Motion in the Unstable Cervical Spine During Hospital Bed Transfers

Conrad, Bryan P.; Rechtine, Glenn R.; Weight, Mark; Clarke, Joanne M.; Horodyski, MaryBeth

doi:10.1097/ta.0b013e3181e89f58

Cited by 18 publications

(12 citation statements)

References 29 publications

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“…In such cases the collar may be withheld or used intermittently. The collar may provide support during certain manoeuvres, such as in stretcher transfers or during evacuation from a vehicle, after which the collar may be opened or removed [99, 117]. With adequate MILS this can be achieved with minimal spinal displacement [118].…”

Section: Resultsmentioning

confidence: 99%

The Norwegian guidelines for the prehospital management of adult trauma patients with potential spinal injury

Kornhall

Jørgensen

Brommeland

et al. 2017

Scand J Trauma Resusc Emerg Med

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The traditional prehospital management of trauma victims with potential spinal injury has become increasingly questioned as authors and clinicians have raised concerns about over-triage and harm. In order to address these concerns, the Norwegian National Competence Service for Traumatology commissioned a faculty to provide a national guideline for pre-hospital spinal stabilisation. This work is based on a systematic review of available literature and a standardised consensus process. The faculty recommends a selective approach to spinal stabilisation as well as the implementation of triaging tools based on clinical findings. A strategy of minimal handling should be observed.Electronic supplementary materialThe online version of this article (doi:10.1186/s13049-016-0345-x) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

The Norwegian guidelines for the prehospital management of adult trauma patients with potential spinal injury

Kornhall

Jørgensen

Brommeland

et al. 2017

Scand J Trauma Resusc Emerg Med

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“…Conversely, a number of studies have examined spine movement in simulated environments (e.g., cadavers with or without rigor mortis or healthy volunteers) using a wide range of devices and assessment criteria, and the results of these studies are somewhat contradictory and confusing. For instance, studies have shown that collars can be placed and removed without large displacements, 66 a rigid collar can increase movement in the upper cervical spine, 67 there is similar restriction in cervical range of motion using soft and rigid collars, 68 there is less motion with a collar in place than without a collar, 69 using a collar does not effectively reduce motion in an unstable spine, 70,71 there is…”

Section: How Effective Are Cervical Collars?mentioning

confidence: 99%

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

Sundstrøm

Asbjørnsen

Habiba

et al. 2014

Journal of Neurotrauma

144

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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“…For the same outcome, we also identified very-low-quality evidence (downgraded for indirectness) from 13 nonrandomized studies [140][141][142][143][144][145][146][147][148][149][150][151][152] Seven additional studies [153][154][155][156][157][158][159] were not included in the final analysis because they were missing data (mean and/or SD of intervention and control group not reported).…”

Section: (Semi)rigid Collar (I) Compared With No Collar (C)mentioning

confidence: 99%

Part 9: First Aid

Em¹,

Da²,

Buck³

et al. 2015

Circulation

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and curriculum development, and a specialist in first aid evidence evaluation methodology and guideline development.The task force convened in June 2013 to review the topics and questions that were evaluated in 2005 and 2010, past research questions formulated in the PICO style (population, intervention, comparator, outcomes) that were never completed, and the new questions that had been submitted since 2010 to the task force, and a priority list created. Topics were reviewed for areas of controversy, known additional new science, and subject matter not previously evaluated. Task force members created a priority list for review, and the top 10 priority-ranked PICO questions were assigned. After the successful commencement of the workflow, the task force co-chairs added a further 12 PICO questions, including 5 new questions, 1 derived question, and 6 that had been previously reviewed. Selected PICO questions that had been previously reviewed were, in some cases, reworded to facilitate literature searches, and outcomes were decided upon by group consensus.Evidence reviewers were recruited through a call for volunteers distributed by ILCOR to stakeholder organizations around the world. More than 30 individual reviewers were assigned to topics, usually by preference or expertise, but avoiding any direct conflicts of interest. In general, 2 evidence reviewers were assigned to each PICO, supervised by a member of the task force designated as the task force question owner. Evidence reviewers included physicians with diverse specialties including emergency medicine, EMS, wilderness medicine, critical care, cardiology, occupational medicine, toxicology, anesthesia, pediatric emergency medicine, public health, and epidemiology, as well as paramedics, nurse practitioners and first aid education specialists with experience in guideline and curriculum development, and professional evidence evaluation and methodology experts. The Evidence Evaluation ProcessFor the 2015 international evidence evaluation process, the AHA developed a new Web-based information and documentation platform, the Systematic Evidence Evaluation and Review System (SEERS), to support the ILCOR systematic reviews and to capture the data in reusable formats. This Webbased system facilitated structured reviews in a consistent format that would support the ultimate development of science summaries and evidence-based treatment recommendations.Each task force performed a detailed systematic review based on the recommendations of the Institute of Medicine of the National Academies, 1 using the methodological approach proposed by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Working Group.2 After identifying and prioritizing the PICO questions to be addressed, 3 and with the assistance of information specialists, a detailed search for relevant articles was performed in each of 3 online databases (PubMed, Embase, and the Cochrane Library).By using detailed inclusion and exclusion criteria, articles were screened for further evalu...

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Motion in the Unstable Cervical Spine During Hospital Bed Transfers

Abstract: Bed transfers made with a lateral transfer device seem to be as safe as those made by the lift and slide manual transfer. None of the collars tested were significantly better at preventing cervical spine motion during a transfer, but each allowed less movement than no collar.

Cited by 18 publications

References 29 publications

The Norwegian guidelines for the prehospital management of adult trauma patients with potential spinal injury

The Norwegian guidelines for the prehospital management of adult trauma patients with potential spinal injury

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

Part 9: First Aid

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