The effects of neutral positioning with and without padding on spinal immobilization of healthy subjects
Prehospital Emergency Care
OBJECTIVES: To compare the incidences and severities of pain experienced by healthy volunteers undergoing spinal immobilization in the neutral position with and without occipital padding. To compare the incidence of pain when immobilized in the neutral position with the incidence in a non-neutral position. METHODS: Thirty-nine healthy volunteers over the age of 18 years who had no acute pain or illness, were not pregnant, and had no history of back problems or surgery voluntarily participated
... rily participated in a prospective, randomized, crossover study conducted in a clinical laboratory setting. Appropriately sized rigid cervical collars were applied to the subjects, who were then immobilized on wooden backboards with their cervical spines maintained in the neutral position using towels (padded) or plywood (unpadded) under their occiputs. The subjects were secured to the board with straps, soft head blocks, and tape for 15 minutes to simulate a typical ambulance transport time. The straps, head blocks, and tape were removed, and the subjects remained on the board for an additional 45 minutes to simulate a typical emergency department experience. The subjects were then asked to identify the location(s) of any pain or anterior and posterior body outlines and to indicate the corresponding severity of pain on a 10-cm visual analog scale. The subjects were also asked questions about movement, respiratory symptoms, and strap discomfort in an attempt to distract them from the true focus of the study (i.e., pain). A similar survey was given to each participant a complete 24 hours later. The same subjects were immobilized with the alternate occipital material a minimum of two weeks later utilizing the same procedure. They again completed both surveys.