Efficacy of Prehospital Spine and Limb Immobilization in Multiple Trauma Patients

Background: Injuries are a major cause of mortality and disability worldwide and are estimated to become the third leading cause of death by ۲۰۲۰. Most traffic deaths occur during the prehospital phase; consequently, prehospital trauma care has received considerable attention during the past decade. However, there is no study on the prehospital immobilization of spine and limbs in patients with multiple trauma in Iran. Objectives: This study aimed to investigate the epidemiology of trauma and the quality of limb and spine immobilization in patients with multiple trauma transferred to Shahid Beheshti Medical Center via emergency medical services (EMS). Patients and Methods: This cross-sectional study was conducted in ۲۰۱۳. The study population consisted of all patients with multiple trauma who had been transferred by EMS to the Central Trauma Department of the Shahid Beheshti Medical Center, Kashan, Iran. The study used a checklist and we recruited a convenience sample of ۴۰۰ patients with multiple trauma. Data were described by using frequency tables, central tendency measures, and variability indices. Moreover, we analyzed data using SPSS. Results: The study sample consisted of ۳۰۱ (۷۵.۲%) males and ۹۹ (۲۴.۸%) females. The most common mechanism of trauma was traffic injuries (۸۷.۲۵%). Motorcyclists constituted ۵۲.۲۵% of the road traffic injuries victims. Overall, the quality of immobilization was at an undesirable level in ۹۵.۸% of patients with spine and limbs injuries. A significant association was observed between the quality of spine and limbs immobilization and the EMS workers’ education level (P = ۰.۰۰۵). Conclusions: The quality of spine and limb immobilizations was undesirable in more than ۹۰% of cases. Due to the importance of good spine and limb immobilization in patients with multiple trauma, prehospital EMS technicians should be retrained for proper immobilization in patients suspected of spine or limb injuries. Developing evidence-based protocols and strengthening the regulatory and supervisory system to improve quality of prehospital emergency care in patients with multiple trauma is recommended.

Keywords:

Epidemiology , Healthcare Quality , Emergency care , Prehospital , Immobilization , Multiple Trauma