Anest. intenziv. Med. 2016;27(6):375-379

Preventive immobilisation of the cervical spine in pre-hospital emergency care in trauma patients: updateReview Article

R. Jančálek^1,2

¹ Neurochirurgická klinika FN u sv. Anny v Brně a Lékařské fakulty Masarykovy univerzity, Brno

² Zdravotnická záchranná služba Jihomoravského kraje, Brno

Cervical spine or spinal cord injury occurs in 2-3% of trauma patients. Preventive immobilization of the cervical spine during prehospital care in trauma patients is common clinical practice because of the secondary spinal cord injury risks due to patient manipulation. The potential negative impacts of immobilization with hard cervical collar have led to the rise of the concept of selective cervical spine immobilization. Cervical immobilization of trauma patients who are (i) awake, alert, and are not intoxicated; (ii) who are without neck pain or tenderness; (iii) who do not have abnormal neurological examination; and (iv) who do not have any significant associated injury that might detract from their general evaluation, is not recommended. On the other hand, if any of the above four criteria is present, immobilization of the cervical spine is indicated. Spinal immobilization in patients with penetrating trauma is not recommended because of the increased mortality due to delayed resuscitation.

Keywords: prehospital care; cervical spine; trauma; immobilization

Received: July 25, 2016; Accepted: August 15, 2016; Published: December 1, 2016  Show citation