Objective: To compare head motions that occur when trained professionals perform the head squeeze (HS) and trap squeeze (TS) C-spine stabilization techniques.
Design: Cross-over design.
Participants: Twelve experienced lead rescuers.
Main Outcome Measures: Peak head motion with respect to initial conditions using inertial measurement units attached to the forehead and trunk of the simulated patient. We compared both HS and TS during lift-and-slide (L&S) and log-roll (LR) placement on spinal board, and agitated patient trying to sit up (AGIT-Sit) or rotate his head (AGIT-Rot). The a priori minimal important difference (MID) was 5 degrees for flexion or extension and 3 degrees for rotation or lateral flexion.
Results: The L&S technique was statistically superior to the LR technique. The only differences to exceed the MID were extension and rotation during LR (HS > TS). In the AGIT-Sit test scenario, differences in motion exceeded MID (HS > TS) for flexion, rotation, and lateral flexion. In the AGIT-Rot scenario, differences in motion exceeded MID for rotation only (HS >TS). There was similar intertrial variability of motion for HS and TS during L&S and LR but significantly more variability with HS compared with TS in the agitated patient.
Conclusions: The L&S is preferable to the LR when possible for minimizing unwanted C-spine motion. There is little overall difference between HS and TS in a cooperative patient. When a patient is confused, the HS is much worse than the TS at minimizing C-spine motion.
From the *Department of Surgery, School of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada; †Research Centre on Aging, CSSS-IUGS, Sherbrooke, Quebec, Canada; ‡Centre for Clinical Epidemiology and Community Studies, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Quebec, Canada; §Cirque du Soleil, Las Vegas, Nevada; ¶Division of Sports Medicine, Department of Orthopaedic Surgery, School of Medicine, Stanford University, Stanford, California; ‖Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada; **Emergency Department, Jewish General Hospital, McGill University; Montreal, Quebec, Canada; ††Urgences-santé, Montreal, Quebec, Canada; ‡‡Department of Exercise Science/Athletic Therapy, Concordia University, Montreal, Quebec, Canada; and §§Department of Mathematics and Statistics, McGill University, Montreal, Quebec, Canada.
Submitted for publication July 12, 2010; accepted January 10, 2011.
Supported by the Canadian Academy of Sport & Exercise Medicine.
The authors report no conflicts of interest.
Corresponding Author: Ian Shrier, MD, PhD, Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, 3755 Cote Ste-Catherine, Montreal, Quebec H3T 1E2, Canada (e-mail: firstname.lastname@example.org).