The definite risks and questionable benefits of liberal pre-hospital spinal immobilisation

Purvis, Thomas Adam; Carlin, Brian; Driscoll, Peter

doi:10.1016/j.ajem.2017.01.045

Cited by 36 publications

(27 citation statements)

References 23 publications

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“…Few studies have evaluated the effectiveness of manual stabilization techniques such as head-squeeze or trap-squeeze. 145,146 Specific knowledge gaps include interventions that may be of benefit when providing first aid to a spine-injured/high-risk spinal injury patient, such as verbal prompts or manual stabilization, while awaiting arrival of advanced care providers.…”

Section: [H2]cervical Spine Motion Restrictionmentioning

confidence: 99%

ILCOR Scientific Knowledge Gaps and Clinical Research Priorities for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: A Consensus Statement

Kleinman¹,

Perkins²,

Bhanji³

et al. 2018

Circulation

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Despite significant advances in the field of resuscitation science, important knowledge gaps persist. Current guidelines for resuscitation are based on the International Liaison Committee on Resuscitation 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, which includes treatment recommendations supported by the available evidence. The writing group developed this consensus statement with the goal of focusing future research by addressing the knowledge gaps identified during and after the 2015 International Liaison Committee on Resuscitation evidence evaluation process. Key publications since the 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations are referenced, along with known ongoing clinical trials that are likely to affect future guidelines.

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Section: [H2]cervical Spine Motion Restrictionmentioning

confidence: 99%

ILCOR Scientific Knowledge Gaps and Clinical Research Priorities for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: A Consensus Statement

Kleinman¹,

Perkins²,

Bhanji³

et al. 2018

Circulation

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“…In contrast, there is strong evidence that the prehospital spinal immobilisation is associated with complications ranging from discomfort to significant physiological compromise [13].…”

Section: Discussionmentioning

confidence: 99%

Patient experience of spinal immobilisation after trauma

Ottosen

Steinmetz

Larsen

et al. 2019

Scand J Trauma Resusc Emerg Med

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Background Spinal immobilisation of blunt trauma victims with potential spinal cord injury is considered standard of care. The traditional management has, however, been increasingly questioned and concerns about harm have been raised. Few studies have described the perspective of the trauma patient regarding the spinal immobilisation. The objective of this study was therefore to evaluate the patient experience of immobilisation after trauma. Methods We prospectively screened adult trauma patients admitted to a level 1 trauma centre for eligibility. We included adult trauma patients who had been, and remembered being, immobilised for spinal protection with a cervical collar and a spine board prehospitally or upon arrival at the trauma centre. A semi-structured interview was conducted 2 to 72 h after admission either in person or by telephone. Results One hundred and fourteen patients were eligible for inclusion based on the patient charts. Out of 98 patients assessed for participation, 48 (49%) had no memory of being immobilised. We thus included 50 patients with a median age of 37 years (IQR: 26–60) of whom 38 (76%) were men. The median injury severity score was 9 (IQR: 3–15) and the median time with a cervical collar from initial application to in-hospital removal or until the interview was given was 91 min (IQR: 72–136). Nineteen patients (38%) reported discomfort and 12 patients (24%) experienced pain related to the immobilisation. Forty patients (80%) reported a sense of protection related to the immobilisation. Conclusion Discomfort related to spinal immobilisation was reported in 38% of trauma patients. However, a sense of protection was a recurring theme in 80% of the trauma patients, who recalled being immobilised. Nearly half of the awake trauma patients had no memory of being immobilised.

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“…Da bei der Nutzung hyperangulierter Spatel keine optische Achse zur Glottis hergestellt werden muss, ist zwar eine geringere Mundöffnung notwendig, doch dürfte selbst diese bei korrekt anliegender Zervikalstütze das Einführen eines Spatels unmöglich machen. Deshalb erfolgt die endotracheale Intubation grundsätzlich in MILS [4,12,22,27,28].…”

Section: Immobilisation Der Hwsunclassified

Atemwegsmanagement bei Verletzungen der Halswirbelsäule

Obermaier¹,

Schneider²,

Popp³

et al. 2020

Notarzt

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ZusammenfassungDas Atemwegsmanagement bei Trauma der Halswirbelsäule ist eine Herausforderung: Der vital bedrohte Patient soll eine suffiziente Immobilisation erhalten, wodurch aber die Atemwegssicherung erschwert wird. Der Beitrag thematisiert den Stellenwert von Immobilisierung und Atemwegssicherung in dieser zeitkritischen Situation, Vorteile und Fallstricke verschiedener Atemwegshilfsmittel sowie die pathoanatomischen und pathophysiologischen Hintergründe.

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The definite risks and questionable benefits of liberal pre-hospital spinal immobilisation

Cited by 36 publications

References 23 publications

ILCOR Scientific Knowledge Gaps and Clinical Research Priorities for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: A Consensus Statement

ILCOR Scientific Knowledge Gaps and Clinical Research Priorities for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: A Consensus Statement

Patient experience of spinal immobilisation after trauma

Atemwegsmanagement bei Verletzungen der Halswirbelsäule

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