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Spinal Inmovilization ( Strap Use )

trauma-list@trauma.org trauma-list@trauma.org
Sat, 30 Nov 2002 10:50:35 -0500 (EST) 

Dear Dan:

About the disposition of the tapes or belts for fixation in the Spinal Long Board, there are very few references that are able to determine an appropriate evidence level.

 Different devices exist in the market but the basic recommendations should really be to fill the empty spaces among the extremities and to be able to diminish to the maximum the ranges of lateral displacement for thorax, low extremities and pelvis in the Board. 
 
The vacuum devices eliminate you this problem but at a cost a little  high, but keeping in mind the lesion possibility for bad fixation in the Long Board, finally is not so high that cost of the device. 
 
Unfortunately not to all the prehospital scenarios you can enter with vacuum immobilization devices.  
  
I send you a couple of references where this thematic has been presented and one of them is the evidence summary for the prehospital spinal trauma transport. 

One of them are the guidelines of the American Association of Neurological Surgeons published in Neurosurgery (2.002). and the other one is a study for inmovilization during vehicle motion.

  1.Hadley M.  et al: Transportation of patients with acute traumatic cervical spine injuries: Neurosurgery, 50:S18-S20,2002.

2.Perry SD, McLellan B, Mcllroy WE: The efficacy of head inmobilzation Techniques during simulated vehicle motion. 
Spine: 24:1839-1844,2000.

  
Definitively a thing is clear:  
  
We should carry out many prehospital studies to obtain better evidence of all and each one of the existent devices.

In february of 2.003, we publish our national statment in this topic and if you want we can send you a copy.

Andrés Rubiano M.D.
Neurosurgeon
NAEMT Prehospital Instructor (PHTLS-AMLS)
Colombian National Association of Prehospital Medicine
SIREM Foundation
www.fundacionsirem.com
Mail to: andresrubiano@hispavista.com
         andresrubiano@007mundo.com