Spinal Motion Restriction Feasibility (SMRF) Randomised Control Trial: A mixed methods study comparing prehospital semi-rigid collar use and non-collar use in immobilisation of potential spinal cord injury
Date: Wednesday 25th May 2022
Background: Spinal cord injury (SCI) is a rare event where prehospital spinal immobilisation has traditionally comprised of the application of semi-rigid cervical collar, blocks, tape and back board as standard practice for over 50 years. Contemporary literature and consensus are now challenging these practices in favour of pragmatic patient centred supportive techniques.
Methods: The Spinal Motion Restriction Feasibility Study used a mixed methods approach, including a randomised control trial and participant survey, to determine if there is a difference in patient outcomes/experience comparing prehospital semi-rigid collar and non-collar use in immobilisation of potential SCI.
Prehospital clinicians identified potential participants who experienced trauma and clinical assessment suggested potential SCI and randomised by timeframes into control (collar) group and intervention (non-collar) group. Primary outcomes included: Time: on scene, to imaging, in Emergency Department (ED) and new neurology. Secondary outcomes included: injuries, immobilisation induced pressure sores, compliance with immobilisation, and patient experience.
Descriptive statistics categorise demographics and injuries. Categorical and ordinal variables were expressed as proportions and continuous variables as means with standard deviations. Independent samples t test was performed to identify differences in means. Qualitative grounded theory thematic analysis of free text in participant experience surveys was also undertaken.
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Lee Thompson PhD. Specialist Paramedic (Trauma).
I am a specialist paramedic (trauma) with North East Ambulance Service with a specialist interest in older adult/frailty trauma. I am the chief investigator for the Spinal Motion Restriction Feasibility (SMRF) study and the Northumbria Low Energy Trauma Score RCT pilot study. I am currently developing an apprentice Advanced Care Practitioner program in Emergency Care as part of a hybrid program between NEAS, Northumbria University and Northumbria Specialist Emergency Care Hospital.