Use of traction in cervical spine fractures during interhospital transfer by aircraft

Despite significant improvement in the organization and function of the nation's emergency medical services and the increasing sophistication of initial providers of critical care, there has apparently been no reduction in the incidence of neurological deficits suffered by patients with unstable cervical spine injuries during management prior to intervention by the spine surgeon. In analyzing the techniques used to stabilize patients with suspected unstable cervical spine injuries during this phase, we conclude that present standard techniques are either insufficient or potentially destabilizing. We have developed a system that will permit the use of cervical traction, applied with a halter or the standard Gardner-Wells tongs, during the prehospital phase of management of patients with cervical spine injuries. Based on our experience with the system, we recommend that patients with such injuries be stabilized with skeletal traction when transferred between hospitals by air ambulance. Logic permits consideration of the concept even earlier in the prehospital phase of management and in ground ambulances.