Spinal immobilization - Research Paper Example

This is because of lack of effective measure to ascertain the degree and site of spinal injury at the time of presentation in any emergency setting. Also, the definition of the definite position of spinal immobilization is poor and lacking. Jin et al (2007) conducted a retrospective study to examine the sensitivity of the prehospital immobilization protocol in which age criterion is present to 5 criteria of spine clearance. The five criteria include decreased awareness, presence of intoxication, neurological deficit, pain on palpation of the spine and age criterion; which is 65 years or older.

According to the protocol, standard full immobilization would be done to individuals with more than one criteria. This study included 238 victims of blunt trauma; of which 236 has atleast one positive criteria, suggesting 99.2 percent sensitivity. Of the 2 patients who did not receive immobilization, one had a small fissure in the arch of C2 and the other had fracture of the transverse process of L3. Both of them were discharged on the next day without any medical interventions or complications.

Based on these results, the researchers concluded that spinal immobilization protocol must be based on clinical criteria rather than on mechanism of trauma. They also recommended a prospective study to confirm such findings. The effectiveness and benefits of immobilization of the spine depends on the perfection in application of the immobilization technique. Peery et al (2007) conducted a study to assess and examine the quality of long spine board spinal immobilization in patients presenting to the emergency room via emergency medical service.

During examination, evaluation of the location and number of the restraining straps and also their degree of tightness was done. 50 patients were included in the study. 30 percent of these had atleast one unattached tape to attach head to the board. Also, 88 percent had more than 2 cm slack between the body. This study draws evidence that immobilization is not done well in emergency medical service and better measures and protocols need to be drawn for improved immobilization. Thus, even though spinal immobilization may provide genuine benefits, they be lost due to poor application.

Generally, immobilization of spine consists of a cervical collar that supports either side of the head, and the long and short back boards which have straps attached to them to immobilize the rest of the body. With regard to the boards, there is lot of controversy whether long boards are superior to short boards. According to Cline (1985; cited in AANS, 2001 ), short boards are superior to cervical collar alone. Mozalewski (cited in AANS, 2001 ) opined that unless the motion of trunk also was minimized along with motion of head, spine immobilization was ineffective.

The literature review by AANS (2001) drew some implications about spine immobilization practices in an emergency setting. The review opines that studies pertaining to spinal immobilization are limited because none of the studies actually evaluate the full range of available devices. However, from whatever results are available, it appears that a combination of cervical collar immobilization with supportive straps on a rigid long spinal backboard to secure the whole body including the trunk is superior to cervi