Skip to main content
Erschienen in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2014

Open Access 01.12.2014 | Oral presentation

Learning from the dead: improving safety while placing unconscious trauma patients in various lateral positions

verfasst von: Per Kristian Hyldmo, Bryan P Conrad, Dewayne N Dubose, Jo Røislien, Mark Prasarn, Eldar Søreide, Glenn Rechtine, MaryBeth Horodyski

Erschienen in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Sonderheft 1/2014

download
DOWNLOAD
print
DRUCKEN
insite
SUCHEN

Background

The unconscious trauma patient with a possible unstable spinal injury constitutes a clinical challenge. To protect the unintubated airway, some guidelines [1, 2] recommend that the patient be turned into a lateral position, e.g. the Recovery Position (RP) [1] or the Lateral Trauma Position (LTP) [2]. Other lateral positions have also been proposed, as the HAINES position [3] and variations thereof. However, moving the patient may cause secondary neurological injury. The aim of this study was to explore how much motion lateral position techniques produce in an unstable cervical spine injury.

Method

We surgically created a global ligamentous instability between C5 and C6 in five fresh cadavers [4]. Four different techniques were evaluated; RP, LTP and two varieties of HAINES (one or both legs flexed; H1 and H2). Relative angular and linear motion between C5 and C6 was measured using an electromagnetic tracking device (Liberty, Polhemus Inc.™, Colchester, VT). Each method was repeated tree times in each cadaver. Both angular and linear movements were measured. Data were analysed using generalized linear mixed models (GLMM), adjusting for intra-cadaver correlation.

Results

Compared to RC, LTP created significantly less movement during lateral bending (p=.037), while H1and H2 had significantly less movement than RC in axial translation (p=.009 and .033). There was a tendency towards LTP and H1 and H2 performing better than RC also for other movements.

Conclusion

Our results indicate that in unconscious trauma patients, LTP or one of the two HAINES techniques is preferable to the classic recovery position in the setting of an unstable cervical spine injury.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://​creativecommons.​org/​licenses/​by/​4.​0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://​creativecommons.​org/​publicdomain/​zero/​1.​0/​) applies to the data made available in this article, unless otherwise stated.
Literatur
1.
Zurück zum Zitat Deakin CD, et al: European Resuscitation Council Guidelines for Resuscitation 2010 Section 4. Adult advanced life support. Resuscitation. 2010, 81: 1305-1352. 10.1016/j.resuscitation.2010.08.017.CrossRefPubMed Deakin CD, et al: European Resuscitation Council Guidelines for Resuscitation 2010 Section 4. Adult advanced life support. Resuscitation. 2010, 81: 1305-1352. 10.1016/j.resuscitation.2010.08.017.CrossRefPubMed
2.
Zurück zum Zitat Berlac P, et al: Pre-hospital airway management: guidelines from a task force from the Scandinavian Society for Anaesthesiology and Intensive Care Medicine. Acta Anaesthesiol Scand. 2008, 52: 897-907. 10.1111/j.1399-6576.2008.01673.x.CrossRefPubMed Berlac P, et al: Pre-hospital airway management: guidelines from a task force from the Scandinavian Society for Anaesthesiology and Intensive Care Medicine. Acta Anaesthesiol Scand. 2008, 52: 897-907. 10.1111/j.1399-6576.2008.01673.x.CrossRefPubMed
3.
Zurück zum Zitat Haines J: Positioning an unconscious patient with suspected neck injury. JEMS: Journal of Emergency Medical Services. 1996, 21: 85-85.PubMed Haines J: Positioning an unconscious patient with suspected neck injury. JEMS: Journal of Emergency Medical Services. 1996, 21: 85-85.PubMed
4.
Zurück zum Zitat Horodyski M, et al: Cervical Collars are Insufficient for Immobilizing an Unstable Cervical Spine Injury. J Emerg Med. 2011, 41 (5): 513-519. 10.1016/j.jemermed.2011.02.001.CrossRefPubMed Horodyski M, et al: Cervical Collars are Insufficient for Immobilizing an Unstable Cervical Spine Injury. J Emerg Med. 2011, 41 (5): 513-519. 10.1016/j.jemermed.2011.02.001.CrossRefPubMed
Metadaten
Titel
Learning from the dead: improving safety while placing unconscious trauma patients in various lateral positions
verfasst von
Per Kristian Hyldmo
Bryan P Conrad
Dewayne N Dubose
Jo Røislien
Mark Prasarn
Eldar Søreide
Glenn Rechtine
MaryBeth Horodyski
Publikationsdatum
01.12.2014
Verlag
BioMed Central
DOI
https://doi.org/10.1186/1757-7241-22-S1-O4

Weitere Artikel der Sonderheft 1/2014

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2014 Zur Ausgabe

Extended abstract

Paramedic intubation