (ISS) was 21.8 ± 11.8. Seventy percent of patients had no spine injury, 25.9% scored 2–3 on the AIS, and 4.1% scored 4–6 on the AIS. Among patients with isolated traumatic brain injury (TBI), 26.8% had spinal injuries with an AIS score of 4–6. Among patients with multi-system trauma and TBI, 44.7% had spinal injuries that scored 4–6 on the AIS. Regression analysis predicted a serious spine injury (SI; AIS 3–6) with a prevalence of 10.6% and cervical spine injury (CSI; AIS 3–6) with a prevalence of 5.1%. Blunt trauma was a predictor for SI and CSI (OR 4.066 and OR 3.640, respectively; both p < 0.001) and fall > 3 m for SI (OR 2.243; p < 0.001) but not CSI (OR 0.636; p < 0.001). Pre-hospital shock was predictive for SI and CSI (OR 1.87 and OR 2.342, respectively; both p < 0.001), and diminished or absent motor response was also predictive for SI (OR 3.171) and CSI (OR 7.462; both p < 0.001). Patients over 65 years of age were more frequently affected by CSI. Conclusions In addition to the clinical symptoms of pain, we identify ‘4S’ [spill (fall) > 3 m, seniority (age > 65 years), seriously injured, skull/traumatic brain injury] as an indication for increased attention for CSIs or indication for spinal motion restriction.

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Section: Discussionmentioning

confidence: 99%

Epidemiology and predictors of traumatic spine injury in severely injured patients: implications for emergency procedures

Häske

Lefering

Stock

et al. 2020

Eur J Trauma Emerg Surg

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“…2) Az ajánlás egyetért a korábbi irodalmakban ajánlottakkal, miszerint az éber, ABCDE stabil betegek megtalálják a megfelelő pozíciót, mely számukra kényelmes és csökkenti a fájdalmat a gerincük stabilizálása érdekében [37,38].…”

Section: Elősegíti-e a Triage Eszköz Alkalmazása A Döntés Meghozását Hogy Milyen Módszerrel Rögzítsük (Vagy Ne Rögzítsük) A Gerincet?unclassified

gerincsérültek rögzítése-merre tovább

Bánfai-Csonka

Bánfai

2021

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traumás gerincvelő sérülések előfordulása viszonylag alacsony, azonban nem elhanyagolható kórkép, hiszen visszafordíthatatlan következményekkel járhat, ha nem ismerjük fel időben. Már az 1960-as évektől kezdve számos országban a gerincsérültek ellátásának protokollja tartalmazza a merev nyakrögzítő gallér és a gerinchordágy (board) használatát, azonban ezen eszközök alkalmazásának hatékonysága már többször felmerült kérdésként, azonban magas evidenciával bíró tanulmányok hiányában mégsem változtattak érdemben az ellátási protokollokon. Jelen közleményünk célja, hogy felhívja a figyelmet ezen eszközök használatának esetleges hátrányaira, veszélyeire, mindezt egy dán szisztematikus összefoglaló közlemény alapján. Ezen szakirodalmi áttekintés alapján a „Danish National Board of Health” új ajánlást fogalmazott meg, mely nem a baleseti mechanizmus alapján dönt a gerinc rögzítéséről és annak módjáról, hanem a klinikai/fizikális vizsgálatok eredményei alapján. Hazánkban is fontos lenne ezen irányelvek átgondolása és egyesítése mind prehospitális, mind pedig hospitális szempontból.

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“…This section presents the main result of this study in the following lemma. (8) satisfying restrictions (9) and (10) with the adaptive controller (19) adjusted with the time-dependent gains and given in (23). If the tuning parameters and of the gains and given in (23) satisfy…”

Section: The Adaptive Controllermentioning

confidence: 99%

“…In particular, the continuous immobilization in all planes can lead to sacral pressure points, heel and elbow breakdown, risk of deep venous thrombosis, muscle atrophy, etc. [19]. Most of these inconveniences can be saved if a complementary mobilization therapy of isometric exercises is realized.…”

Section: Introductionmentioning

confidence: 99%

Impedance Adaptive Controller for a Prototype of a Whiplash Syndrome Rehabilitation Device

Guzman-Victoria

Salgado

Mera

et al. 2019

Mathematical Problems in Engineering

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The objective of this study was to design of an output based impedance adaptive controller for a special class of cervical orthoses, a class of biomedical devices for the rehabilitation of neck illnesses. The controller used the adaptive sliding mode theory to enforce the tracking of the reference trajectory if the patient was not resistant to the therapy. If the patient rejects the orthosis activity, a second impedance-based controller governs the orthosis movement allowing the patient to take the leading role in the orthosis sequence of movements. The proposed controller considers a weighted controller combining the tracking and the impedance controls in a single structure. The monitoring of the external force was evaluated on a novel weighting function defining on-line the role of each controller. The proposed orthosis was motivated by the prevalence of whiplash, which is a syndrome that is produced by forced hyperextension and hyperflexion of the neck. This study included the development of a technological prototype of the orthotic type to support the recovery of patients diagnosed with whiplash. The sections that make up the orthotic device are two independent systems that move the patient’s head in the sagittal and frontal planes. For this purpose, the mechanical structure of the cervical orthosis was made up of 7 pieces printed in 3D with polylactic acid (PLA). The operation of the cervical orthosis was evaluated in two sections: (a) using a simulation system, which consists of a spring with an artificial head and the development of a graphic interface in Matlab, and (b) evaluating the controller on the proposed orthosis. With these elements, the follow-up of the trajectory proposed by the actuators was evaluated, as well as its performance in the face of the opposition that a patient generates. The superiority of the proposed controller was confirmed by comparing the tracking efficiency with proportional-integral-derivative and first-order sliding variants.

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No place for the rigid cervical collar in pre-hospital care

Cited by 9 publications

References 29 publications

Epidemiology and predictors of traumatic spine injury in severely injured patients: implications for emergency procedures

Epidemiology and predictors of traumatic spine injury in severely injured patients: implications for emergency procedures

gerincsérültek rögzítése-merre tovább

Impedance Adaptive Controller for a Prototype of a Whiplash Syndrome Rehabilitation Device

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