Cervical spine motion during ambulance transport : effects of driving task and spinal precautions

Abstract

Problem: Spinal precautions designed to protect an injured spine lack validated efficacy. The purpose is to determine the influence of ambulance motion on head-neck (H-N) kinematics during transport and to compare the effectiveness of two spinal precautions protocols: spinal immobilization (SI) and spinal motion restriction (SMR). Methods: Balanced-order, repeated measures comparison of two spinal precaution conditions on H-N kinematics of healthy volunteers during various ambulance driving tasks (7 tasks, 4 speeds). Acceleration and orientation of the head, sternum, and ambulance will be measured by accelerometers. Results: The overall effect of spinal precautions was less than expected. H-N motion varied across speed and driving task, providing a range of angular displacements [4-34°] and accelerations [1.5-13.5m/s²]. Conclusions: For most driving tasks, SI and SMR do not differ greatly in their efficacy. Both protocols allowed for considerable amounts of motion, warranting improvements to spinal precautions methods and devices. Further investigation into ambulance driving with patients is warranted.