Vol 9, No 2 (2024)
Research paper
Published online: 2023-12-22
ATTITUDES OF PREHOSPITAL EMERGENCY HEALTH CARE WORKERS TOWARDS SPINAL CORD IMMOBILIZATION IN PATIENTS WITH MULTIPLE TRAUMA
1
, 1, 1, 1
, 1, 1, 1
DOI: 10.5603/demj.95409
Disaster Emerg Med J 2024;9(2):65-72.
Abstract
INTRODUCTION: To evaluate the attitudes of prehospital emergency health care workers towards spinal cord immobilization in trauma patients.
MATERIAL AND METHODS: This is a descriptive study, and its participants were 407 pre-hospital emergency healthcare workers working in a province in the west of the country between April 2022 and October 2022. The data were collected online with a questionnaire consisting of twenty-four questions. Statistical significance was defined as a p value of 0.05 for all analyses.
RESULTS: 73% of the participants that they decided to perform routine spinal cord immobilization in all trauma patients regardless of the clinical findings. 85% of the participants said they generally preferred the backboard for spinal cord immobilization of trauma-injured people.
CONCLUSIONS: The study showed that prehospital emergency health care workers stated that they routinely perform spinal cord immobilization in every traumatized patient, despite knowing the indication for spinal cord immobilization of trauma patients.
Keywords: backboardparamedicspinal cordtraumavacuum stretcher
References
- Cameron AP, Kna JB, Teeter W. Trauma in adults. In: Tintinalli JE, et al. ed. Tintinalli’s emergency medicine: a comprehensive study guide. McGraw Hill Education 2020: 1669–1762.
- Yıldırım SA. General aroach to trauma cases. In: Ekşi A, Gümüşsoy S. ed. Trauma book in pre-hosital emergency health service. EMA Tıp Kitapevi, Istanbul 2020: 3–22.
- Turkish Statistical Institute. Cause of Death Statistics. https://data.tuik.gov.tr/Kategori/GetKategori?p=saglik-ve-sosyal-koruma-101&dil=1 (19.01.2023).
- Sarı A. Retrospective evaluation of sociodemographic characteristics and clinical outcomes of patients applying to pamukkale university faculty of medicine hospital emergency department by 112 ambulance. 2020. http://acikerisim.pau.edu.tr:8080/xmlui/handle/11499/35293 (19.01.2023).
- Alizadeh A, Dyck SM, Karimi-Abdolrezaee S. Traumatic spinal cord injury: an overview of pathophysiology, models and acute injury mechanisms. Front Neurol. 2019; 10: 282.
- Hagan M, Feler J, Sun F, et al. Spinal cord injury in adult and pediatric populations. Interdisciplinary Neurosurgery. 2022; 29: 101594.
- Galeiras Vázquez R, Ferreiro Velasco ME, Mourelo Fariña M, et al. Update on traumatic acute spinal cord injury. Part 1. Med Intensiva. 2017; 41(4): 237–247.
- Kondapalli S, Parikh P, Repas S, et al. Benchmarking performance in emergency medical services for improving trauma care: A data driven approach. Inform Med Unlocked. 2022; 29: 100882.
- Paksoy VM. Comparison of international practice models in emergency health care: anglo-american and franco-german model. Journal Of Vocational School Of Health Service. 2016. https://dergipark.org.tr/en/pub/inonusaglik/issue/26767/410372 (16.01.2023).
- Middleton PM, Davies SR, Anand S, et al. The pre-hospital epidemiology and management of spinal cord injuries in New South Wales: 2004–2008. Injury. 2012; 43(4): 480–485.
- Geduld C, Muller H, Saunders CJ. Factors which affect the application and implementation of a spinal motion restriction protocol by prehospital providers in a low resource setting: A scoping review. Afr J Emerg Med. 2022; 12(4): 393–405.
- Kaba H. Stabilization of the patient with spinal trauma. In: Ekşi A, Gümüşsoy S. ed. Trauma book in pre-hospital emergency health service. EMA Tıp Kitapevi, Istanbul 2020: 349–366.
- White CC, Domeier RM, Millin MG, et al. EMS spinal precautions and the use of the long backboard - resource document to the position statement of the National Association of EMS Physicians and the American College of Surgeons Committee on Trauma. Prehosp Emerg Care. 2014; 18(2): 306–314.
