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Comparing the Efficacy of Long Spinal Board, Sked Stretcher, and Vacuum Mattress in Cervical Spine Immobilization; a
Wijittra Liengswangwong1, Natcha Lertviboonluk1, Chaiyaporn Yuksen1
1Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand.
Introduction:
Inadequate spinal motion restriction in patients suffering from spinal injuries could lead to further neurological damage, ultimately worsening their prognosis. This study aimed to investigate the efficacy of long spinal boards (LSB), ske stretcher, and vacuum mattress for cervical spine immobilization during transportation of patients by measuring the angular motion of the cervical spine following lifting, transferring, and tilting.
Methods:
We conducted an experimental study using a box of three randomizations and crossover designs without a washout period effect for the long spinal board, sked stretcher, and vacuum mattress. We concealed the randomization with sequentially numbered, opaque, sealed envelopes (SNOSE). Kinematic data were collected using eight optoelectronic cameras at 200 Hz (BTS Bioengineering, Milan, Italy) in triangular planes (lateral bending, flexion-extension, and axial rotation) while performing all three motions (static lift-hold, transfer, and 90° tilt).
Results:
12 cases (7 males and 5 females) with the mean age of 20 ± 3.03 (range: 18-28) years were studied. The three highest angular motions were observed in the axial rotation plane during patient's tilting under immobilization on all devices (Vacuum mattress having the highest value of 99.01±8.93, followed by the LSB at 89.89±34.35 and the sked stretcher at 86.30±7.73 degrees). During patient lifting, a higher angular motion was observed with vacuum mattress immobilization in flexion extension (Coefficient = 4.45; 95%CI: 0.46 - 8.45; p =0.029) and axial rotation (Coefficient = 3.70; 95%CI: 0.58 - 6.81; p =0.020) planes. During patient transfer, a higher angular motion was observed with sked stretcher in the flexion-extension plane (Coefficient = 2.98; 95%CI: 0.11 - 5.84; p = 0.042). During patient tilting to 90 degrees, a higher angular motion was observed with vacuum mattress immobilization in lateral bending (Coefficient = -4.08; 95%CI: -7.68 - -0.48; p = 0.026) for the vacuum mattress.
Conclusion:
Based on the finding of the present study, patients on the vacuum mattress experience significantly higher angular motion in flexion extension and axial rotation during lifting, as well as lateral bending during 90-degree tilting. In addition, patients on the sked stretcher showed significantly higher angular motion in flexion-extension during the transferring. However, the predictive margins for immobilization across all devices did not demonstrate clinically significant differences among the three immobilization devices.
