https://doi.org/10.4081/scenario.2024.583
The use of the spinal immobilization in prehospital settings is still the most effective device for the patient’s safety? A narrative review of the literature
Submitted: 3 February 2024
Accepted: 12 May 2024
Published: 20 May 2024
Accepted: 12 May 2024
Abstract Views: 1246
PDF (Italiano): 341
Materiali supplementari (Italiano): 87
Materiali supplementari (Italiano): 87
Publisher's note
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Introduction: in out-of-hospital treatment, immobilization of the spine with the spinal board and cervical collar has been considered the best method to ensure patient safety for many years. In recent years, many doubts have arisen about the actual effectiveness of this practice. The aim of this paper is to find out if this garment is still the best for the patient and to find possible alternatives to its use.
Materials and Methods: a literature search was conducted by consulting Medline databases via PubMed, GoogleScholar, Web of science and Scopus. The search was conducted in the month of January 2023. Articles in Italian and English dealing with the use of the spinal board and other immobilization aids published within the last 5 years were included.
Results: 33 articles were identified in the various databases and 10 articles were subsequently included in the review.
Discussion: the use of the spinal board in the out-of-hospital setting is no longer the most effective method of ensuring patient safety and can only be used in certain cases. The use of spinal motion restriction takes the field as an alternative technique.
Conclusions: it is necessary that standard immobilization with a cervical collar and spinal board be performed only incases where it is considered truly necessary. Operators should use tools that help them identify such high-risk individuals.
Feller R, Furin M, Alloush A, Reynolds C. EMS Immobilization Techniques. 2022 Oct 3. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 29083568.
White CC 4th, Domeier RM, Millin MG; Standards and Clinical Practice Committee, National Association of EMS Physicians. 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;18:306-14.
Sanson G, Nardi G, De Blasio E, et al. Prehospital Trauma Care-Approccio e trattamento al traumatizzato in fase preospedaliera e nella prima fase intraospedaliera. Italian Resuscitation Council, 2007.
Castro-Marin F, Gaither JB, Rice AD, et al. Prehospital protocols reducing long spinal board use are not associated with a change in incidence of spinal cord injury. Prehosp Emerg Care 2020;24:401-10.
Fischer PE, Perina DG, Delbridge TR, et al. Spinal motion restriction in the trauma patient - a joint position statement. Prehosp Emerg Care 2018;22:659-61.
Häske D, Blumenstock G, Hossfeld B, et al. The immo traffic light system as a decision-making tool for prehospital spinal immobilization. DtschArztebl Int 2022;119:753-8.
Maschmann C, Jeppesen E, Rubin MA, Barfod C. New clinical guidelines on the spinal stabilisation of adult trauma patients - consensus and evidence based. Scand J Trauma Resusc Emerg Med 2019;27:77.
Cuthbertson JL, Weinstein ES. Spinal immobilization in disasters: a systematic review. Prehosp Disaster Med 2020;35:406-11.
Sumann G, Moens D, Brink B, et al. Multiple trauma management in mountain environments - a scoping review Evidence based guidelines of the International Commission for Mountain Emergency Medicine (ICAR MedCom). Intended for physicians and other advanced life support personnel. Scand J Trauma Resusc Emerg Med 2020;28:117.
Lacey L, Palokas M, Walker J. Preventative interventions, protocols or guidelines for trauma patients at risk of cervical collar-related pressure ulcers: a scoping review. JBI Database System Rev Implement Rep 2019;17:2452-75.
Patel MB, Humble SS, Cullinane DC, et al. Cervical spine collar clearance in the obtunded adult blunt trauma patient: a systematic review and practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg 2015;78:430-41.
Velopulos CG, Shihab HM, Lottenberg L, et al. Prehospital spine immobilization/spinal motion restriction in penetrating trauma: A practice management guideline from the Eastern Association for the Surgery of Trauma (EAST). J Trauma Acute Care Surg 2018;84:736-44.
Alghamdi I, Bazaie N, Alqurashi N, Ahmed Z. The impact of prehospital spinal immobilization in patients with penetrating spinal injuries: a systematic review and meta-analysis. Trauma Care 2022;2:226-37.
Geldenhuys MJ, Downing C. Evidence-based nursing care for spinal nursing immobilization: a systematic review. J Emerg Nurs 2020;46:318-37.
Habibi Arejan R, Asgardoon MH, Shabany M, et al. Evaluating prehospital care of patients with potential traumatic spinal cord injury: scoping review. Eur Spine J 2022;31:1309-29.
National Association of EMS Physicians and American College of Surgeons Committee on Trauma. EMS Spinal Precautions and the Use of the Long Backboard. 2013. doi: 10.3109/10903127.2013.773115.
McDonald N, Kriellaars D, Weldon E, Pryce R. Head-neck motion in prehospital trauma patients under spinal motion restriction: a pilot study. Prehosp Emerg Care 2021;25:117-24.
Gabrieli A, Nardello F, Geronazzo M, et al. Cervical spine motion during vehicle extrication of healthy volunteers. Prehosp Emerg Care 2020;24:712-20.
How to Cite
Righi, L., Dell'Anno, A., & Trapassi, S. (2024). The use of the spinal immobilization in prehospital settings is still the most effective device for the patient’s safety? A narrative review of the literature. Scenario® - Il Nursing Nella Sopravvivenza, 41(2). https://doi.org/10.4081/scenario.2024.583
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