- Fischer PE, Perina DG, Delbridge TR, et al. Spinal motion restriction in the trauma patient — a joint position statement. Prehosp Emerg Care. 2018; 22(6): 659–661.
- Purvis TA, Carlin B, Driscoll P. The definite risks and questionable benefits of liberal pre-hospital spinal immobilisation. Am J Emerg Med. 2017; 35(6): 860–866.
- Mahshidfar B, Mofidi M, Yari AR, et al. Long backboard versus vacuum mattress splint to immobilize whole spine in trauma victims in the field: a randomized clinical trial. Prehosp Disaster Med. 2013; 28(5): 462–465.
- Jones Rhodes W, Steinbruner D, Finck L, et al. Community implementation of a prehospital spinal immobilization guideline. Prehosp Emerg Care. 2016; 20(6): 792–797.
- Barney R, Cordell w, Miller E. Pain associated with i̇mmobilization on rigid spine boards. Ann Emergy Med. 1989; 18(9): 918.
- Lerner EB, Billittier AJ, Moscati RM. The effects of neutral positioning with and without padding on spinal immobilization of healthy subjects. Prehosp Emerg Care. 1998; 2(2): 112–116.
- Berg G, Nyberg S, Harrison P, et al. Near-infrared spectroscopy measurement of sacral tissue oxygen saturation in healthy volunteers immobilized on rigid spine boards. Prehosp Emerg Care. 2010; 14(4): 419–424.
- Milland K, Al-Dhahir MA. EMS long spine board immobilization. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK567763/ (22.01.2023).
- Pernik MN, Seidel HH, Blalock RE, et al. Comparison of tissue-interface pressure in healthy subjects lying on two trauma splinting devices: the vacuum mattress splint and long spine board. Injury. 2016; 47(8): 1801–1805.
- Cross DA, Baskerville J. Comparison of perceived pain with different immobilization techniques. Prehosp Emerg Care. 2001; 5(3): 270–274.
- Rahmatalla S, DeShaw J, Stilley J, et al. Comparing the efficacy of methods for immobilizing the thoracic-lumbar spine. Air Med J. 2018; 37(3): 178–185.
- Wampler DA, Pineda C, Polk J, et al. The long spine board does not reduce lateral motion during transport — a randomized healthy volunteer crossover trial. Am J Emerg Med. 2016; 34(4): 717–721.
- Johnson DR, Hauswald M, Stockhoff C. Comparison of a vacuum splint device to a rigid backboard for spinal immobilization. Am J Emerg Med. 1996; 14(4): 369–372.
- Quinn RH, Williams J, Bennett BL, et al. Wilderness Medical Society. Wilderness Medical Society practice guidelines for spine immobilization in the austere environment: 2014 update. Wilderness Environ Med. 2014; 25(4 Suppl): S105–S117.
- Ellerton J, Tomazin I, Brugger H, et al. Immobilization and splinting in mountain rescue. Official recommendations of the International Commission for Mountain Emergency Medicine, ICAR MEDCOM, Intended for Mountain Rescue First Responders, Physicians, and Rescue Organizations. High Altitude Medicine & Biology. 2009; 10(4): 337–342.
- Uzun DD, Jung MK, Weerts J, et al. Remaining cervical spine movement under different immobilization techniques. Prehosp Disaster Med. 2020; 35(4): 382–387.
- Vaillancourt C, Charette M, Taljaard M, et al. Pragmatic strategy empowering paramedics to assess low-risk trauma patients with the canadian c-spine rule and selectively transport them without immobilization: protocol for a stepped-wedge cluster randomized trial. JMIR Res Protoc. 2020; 9(6): e16966.
- Bauer D, Kowalski R. Effect of spinal immobilization devices on pulmonary function in the healthy, nonsmoking man. Ann Emerg Med. 1988; 17(9): 915–918.
- Walsh M, Grant T, Mickey S. Lung function compromised by spinal immobilization. Ann Emerg Med. 1990; 19(5): 615–616.
- Abram S, Bulstrode C. Routine spinal immobilization in trauma patients: what are the advantages and disadvantages? Surgeon. 2010; 8(4): 218–222.