The role of cervical collars and verbal instructions in minimising spinal movement during self-extrication following a motor vehicle collision - a biomechanical study using healthy volunteers

dc.contributor.authorNutbeam, Tim
dc.contributor.authorFenwick, Rob
dc.contributor.authorMay, Barbara
dc.contributor.authorStassen, Willem
dc.contributor.authorSmith, Jason E
dc.contributor.authorWallis, Lee
dc.contributor.authorDayson, Mike
dc.contributor.authorShippen, James
dc.date.accessioned2021-10-08T14:27:36Z
dc.date.available2021-10-08T14:27:36Z
dc.date.issued2021-07-31
dc.date.updated2021-08-01T03:14:58Z
dc.description.abstractBackground Motor vehicle collisions account for 1.3 million deaths and 50 million serious injuries worldwide each year. However, the majority of people involved in such incidents are uninjured or have injuries which do not prevent them exiting the vehicle. Self-extrication is the process by which a casualty is instructed to leave their vehicle and completes this with minimal or no assistance. Self-extrication may offer a number of patient and system-wide benefits. The efficacy of routine cervical collar application for this group is unclear and previous studies have demonstrated inconsistent results. It is unknown whether scripted instructions given to casualties on how to exit the vehicle would offer any additional utility. The aim of this study was to evaluate the effect of cervical collars and instructions on spinal movements during self-extrication from a vehicle, using novel motion tracking technology. Methods Biomechanical data on extrications were collected using Inertial Measurement Units on 10 healthy volunteers. The different extrication types examined were: i) No instructions and no cervical collar, ii) No instructions, with cervical collar, iii) With instructions and no collar, and iv) With instructions and with collar. Measurements were recorded at the cervical and lumbar spine, and in the anteroposterior (AP) and lateral (LAT) planes. Total movement, mean, standard deviation and confidence intervals are reported for each extrication type. Results Data were recorded for 392 extrications. The smallest cervical spine movements were recorded when a collar was applied and no instructions were given: mean 6.9 mm AP and 4.4 mm LAT. This also produced the smallest movements at the lumbar spine with a mean of 122 mm AP and 72.5 mm LAT. The largest overall movements were seen in the cervical spine AP when no instructions and no collar were used (28.3 mm). For cervical spine lateral movements, no collar but with instructions produced the greatest movement (18.5 mm). For the lumbar spine, the greatest movement was recorded when instructions were given and no collar was used (153.5 mm AP, 101.1 mm LAT). Conclusions Across all participants, the most frequently occurring extrication method associated with the least movement was no instructions, with a cervical collar in situ.en_US
dc.identifier.apacitationNutbeam, T., Fenwick, R., May, B., Stassen, W., Smith, J. E., Wallis, L., ... Shippen, J. (2021). The role of cervical collars and verbal instructions in minimising spinal movement during self-extrication following a motor vehicle collision - a biomechanical study using healthy volunteers. <i>Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine</i>, 29(1), 108. http://hdl.handle.net/11427/35136en_ZA
dc.identifier.chicagocitationNutbeam, Tim, Rob Fenwick, Barbara May, Willem Stassen, Jason E Smith, Lee Wallis, Mike Dayson, and James Shippen "The role of cervical collars and verbal instructions in minimising spinal movement during self-extrication following a motor vehicle collision - a biomechanical study using healthy volunteers." <i>Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine</i> 29, 1. (2021): 108. http://hdl.handle.net/11427/35136en_ZA
dc.identifier.citationNutbeam, T., Fenwick, R., May, B., Stassen, W., Smith, J.E., Wallis, L., Dayson, M. & Shippen, J. et al. 2021. The role of cervical collars and verbal instructions in minimising spinal movement during self-extrication following a motor vehicle collision - a biomechanical study using healthy volunteers. <i>Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.</i> 29(1):108. http://hdl.handle.net/11427/35136en_ZA
dc.identifier.ris TY - Journal Article AU - Nutbeam, Tim AU - Fenwick, Rob AU - May, Barbara AU - Stassen, Willem AU - Smith, Jason E AU - Wallis, Lee AU - Dayson, Mike AU - Shippen, James AB - Background Motor vehicle collisions account for 1.3 million deaths and 50 million serious injuries worldwide each year. However, the majority of people involved in such incidents are uninjured or have injuries which do not prevent them exiting the vehicle. Self-extrication is the process by which a casualty is instructed to leave their vehicle and completes this with minimal or no assistance. Self-extrication may offer a number of patient and system-wide benefits. The efficacy of routine cervical collar application for this group is unclear and previous studies have demonstrated inconsistent results. It is unknown whether scripted instructions given to casualties on how to exit the vehicle would offer any additional utility. The aim of this study was to evaluate the effect of cervical collars and instructions on spinal movements during self-extrication from a vehicle, using novel motion tracking technology. Methods Biomechanical data on extrications were collected using Inertial Measurement Units on 10 healthy volunteers. The different extrication types examined were: i) No instructions and no cervical collar, ii) No instructions, with cervical collar, iii) With instructions and no collar, and iv) With instructions and with collar. Measurements were recorded at the cervical and lumbar spine, and in the anteroposterior (AP) and lateral (LAT) planes. Total movement, mean, standard deviation and confidence intervals are reported for each extrication type. Results Data were recorded for 392 extrications. The smallest cervical spine movements were recorded when a collar was applied and no instructions were given: mean 6.9 mm AP and 4.4 mm LAT. This also produced the smallest movements at the lumbar spine with a mean of 122 mm AP and 72.5 mm LAT. The largest overall movements were seen in the cervical spine AP when no instructions and no collar were used (28.3 mm). For cervical spine lateral movements, no collar but with instructions produced the greatest movement (18.5 mm). For the lumbar spine, the greatest movement was recorded when instructions were given and no collar was used (153.5 mm AP, 101.1 mm LAT). Conclusions Across all participants, the most frequently occurring extrication method associated with the least movement was no instructions, with a cervical collar in situ. DA - 2021-07-31 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine LK - https://open.uct.ac.za PY - 2021 T1 - The role of cervical collars and verbal instructions in minimising spinal movement during self-extrication following a motor vehicle collision - a biomechanical study using healthy volunteers TI - The role of cervical collars and verbal instructions in minimising spinal movement during self-extrication following a motor vehicle collision - a biomechanical study using healthy volunteers UR - http://hdl.handle.net/11427/35136 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s13049-021-00919-w
dc.identifier.urihttp://hdl.handle.net/11427/35136
dc.identifier.vancouvercitationNutbeam T, Fenwick R, May B, Stassen W, Smith JE, Wallis L, et al. The role of cervical collars and verbal instructions in minimising spinal movement during self-extrication following a motor vehicle collision - a biomechanical study using healthy volunteers. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2021;29(1):108. http://hdl.handle.net/11427/35136.en_ZA
dc.language.isoenen_US
dc.language.rfc3066en
dc.publisher.departmentDivision of Emergency Medicineen_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceScandinavian Journal of Trauma, Resuscitation and Emergency Medicineen_US
dc.source.journalissue1en_US
dc.source.journalvolume29en_US
dc.source.pagination108en_US
dc.source.urihttps://sjtrem.biomedcentral.com/
dc.titleThe role of cervical collars and verbal instructions in minimising spinal movement during self-extrication following a motor vehicle collision - a biomechanical study using healthy volunteersen_US
dc.typeJournal Articleen_US
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