Routine spinal immobilization in trauma patients: What are the advantages and disadvantages?

Abram, Simon G F; Bulstrode, C.

doi:10.1016/j.surge.2010.01.002

Cited by 63 publications

(51 citation statements)

References 29 publications

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“…9 Moreover, and perhaps more concerning, there is a growing body of evidence and opinion against the use of collars. [9][10][11][12][13][14] Improving prehospital management has a substantial effect on society as a whole and is a high-priority research area. 15 In this review, we argue that it is time to reconsider the unjustified dogma of collar use in prehospital trauma care.…”

Section: Introductionmentioning

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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Section: Introductionmentioning

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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“…[19]  Confounding clinical examination and vital sign recordings. [20] Hauswald, [21] and the authors of three systematic reviews, [18,22,23] conclude that phSI may be contributing to patient morbidity and mortality.…”

Section: Side Effectsmentioning

confidence: 99%

“…In the systematic review by Abram et al, [23] the number of immobilisations needed to prevent one patient from suffering permanent neurological damage was calculated using the work of Davis and Platzer. [25,26] The Number Needed to Treat (NNT) from Davis et al was 150, and from Platzer et al was 392.…”

Section: Benefitsmentioning

confidence: 99%

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

Purvis

Carlin

Driscoll

2017

The American Journal of Emergency Medicine

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Intro:The routine practice of pre-hospital spinal immobilisation (phSI) for patients with suspected spinal injury has existed for decades. However, the controversy surrounding it resulted in the 2013 publication of a Consensus document by the Faculty of Pre-Hospital Care. The question remains as to whether the quality of evidence in the literature is sufficient to support the Consensus guidelines. This critical review aims to determine the validity of current recommendations by balancing the potential benefits and side effects of phSI. Method.A review of the literature was carried out by two independent assessors using Medline, PubMed, EMBASE and the Cochrane Library databases. Manual searches of related journals and reference lists were also completed. The selected body of evidence was subsequently appraised using a checklist derived from SIGN and CASP guidelines, as well as Crombie's guide to critical appraisal.

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“…Spinal immobilisation using these techniques is not without negative sequelae 2. There is the potential for harm to be caused by the log-rolling used to place and remove the patient on the spinal board and by the immobilisation on the spinal board.…”

Section: Introductionmentioning

confidence: 99%

Minimal patient handling: a faculty of prehospital care consensus statement

2013

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This paper outlines the emerging best practice when packaging a prehospital trauma patient while providing spinal immobilisation. The best practice described is based on the recommendations of a consensus meeting held by the Faculty of Pre-Hospital Care, Royal College of Surgeons of Edinburgh, in the West Midlands in April 2012, where the opinion of experienced practitioners from across the prehospital and emergency care community considered the currently available evidence and reviewed current clinical practice. Initial consensus points were then subject to further review and dialogue with stakeholders from the initial meeting. The recommendations drawn from the meeting and subsequent dialogue represent a 'general agreement' to the principles and practices described in the paper. The recommendations will provide guidance for clinical practice and governance alongside other consensus statements from the Faculty of Pre-Hospital Care that seek to address prehospital spinal immobilisation and pelvic immobilisation.

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Routine spinal immobilization in trauma patients: What are the advantages and disadvantages?

Cited by 63 publications

References 29 publications

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

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

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

Minimal patient handling: a faculty of prehospital care consensus statement

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