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Cervical spine immobilisation following blunt trauma in pre-hospital and emergency care: A systematic review.
Pandor, Abdullah; Essat, Munira; Sutton, Anthea; Fuller, Gordon; Reid, Stuart; Smith, Jason E; Fothergill, Rachael; Surendra Kumar, Dhushy; Kolias, Angelos; Hutchinson, Peter; Perkins, Gavin D; Wilson, Mark H; Lecky, Fiona.
Afiliación
  • Pandor A; SCHARR, University of Sheffield, Sheffield, United Kingdom.
  • Essat M; SCHARR, University of Sheffield, Sheffield, United Kingdom.
  • Sutton A; SCHARR, University of Sheffield, Sheffield, United Kingdom.
  • Fuller G; SCHARR, University of Sheffield, Sheffield, United Kingdom.
  • Reid S; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom.
  • Smith JE; Department of Emergency, University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom.
  • Fothergill R; London Ambulance Service NHS Trust, London, United Kingdom.
  • Surendra Kumar D; Department of Critical Care, University Hospitals Coventry and Warwickshire, Coventry, United Kingdom.
  • Kolias A; Department of Clinical Neurosciences, Addenbrooke's Hospital & University of Cambridge, Cambridge, United Kingdom.
  • Hutchinson P; Department of Clinical Neurosciences, Addenbrooke's Hospital & University of Cambridge, Cambridge, United Kingdom.
  • Perkins GD; Warwick Medical School, University of Warwick, Coventry, United Kingdom.
  • Wilson MH; Imperial College London, St Mary's Hospital, London, United Kingdom.
  • Lecky F; SCHARR, University of Sheffield, Sheffield, United Kingdom.
PLoS One ; 19(4): e0302127, 2024.
Article en En | MEDLINE | ID: mdl-38662734
ABSTRACT

OBJECTIVES:

To assess whether different cervical spine immobilisation strategies (full immobilisation, movement minimisation or no immobilisation), impact neurological and/or other outcomes for patients with suspected cervical spinal injury in the pre-hospital and emergency department setting.

DESIGN:

Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES MEDLINE, EMBASE, CINAHL, Cochrane Library and two research registers were searched until September 2023. ELIGIBILITY CRITERIA All comparative studies (prospective or retrospective) that examined the potential benefits and/or harms of immobilisation practices during pre-hospital and emergency care of patients with a potential cervical spine injury (pre-imaging) following blunt trauma. DATA EXTRACTION AND

SYNTHESIS:

Two authors independently selected and extracted data. Risk of bias was appraised using the Cochrane ROBINS-I tool for non-randomised studies. Data were synthesised without meta-analysis.

RESULTS:

Six observational studies met the inclusion criteria. The methodological quality was variable, with most studies having serious or critical risk of bias. The effect of cervical spine immobilisation practices such as full immobilisation or movement minimisation during pre-hospital and emergency care did not show clear evidence of benefit for the prevention of neurological deterioration, spinal injuries and death compared with no immobilisation. However, increased pain, discomfort and anatomical complications were associated with collar application during immobilisation.

CONCLUSIONS:

Despite the limited evidence, weak designs and limited generalisability, the available data suggest that pre-hospital cervical spine immobilisation (full immobilisation or movement minimisation) was of uncertain value due to the lack of demonstrable benefit and may lead to potential complications and adverse outcomes. High-quality randomised comparative studies are required to address this important question. TRIAL REGISTRATION PROSPERO REGISTRATION Fiona Lecky, Abdullah Pandor, Munira Essat, Anthea Sutton, Carl Marincowitz, Gordon Fuller, Stuart Reid, Jason Smith. A systematic review of cervical spine immobilisation following blunt trauma in pre-hospital and emergency care. PROSPERO 2022 CRD42022349600 Available from https//www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022349600.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Traumatismos Vertebrales / Heridas no Penetrantes / Vértebras Cervicales / Servicios Médicos de Urgencia / Inmovilización Límite: Humans Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Traumatismos Vertebrales / Heridas no Penetrantes / Vértebras Cervicales / Servicios Médicos de Urgencia / Inmovilización Límite: Humans Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido
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