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Acquiring and Maintaining Competence in the Application of Extrication Cervical Collars by a Group of First Responders

Published online by Cambridge University Press:  28 June 2012

Colin J. Ireland*
Affiliation:
St. John Ambulance, Australia
Kathryn M. Zeitz
Affiliation:
St. John Ambulance, Australia
Franklin H.G. Bridgewater
Affiliation:
St. John Ambulance, Australia
*
State Nursing OfficerSt. John Ambulance Australia SA Inc85 Edmund AveUnley, South AustraliaAustralia5061 E-mail: [email protected]

Abstract

Introduction:

Research on skill acquisition and retention in the prehospital setting has focused primarily on resuscitation and defibrillation. Investigation into other first aid skills is required in order to validate practices and support training regimes. No studies have investigated competency using an extrication cervical collar for cervical spine immobilization.

Objective:

This study was conducted to confirm that a group of first responders could acquire and maintain competency in the application of an extrication cervical collar over a 12-month period.

Methods:

Participants attended a standardized training session that addressed the theory of application of an extrication cervical collar followed by hands-on practice. The training was presented by the same instructor and covered the nine key elements necessary in order to be deemed competent in extraction cervical collar application. Following the practical session, the competency of the participants was assessed. Participants were requested not to practice the skill during the 12-month period. Following the 12-month period, their skills were re-assessed by the same assessor.

Results:

Of the 64 subjects who participated in the study, 100% were competent after the initial first assessment. Forty-one participants (64%) were available for the second assessment (12 months later); of these, 25 (61%) maintained competence.

Conclusions:

Although the sample size was small, this research demonstrates that first responders are able to acquire competence in applying an extrication cervical collar. However, skill retention in the absence of usage or re-training is poor. Larger studies should be conducted to validate these results. In addition, there is a need for research on the clinical practice and outcomes associated with spinal immobilization in the prehospital setting.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2008

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References

1. Anonymous: 2005 International Consensus on CPR and ECC Science with Treatment Recommendations. Circulation 2005;112(22:Supplement Section 2 Part 10: First Aid):III-115–25.Google Scholar
2. 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2005;112(24 Supplement Part 14: First Aid):IV196–203.Google Scholar
3. Foreword to Guidelines: Glossary of Terms. In: Australian Resuscitation Council Guidelines. Melbourne: Australian Resuscitation Council, 2006.Google Scholar
4. Personal Communication, Raynovich W, May 2007Google Scholar
5.James, CY, Riemann, BL, Munkasy, BA, Joyner, AB: Comparison of cervical spine motion during application among 4 rigid immobilization collars. J Athl Train 2004;39(2):138145.Google Scholar
6.Askins, V, Eismont, FJ: Efficacy of five cervical orthoses in restricting cervical motion. A comparison study. [see comment]. Spine 1997;22(11):11931198.Google Scholar
7.Mazolewski, P, Manix, TH: The effectiveness of strapping techniques in spinal immobilization. Ann Emerg Med 1994;23(6):12901295.Google Scholar
8.Kwan, I, Bunn, F: Effects of prehospital spinal immobilization: A systematic review of randomized trials on healthy subjects. Prehospital Disast Med 2005;20(1):4753.Google Scholar
9. Guidelines for management of acute cervical spinal and spinal cord injuries. Neurosurgery 2002;50(3 Suppl):S1.Google Scholar
10.Kwan, I, Bunn, F, Roberts, I: Spinal immobilization for trauma patients. Cochrane Database of Systematic Reviews 2001(2):CD002803.Google Scholar
11.Hauswald, M, Ong, G, Tandberg, D, et al. : Out-of-hospital spinal immobilization: its effect on neurologic injury. [see comment]. Acad Emerg Med 1998;5(3):214219.Google Scholar
12.Bernhard, M, Gries, A, Kremer, P, et al. : Spinal cord injury (SCI)—Prehospital management. Resuscitation 2005;66(2):127139.CrossRefGoogle ScholarPubMed
13.Zeitz, CJ, Zeitz, KM, Ward, G, et al. : The acquisition and maintenance of defibrillation skills by lay first responders. Resuscitation 2003;56(1):7782.CrossRefGoogle ScholarPubMed
14.Bowler, P: How Effective is First Aid Training and Delivery? A Report to Research Ethics Committee. Canberra: St. John Ambulance Australia; 1999.Google Scholar
15.Human Research Ethics Committees (HRECs). In: Council NHaMR. Canberra: ACT, 2006.Google Scholar
16.De Lorenzo, RA: A review of spinal immobilization techniques. J Emerg Med 1996;14(5):603613.Google Scholar
17.Wolf, J, Johnson, R: Cervical orthoses. In: Sherk, H, Dunn, E, Eismont, F, et al. (eds): The Cervical Spine. Philadelphia: JB Lippencott; 1989. pp 97105.Google Scholar
18.Ackland, HM, Cooper, JD, Malham, GM, et al. : Factors predicting cervical collar-related decubitus ulceration in major trauma patients. Spine 2007;32(4):423428.Google Scholar
19.Mobbs, RJ, Stoodley, MA, Fuller, J: Effect of cervical hard collar on intracranial pressure after head injury. Aust N Z J Surg 2002;72(6):389391.Google Scholar
20.Rodgers, JA, Rodgers, WB: Marginal mandibular nerve palsy due to compression by a cervical hard collar. J Orthop Trauma 1995;9(2):177179.Google Scholar
21.Liew, SC, Hill, DA: Complication of hard cervical collars in multi-trauma patients. Aust N Z J Surg 1994;64(2):139140.Google Scholar
22.McGuire, RA, Degnan, G, Amundson, GM: Evaluation of current extrication orthoses in immobilization of the unstable cervical spine. Spine 1990;15(10): 10641067.Google Scholar
23.Ivy, ME, Cohn, SM: Addressing the myths of cervical spine injury management. Am J Emerg Med 1997;15(6):591595.Google Scholar
24.Harris, MB, Waguespack, AM, Kronlage, S: ‘Clearing” cervical spine injuries in polytrauma patients: Is it really safe to remove the collar? Orthopedics 1997;20(10):903907.Google Scholar
25. De Lorenzo, RA, Olson, JE, Boska, M, et al. : Optimal positioning for cervical immobilization. [see comment]. Ann Emerg Med 1996;28(3):301308.Google Scholar
26.Rosen, PB, McSwain, NE Jr., Arata, M, et al. : Comparison of two new immobilization collars. Ann Emerg Med 1992;21(10):11891195.Google Scholar
27.Train Small Groups: Plan, Conduct and Review Assessment Workbook. Adelaide: Torrens Valley Technical and Further Education; 2001.Google Scholar
28.Sen, A: Spinal immobilization in prehospital trauma patients. Journal of Emergency Primary Health Care 2005;3(3):Article number CC930130.Google Scholar