Prehospital Emergency Care 2015


1. Prehosp Emerg Care. 2015 January-March;19(1):116-125. Epub 2014 Jul 30.

Cervical Spine Motion during Transfer and Stabilization Techniques.

Shrier I, Boissy P, Lebel K, Boulay J, Segal E, Delaney JS, Vacon LC, Steele RJ.

Abstract Objectives. To compare paramedics' ability to minimize cervical spine
motion during patient transfer onto a vacuum mattress with two stabilization
techniques (head squeeze vs. trap squeeze) and two transfer methods (log roll
with one assistant (LR2) vs. 3 assistants (LR4)). Methods. We used a crossover
design to minimize bias. Each lead paramedic performed 10 LR2 transfers and 10
LR4 transfers. For each of the 10 LR2 and 10 LR4 transfers, the lead paramedic
stabilized the cervical spine using the head squeeze technique five times and the
trap squeeze technique five times. We randomized the order of the stabilization
techniques and LR2/LR4 across lead paramedics to avoid a practice or fatigue
effect with repeated trials. We measured relative cervical spine motion between
the head and trunk using inertial measurement units placed on the forehead and
sternum. Results. On average, total motion was 3.9° less with three assistants
compared to one assistant (p = 0.0002), and 2.8° less with the trap squeeze
compared to the head squeeze (p = 0.002). There was no interaction between the
transfer method and stabilization technique. When examining specific motions in
the six directions, the trap squeeze generally produced less lateral flexion and
rotation motion but allowed more extension. Examining within paramedic
differences, some paramedics were clearly more proficient with the trap squeeze
technique and others were clearly more proficient with the head squeeze
technique. Conclusion. Paramedics performing a log roll with three assistants
created less motion compared to a log roll with only one assistant, and using the
trap squeeze stabilization technique resulted in less motion than the head
squeeze technique but the clinical relevance of the magnitude remains unclear.
However, large individual differences suggest future paramedic training should
incorporate both best evidence practice as well as recognition that there may be
individual differences between paramedics.

PMID: 25076192  [PubMed - as supplied by publisher]





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