The 6-Plus–Person Lift Transfer Technique Compared With Other Methods of Spine Boarding

Abstract

NYContext: To achieve full spinal immobilization during on-thefield management of an actual or potential spinal injury, rescuers transfer and secure patients to a long spine board. Several techniques can be used to facilitate this patient transfer.Objective: To compare spinal segment motion of cadavers during the execution of the 6-plus-person (6+) lift, lift-and-slide (LS), and logroll (LR) spine-board transfer techniques.Design: Crossover study. Setting: Laboratory.Patients or Other Participants: Eight medical professionals (1 woman, 7 men) with 5 to 32 years of experience were enlisted to help carry out the transfer techniques. In addition, test conditions were performed on 5 fresh cadavers (3 males, 2 females) with a mean age of 86.2 6 11.4 years.Main Outcomes Measure(s): Three-dimensional angular and linear motions initially were recorded during execution of transfer techniques, initially using cadavers with intact spines and then after C5-C6 spinal segment destabilization. The mean maximal linear displacement and angular motion obtained and calculated from the 3 trials for each test condition were included in the statistical analysis.Results: Flexion-extension angular motion, as well as anteroposterior and distraction-compression linear motion, did not vary between the LR and either the 6+ lift or LS. Compared with the execution of the 6+ lift and LS, the execution of the LR generated significantly more axial rotation (P 5 .008 and .001, respectively), more lateral flexion (P 5 .005 and .003, respectively), and more medial-lateral translation (P 5 .003 and .004, respectively).Conclusions: A small amount of spinal motion is inevitable when executing spine-board transfer techniques; however, the execution of the 6+ lift or LS appears to minimize the extent of motion generated across a globally unstable spinal segment.Key Words: prehospital care, spine injuries, spinal immobilization, logroll transfer technique, lift-and-slide transfer technique Key Points N The 6-plus-person lift and lift-and-slide transfer techniques appeared to minimize the motion generated across an unstable spinal segment.N Significantly more lateral flexion and axial rotation was generated with the logroll maneuver than with the lift-and-slide and 6-plus-person lift techniques.

Cervical Collars are Insufficient for Immobilizing an Unstable Cervical Spine Injury

“…In our earlier studies using a similar cadaveric model and electromagnetic measurement of motion at the C5-C6 level, we assessed the effectiveness of collars indirectly (7,10,(14)(15)(16). In these previous studies, transfer techniques were evaluated as a cadaver was moved either onto a spineboard, from one hospital bed to another, or from supine to prone for surgical positioning.…”

“…Other studies have used radiographic or video techniques to measure restriction of motion in healthy individuals with no instability (2)(3)(4)(5)(6). The effectiveness of collar immobilization has been indirectly evaluated in other studies involving cadavers and induced instabilities (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). In each of these studies, collars were used in an attempt to reduce spine motion during one or more transfer techniques.…”

Does Application Position of the T-POD Affect Stability of Pelvic Fractures?

“…It has been previously used and validated in the study of unstable traumatic injuries. [27][28][29][30][31][32][33][34][35][36][37][38] We feel that the use of OTA type 61-C1 injuries is another strength given that these represent the "worst case scenario" or completely unstable pelvic fractures. Such injuries carry the greatest risk of severe hemorrhage and would most benefit from the best method of temporary immobilization.…”

Is it safe to use a kinetic therapy bed for care of patients with cervical spine injuries?

“…Another major limitation was the use of only a single kinetic therapy bed. The main strengths of the current study include the use of a large number of cadavers and the use of a well-established spinal injury testing methodology [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30].…”