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A T2 Translational Science Modified Delphi Study: Spinal Motion Restriction in a Resource-Scarce Environment
Eric S Weinstein1, Joseph L Cuthbertson2, Luca Ragazzoni1
1CRIMEDIM, Università del Piemonte Orientale, Novara, Italy.
Prehospital and Disaster Medicine
|July 10, 2020
Summary
This study developed 11 consensus statements for spinal motion restriction (SMR) in resource-scarce environments (RSEs). These findings aim to guide clinical guidelines for prehospital care in challenging settings.
Area of Science:
- Disaster Medicine
- Translational Science
- Prehospital Care
Background:
- Current prehospital spinal injury management guidelines are primarily for resource-rich environments.
- There is a critical need for guidance on spinal motion restriction (SMR) in resource-scarce environments (RSEs).
- RSEs include mass-casualty incidents, low-middle income countries, humanitarian emergencies, conflict zones, and prolonged transport scenarios.
Purpose of the Study:
- To determine appropriate spinal motion restriction (SMR) protocols for resource-scarce environments (RSEs).
- To develop evidence-based statements for clinical guidelines in disaster medicine contexts.
Main Methods:
- A modified Delphi (mD) study involving experts in prehospital care and disaster medicine.
- Experts rated agreement on statements derived from focus groups and existing literature.
- Consensus was defined as a standard deviation of ≤1.0.
Main Results:
- Twenty-two experts participated, with 16 completing three rounds of the mD study.
- Eleven statements reached expert consensus for incorporation into guidelines.
- Nine statements did not reach consensus and require further investigation.
Conclusions:
- Eleven consensus statements provide a foundation for creating SMR clinical guidelines in RSEs.
- Further research on the nine non-consensus statements may yield additional recommendations for RSEs.
- This study contributes to adapting prehospital care standards for diverse and challenging environments.
