SSM paper outline
Spinal immobilization is one of the most common techniques used in prehospital situations. Its basic function is to prevent secondary injury of the spinal cord by prevention of flexion, extension and rotation of the vertebrae. This is important as the effects f spinal cord injury at any vertebral level can have devastating effects, including paraplegia and death. Because of this large risk, prehospital care providers always fall on the side of caution when a cervical injury is suspected in a patient. To determine if the patient is at risk of spinal injury, the mechanism of injury must be assessed. The most common situations in which spinal injury is suspected include car accidents, falls, sports and physical assault. It is
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reported that all patients who were immobilized due to blunt trauma had higher correlation to mortality (23%), this was also associate with an increased amount of CPR on arrival to the emergency department. Of the sample, 94% of cases suffered gunshot wounds. Among these cases, those who underwent c-spine immobilization had a higher unadjusted risk of death. This study argued that the use of a cervical collar may have negative effects clinically, it may mask clinical signs, access to injury and may impair efforts to intubate the patient. However, it was noted in this study that patients with a suspected C-spine injury with penetrating trauma had no significant correlation with an increased risk of death. Haut et al conducted a study comparing the mortality rate of patients who underwent immobilization (43%) and those who were not. Overall this study found that there was ant 8.1% mortality rate overall, immobilized patients were more likely to have had a case of complete severance of the spinal cord with a required SCI repair surgery afterwards. In addition, both authors also stated that spinal immobilization may increase prehospital time, leading to a delay before patients receive treatment from