Effectiveness of Cervical Spine Stabilization Techniques

Boissy, Patrick; Shrier, Ian; Brière, Simon; Mellete, J; Fecteau, Luc; Matheson, Gordon O.; Garza, Dan; Meeuwisse, Willem; Segal, Eli; Boulay, John; Steele, Russell

doi:10.1097/jsm.0b013e31820f8ad5

Cited by 39 publications

(50 citation statements)

References 16 publications

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“…Although the Trap Squeeze is superior compared to the Head Squeeze (<10° vs >20°) when a patient is agitated, 19 it was only slightly superior to the Head Squeeze for a cooperative patient during a LR conducted with 3 assistants. 19 These results may not be generalizable to paramedic pre-hospital care conditions where paramedics work in pairs, and there is often only one assistant immediately available.…”

Section: Introductionmentioning

confidence: 83%

“…As in previous studies by our group and others, 19, 23, 28 we used a standard epidemiological crossover design to minimize confounding bias and variability. In this design, the paramedic responsible for cervical spine stabilization at the head (lead paramedic) performed each of the "interventions" (i.e.…”

Section: Methodsmentioning

confidence: 99%

“…19 These results may not be generalizable to paramedic pre-hospital care conditions where paramedics work in pairs, and there is often only one assistant immediately available.…”

Section: Introductionmentioning

confidence: 97%

“…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. 9 This is because the lift-and-slide is often not feasible given it requires 6-8+ persons, and several feet of space around the patient on all sides 9,22 .…”

Section: Introductionmentioning

confidence: 99%

“…24,25 In the "Trap Squeeze" technique, 19, 26, 27 the lead paramedic grabs the patient's upper shoulders and muscles on either side of the neck (trapezius muscle) and firmly squeezes the head between the forearms. In this way, the lead paramedic limits cervical spine motion by stabilizing the head (via the forearms) to the trunk (via the grip on the trapezius).…”

Section: Introductionmentioning

confidence: 99%

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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: 83%

Section: Methodsmentioning

confidence: 99%

“…19 These results may not be generalizable to paramedic pre-hospital care conditions where paramedics work in pairs, and there is often only one assistant immediately available.…”

Section: Introductionmentioning

confidence: 97%