Effect of a cervical collar on head and neck acceleration profiles during emergency spinal immobilisation and extrication procedures in elite football (soccer) players: protocol for a randomised, controlled cross-over trial.

When immobilisation after a cervical spine or head injury is required, the role of the rigid cervical collar is unclear and controversial. There is a need for further studies investigating the use of a rigid cervical collar when head and neck trauma occurs in sport. This study will compare present practice (immobilisation with a cervical collar) to the same procedure without a collar during a simulated spinal immobilisation and extraction scenario from the field of play to the side-line in football (soccer). It will use a prospective cohort within-subjects cross over randomised, controlled trial design. Healthy participants will assume the role of players with a head or neck injury. Clinical practitioners will perform the immobilisation and extrication procedure according to current clinical guidelines. Three dimensional linear and angular acceleration profiles of the head and torso will be measured and the time taken to complete the procedure. The interventions will be a 'cervical collar' or 'no collar' in random order. Data from the IMUs will be transferred wirelessly to a computer for analysis. Accordingly, within-subject differences between each condition (collar vs no collar) will be assessed with parametric or non-parametric inferential statistics. Statistical significance will be set at p<0.05. Trial registration number: ISRCTN16515969.

How to deploy online guidance during a major incident.

The experience of users of the web resource developed by the Health Protection Agency, following the arrival of H1N1 influenza, can be used to formulate criteria for web communication of up-to-date guidance in any incident management. Users participated in an online questionnaire survey. Responses were analysed quantitatively and qualitatively. Seventy-four per cent (95 per cent CI 67-81) of respondents rated the online content as 'excellent' or 'good', with higher levels of satisfaction among healthcare professionals. Across all respondent categories there was demand for information more specific to their circumstances, alongside implementation of mechanisms such as text and e-mail to alert users to updates of web content. Based on the study findings, several recommendations were made on the use of similar web-based resources in future. With consideration of these recommendations, this strategy of web-based communication can be employed in other high profile incidents requiring a national response.