A radiographic comparison of prehospital cervical immobilization methods.

Three methods of prehospital cervical immobilization were studied radiographically and compared to the short board technique (SBT). The methods were California Stif-Neck Immobilizing Collar (CSC), Kendrick Extrication Device (KED), and Extrication Plus-One (XP-One). Forty-five volunteers were immobilized in the short board (SB) and one of the test devices studied. Cervical movement in the sagittal and frontal planes was measured radiographically. Movement in the horizontal plane was measured directly. Two-tailed, paired t test analysis was performed comparing test devices to the SBT. The SBT proved to be significantly better (P less than .05) in the following comparisons: the CSC in extension and lateral bending; the KED in lateral bending; and the XP-One in extension. We confirm the SBT as the standard of comparison against which newer prehospital devices can be compared objectively. Of the three devices compared against the SBT, the factory-fabricated short board devices (KED and XP-One) provided the greatest degree of immobilization, in addition to logistical advantages over the SBT.

A comparison of methods of cervical immobilization used in patient extrication and transport.

We radiographically studied the efficacy of seven methods of cervical immobilization used in the prehospital setting. The methods were: Philadelphia collar, Hare extrication collar, rigid plastic collar, Philadelphia collar + short board, Hare extrication collar + short board, rigid plastic collar + short board, and the short board used alone. Ninety-seven normal volunteers were randomized to one of these seven methods and each volunteer served as his or her own control. Efficacy was expressed as per cent reduction of baseline movement in the sagittal, frontal, and horizontal planes. The short-board technique appeared to be superior to all the three collars studied. The collars provided no augmentation of immobilization over that provided by the short board alone. We believe that the short-board technique described herein, which is commonly used in the prehospital setting, can be used as the standard of comparison against which newer prehospital devices can be objectively compared.