Top

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Published in:

Open Access 01-12-2011 | Original research

The lateral trauma position: What do we know about it and how do we use it? A cross-sectional survey of all Norwegian emergency medical services

Authors: Sabina Fattah, Guri R Ekås, Per Kristian Hyldmo, Torben Wisborg

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2011

Abstract

Background

Trauma patients are customarily transported in the supine position to protect the spine. The Airway, Breathing, Circulation, Disability, and Exposure (ABCDE) principles clearly give priority to airways. In Norway, the lateral trauma position (LTP) was introduced in 2005. We investigated the implementation and current use of LTP in Norwegian Emergency Medical Services (EMS).

Methods

All ground and air EMS bases in Norway were included. Interviews were performed with ground and air EMS supervisors. Questionnaires were distributed to ground EMS personnel.

Results

Of 206 ground EMS supervisors, 201 answered; 75% reported that LTP is used. In services using LTP, written protocols were present in 67% and 73% had provided training in LTP use. Questionnaires were distributed to 3,025 ground EMS personnel. We received 1,395 (46%) valid questionnaires. LTP was known to 89% of respondents, but only 59% stated that they use it. Of the respondents using LTP, 77% reported access to written protocols. Flexing of the top knee was reported by 78%, 20% flexed the bottom knee, 81% used under head padding. Of 24 air EMS supervisors, 23 participated. LTP is used by 52% of the services, one of these has a written protocol and three arrange training.

Conclusions

LTP is implemented and used in the majority of Norwegian EMS, despite little evidence as to its possible benefits and harms. How the patient is positioned in the LTP differs. More research on LTP is needed to confirm that its use is based on evidence that it is safe and effective.

Available only for authorised users

American College of Surgeons Committee on Trauma: Advanced Trauma Life Support for doctors (Student Course Manual). 2008, Chicago. American College of Surgeons

PHTLS Committee of NAEMT: PHTLS--Basic and Advanced Prehospital Trauma Life Support. 2003, St. Louis: Mosby

Primary Trauma Care Foundation. [http://www.primarytraumacare.org/]

Chesnut RM, Marshall LF, Klauber MR, Blunt BA, Baldwin N, Eisenberg HM: The role of secondary brain injury in determining outcome from severe head injury. J Trauma. 1993, 34: 216-22. 10.1097/00005373-199302000-00006.CrossRefPubMed

Chi JH, Knudson MM, Vassar MJ, McCarthy MC, Shapiro MB, Mallet S: Prehospital hypoxia affects outcome in patients with traumatic brain injury: a prospective multicenter study. J Trauma. 2006, 61: 1134-41. 10.1097/01.ta.0000196644.64653.d8.CrossRefPubMed

Davis DP, Meade W, Sise MJ, Kennedy F, Simon F, Tominaga G: Both hypoxemia and extreme hyperoxemia may be detrimental in patients with severe traumatic brain injury. J Neurotrauma. 2009, 26: 2217-23. 10.1089/neu.2009.0940.CrossRefPubMed

Pigula FA, Wald SL, Shackford SR, Vane DW: The effect of hypotension and hypoxia on children with severe head injuries. J Pediatr Surg. 1993, 28: 310-4. 10.1016/0022-3468(93)90223-8.CrossRefPubMed

Davis DP, Peay J, Sise MJ, Kennedy F, Simon F, Tominaga G: Prehospital airway and ventilation management: a trauma score and injury severity score-based analysis. J Trauma. 2010, 69: 294-301. 10.1097/TA.0b013e3181dc6c7f.CrossRefPubMed

Handley AJ, Koster R, Monsieurs K, Perkins GD, Davies S, Bossaert L:European Resuscitation Council guidelines for resuscitation 2005. Section 2. Adult basic life support and use of automated external defibrillators. Resuscitation 2005, 67(Suppl 1):S7-23CrossRefPubMed

10.

Nolan JP, Soar J, Zideman DA, Biarent D, Bossaert LL, Deakin C, et al:European Resuscitation Council Guidelines for Resuscitation 2010. Section 1. