Prehospital clearance of the cervical spine: does it need to be a pain in the neck?
- 1 July 2007
- journal article
- Published by BMJ in Emergency Medicine Journal
- Vol. 24 (7), 501-503
- https://doi.org/10.1136/emj.2006.041897
Abstract
Prehospital cervical spine (c-spine) immobilisation is common, despite c-spine injury being relatively rare. Unnecessary immobilisation results in a significant burden on limited prehospital and emergency department (ED) resources. This study aimed to determine whether the incidence of unnecessary c-spine immobilisation by ambulance personnel could be safely reduced through the implementation of an evidence-based algorithm. Following a training programme, complete forms on 103 patients were identified during the audit period, of which 69 (67%) patients had their c-spines cleared at scene. Of these, 60 (87%) were discharged at scene, with no clinical adverse events reported, and 9 (13%) were taken to the local ED with non-distracting minor injuries, all being discharged home the same day. 34 (33%) patients could not have their c-spines safely cleared at scene according to the algorithm. Of these, 4 (12%) patients self-discharged at scene and 30 (88%) were conveyed to an ED as per the normal procedure. C-spine clearance at scene by ambulance personnel may have positive impacts on patient care, efficient use of resources and cost to healthcare organisations.Keywords
This publication has 9 references indexed in Scilit:
- Removal of C-spine protection by A&E triage nurses: a prospective trial of a clinical decision making instrumentEmergency Medicine Journal, 2006
- Can nurses, working in the emergency department, independently clear cervical spines?: a review of the literatureAccident and Emergency Nursing, 2004
- The Canadian C-Spine Rule versus the NEXUS Low-Risk Criteria in Patients with TraumaNew England Journal of Medicine, 2003
- The Canadian C-Spine Rule for Radiography in Alert and Stable Trauma PatientsJAMA, 2001
- S PINAL I MMOBILIZATION IN THE F IELD : C LINICAL C LEARANCE C RITERIA AND I MPLEMENTATIONPrehospital Emergency Care, 2001
- Validity of a Set of Clinical Criteria to Rule Out Injury to the Cervical Spine in Patients with Blunt TraumaNew England Journal of Medicine, 2000
- National Survey of the Incidence of Cervical Spine Injury and Approach to Cervical Spine Clearance in U.S. Trauma CentersJournal Of Trauma-Injury Infection and Critical Care, 1999
- Can nurses remove spinal boards and cervical collars safely?Emergency Nurse, 1999
- THE ETIOLOGY OF MISSED CERVICAL SPINE INJURIESJournal Of Trauma-Injury Infection and Critical Care, 1993