Evidence for the use of spinal collars in stabilising spinal injuries in the pre-hospital setting in trauma patients: a
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ORIGINAL ARTICLE
Evidence for the use of spinal collars in stabilising spinal injuries in the pre‑hospital setting in trauma patients: a systematic review Katherine Hawkridge1 · Ikhlaaq Ahmed2 · Zubair Ahmed1,3 Received: 7 September 2020 / Accepted: 7 December 2020 © The Author(s) 2020
Abstract Purpose Spinal collars were introduced in 1967 into the management of spinal trauma care as it was thought that this technique of immobilisation would prevent any further neurological or spinal damage in high-risk patients. The aim of this systematic review was to determine whether the use of spinal collars in the pre-hospital trauma patient was recommended by published literature. Methods A systematic search of the literature was conducted between 1990 and 2020, screening PubMed, Medline, Science Direct and Google Scholar. The consequent findings were then qualitatively synthesised with the aim of effectively evaluating the evidence to resolve the discrepancy between current practice and literature. Results Of the nine eligible studies, six deemed that spinal collars should not be used in pre-hospital trauma patients with the remaining three reporting uncertainty if spinal collars were best practice. Our results suggest that there is a discrepancy between current guidance and practice in that although the guidelines recommend the use of spinal collars in the pre-hospital setting the majority of the studies were against the use of spinal collars. Importantly, none of the studies reported any benefits of spinal collars. Conclusion Our study shows a disparity between current guidelines and the published literature and warrants further direct research to obtain a more comprehensive view of the use of spinal collars in a pre-hospital setting. Keywords Spinal injuries · Pre-hospital · Acute treatment · Trauma · Spinal collars · Trauma management
Introduction Spinal Injury (SI) affects around 1000 people every year in the UK and an estimated 102,000 to 1.2 M new cases worldwide, with survivors experiencing life-long loss of function and reduced mobility [1]. The use of spinal collars to immobilise the spine in the pre-hospital setting for suspected spinal injury is recommended by the National Institute for Health and Care Excellence (NICE) and the Joint * Zubair Ahmed [email protected] 1
Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, College of Medical and Dental Science, University of Birmingham, Birmingham B15 2TT, UK
2
Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham B15 2TT, UK
3
Surgical Reconstruction and Microbiology Research Centre, National Institute for Health Research, Queen Elizabeth Hospital, Birmingham B15 2TH, UK
Royal Colleges Ambulance Liaison Committee (JRCALC). Current guidelines are based on the premise that immobilisation will prevent further neurological damage in patients with SI [2]. There are many different protocols to support the decision about immobilisation and these vary regionally, nationally and internationally [3–7]. How
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