EMS Journal Club

Topic: Spinal Immobilization
Location: Buffalo Wild Wings East Peoria

Residents discussed the use of prehospital spinal immobilization and how it has changed over time.  Using a literature review, the residents determined that backboards are useful in vehicle and terrain extractions but show minimal benefit for long transports.  They also determined that cervical collars are useful in unconscious or altered patients, or those with neurologic deficits, but are not as useful in neuro-intact patients who were ambulatory on-scene.

EMS World: The Evidence Against Backboards by Dr. Bledsoe

NEXUS, the study:
Hoffman, JR, Mower WR, Wolfson AB, Todd KH, Zucker MI. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. NEJM. 2000; 343(2):94-99.

NAEMSP Position Statement on Spinal Immobilization

Wash U-STL Pilot Study 2009 on Prehospital Spinal Immobilization
Engsberg JR, Standeven JW, Shurtleff TL, Eggars JL, Shafer JS, Naunheim RS. Cervical spine motion during extrication. Journal of Emerg Med. 2013; 44(1):122-127.

Irish biomechanics analysis of prehospital spinal immobilization that got a standing ovation at NAEMSP in 2013:
Dixon M, O'Halloran J, Cummins N. Biomechanical analysis of spinal immobilization during prehospital extrication: a proof of concept study. Emerg Med Journal. 2013.

Ashley Huff, PGY-3