To compare head motions that occur when trained professionals perform the head squeeze (HS) and trap squeeze (TS) C-spine stabilization techniques.
Twelve experienced lead rescuers.
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.
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.
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: email@example.com).