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In a recent study featured in the July issue of Academic Emergency Medicine (AEM), researchers have shed light on the changing landscape of spinal motion restriction (SMR) practices over the past decade.
The study, aptly titled Patterns of Change in Prehospital Spinal Motion Restriction: A Retrospective Database Review, offers a detailed look at SMR practices within a specific urban EMS agency located in North America.
A Shift from Tradition
The decade-long review unearthed a notable trend: there was a significant decline in the prehospital use of both cervical immobilization and backboards between 2009 and 2019.
To highlight, the concurrent use of cervical immobilization combined with backboard application plunged from 31% in 2009 to a mere 12% by 2019.
Intriguingly, this shift did not emerge as a result of altered protocols but appeared more as a secular trend, especially prominent in instances involving minor trauma mechanisms.
SMR Guidelines Undergo Transformation
Spine injuries and their potential treatments have long been considered a foundational aspect of training for emergency departments and prehospital environments on a global scale.
Yet, over the last decade, these foundational guidelines have undergone considerable revisions.
Historically, spinal immobilization (SI) practices involved placing patients, deemed at risk of spine injury, supine on rigid, lengthy backboards. Their immobilization was then secured using straps, head blocks, and a stiff cervical collar.
However, more recent guidelines on spinal motion restriction (SMR) have recognized the potential detrimental effects of such immobilization.
These newer guidelines also acknowledge that the supposed benefits of traditional immobilization methods might be overstated.
As a result, SMR practices nowadays typically provide a broader spectrum of treatment options, each tailored to the patient's unique presentation.
It's important to note that even with the growing adoption of modern SMR principles, practices and guidelines still exhibit considerable variation.
Moving Forward with Research
The lead researcher behind this revealing study, Neil McDonald, MPhil, hails from the University of Manitoba and Winnipeg Fire Paramedic Service in Winnipeg, Manitoba, Canada.
As McDonald and his team delve into the findings, they suggest that this downward trend in the application of SI/SMR treatments warrants further exploration in other settings.
In tandem with this, ongoing research within their EMS practice is set to examine the potential impact these evolving treatment trends might have on patient outcomes.
UPDATE:
Buffalo Bills running back Damien Harris was carried off the field in an ambulance with a neck injury during a Sunday, October 15th matchup against the New York Giants.
The injury occurred late in the second quarter as Harris took a handoff up the middle and was met by Giants linebacker Bobby Okereke. Players from both teams signaled for the Bills training staff to aid Harris immediately after the play.
Out of precaution, the player was strapped to a backboard and an ambulance was brought onto the field to take him to the hospital. Harris gave a thumbs up as he was being placed into the ambulance.
