Validation of a field spinal motion restriction protocol in a level I trauma center

The Journal of Surgical Research
James M TatumEric J Ley

Abstract

Spinal motion restriction (SMR) after traumatic injury has been a mainstay of prehospital trauma care for more than 3 decades. Recent guidelines recommend a selective approach with cervical spine clearance in the field when criteria are met. In January 2014, the Department of Health Services of the City of Los Angeles, California, implemented revised guidelines for cervical SMR after blunt mechanism trauma. Adult patients (aged ≥18 y) with an initial Glasgow Coma Scale (GCS) score of ≥13 presented to a single level I trauma center after blunt mechanism trauma over the following 1-y period were retrospectively reviewed. Demographics, injury data, and prehospital data were collected. Cervical spine injury (CSI) was identified by International Classification of Disease, Ninth Revision, codes. Emergency medical services transported 1111 patients to the emergency department who sustained blunt trauma. Patients were excluded if they refused c-collar placement or if documentation was incomplete. A total of 997 patients were included in our analysis with 172 (17.2%) who were selective cleared of SMR per protocol. The rate of Spinal Cord Injury was 2.2% (22/997) overall and 1.2% (2/172) in patients without SMR. The sensitivity and speci...Continue Reading

Citations

Feb 23, 2019·Military Medical Research·Zhao-Wen ZongUNKNOWN Disaster Medicine Branch of the Chongqing Association of Integrative Medicine
Feb 26, 2019·Journal of Burn Care & Research : Official Publication of the American Burn Association·Laura A GalganskiTina L Palmieri
Oct 8, 2020·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·David HäskeUNKNOWN TraumaRegister DGU
May 18, 2021·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Mark Hauswald

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