Assessing spinal movement during four extrication methods: a biomechanical study using healthy volunteers

Tim Nutbeam, Rob Fenwick, Barbara May, Willem Stassen, Jason E. Smith, Jono Bowdler, Lee Wallis, James Shippen

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    6 Citations (Scopus)
    78 Downloads (Pure)

    Abstract

    Background: Motor vehicle collisions are a common cause of death and serious injury. Many casualties will remain in their vehicle following a collision. Trapped patients have more injuries and are more likely to die than their untrapped counterparts. Current extrication methods are time consuming and have a focus on movement minimisation and mitigation. The optimal extrication strategy and the effect this extrication method has on spinal movement is unknown. The aim of this study was to evaluate the movement at the cervical and lumbar spine for four commonly utilised extrication techniques. Methods: Biomechanical data was collected using inertial Measurement Units on 6 healthy volunteers. The extrication types examined were: roof removal, b-post rip, rapid removal and self-extrication. Measurements were recorded at the cervical and lumbar spine, and in the anteroposterior (AP) and lateral (LAT) planes. Total movement (travel), maximal movement, mean, standard deviation and confidence intervals are reported for each extrication type. Results: Data from a total of 230 extrications were collected for analysis. The smallest maximal and total movement (travel) were seen when the volunteer self-extricated (AP max = 2.6 mm, travel 4.9 mm). The largest maximal movement and travel were seen in rapid extrication extricated (AP max = 6.21 mm, travel 20.51 mm). The differences between self-extrication and all other methods were significant (p < 0.001), small non-significant differences existed between roof removal, b-post rip and rapid removal. Self-extrication was significantly quicker than the other extrication methods (mean 6.4 s). Conclusions: In healthy volunteers, self-extrication is associated with the smallest spinal movement and the fastest time to complete extrication. Rapid, B-post rip and roof off extrication types are all associated with similar movements and time to extrication in prepared vehicles.

    Original languageEnglish
    Article number7
    JournalScandinavian Journal of Trauma, Resuscitation and Emergency Medicine
    Volume30
    DOIs
    Publication statusPublished - 15 Jan 2022

    Bibliographical note

    © The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which
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    Funder


    Research funded by a charitable grant from the Road Safety Trust. The Road Safety Trust had no role in the design, data collection, analysis or writing of this manuscript.

    Funding Information:
    This work is kindly supported by the National Fire Chiefs Council, Avon Fire and Rescue Service and Severn Park Fire and Rescue Centre

    Publisher Copyright:
    © 2022, The Author(s).

    ASJC Scopus subject areas

    • Emergency Medicine
    • Critical Care and Intensive Care Medicine

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