Spinal Immobilisation Study
A Randomised Prospective Study of Triple Immobilisation vs Movement Minimisation of the spine following trauma.
Spinal Immobilisation is Controversial. Triple Immobilisation (Collar, Blocks and Tape) has been the standard of care for 30 years with the intention of reducing subsequent spinal cord injury. However, there is minimal evidence of this and it may be associated with additional harm (apspiration pneumonia, pressure sores, raised intracranial pressure). This study investigates triple immobilsation verses movement minimisation as techniques to immobilise the spine following blunt trauma.
The Primary Hypothesis is: Movement minimisation (intervention) is deemed non-inferior (i.e. no worse) compared to triple mobilisation (control) in patients with potential c-spine injury (pre-imaging) following blunt trauma, in relation to motor and cognitive function at hospital discharge following randomisation.
The Primary Outcome is:
Total Functional Independence Measurement motor (FIM-motor) score at discharge
This is a randomised prospective non-inferiority study of triple immobilisation vs movement minimisation. Eligible patients (=those who would normally be considered for triple immobilisation) are randomised on scene to either recieve triple immobilisation or movement minimisation. This randomisation is done by the treating paramedic team using the App linked from above. If the patient has capacity, verbal consent is requested at this time, however, usually the patient does not have capacity or the situation does not allow fully informed consent, so consent is sort again in the hospital.
Currently London and South Central Ambulance Services are recruiting. If you are a paramedic in either of these services, you can recruit once you have undertaken the online or face to face training. You will be given a PIN that enables you to access the randomisation webpage above. If you need more information, please get in touch.
If you work in a hosopital in one of these areas and you are not already a SIS site, please get in touch as we would love to get you on board.
What is Movement Minimsation?
For this study, movement minimisation comprises two blocks or rolled up blankets to minimise lateral movement. Tape can be used to hold the blocks / blankets in place to the scoop/trolly under the patient.
- No collar
- No tape over the patient
- Patient can sit up to 30 degrees
Inclusion Criteria
All patients who would have triple immobilisation for blunt trauma
- All ages
- All GCS
- All neurology
- Patients destined for a SIS participating ED
Exclusion Criteria
Patients not requiring triple immobilisation
Patients for whom triple immobilisation would be contraindicated (e.g ankylosing spondylitis).
Are you a patient?
This site is primarily for paramedics and hospital staff, but if you are a patient seeking more information, please click below
Adult Patient Information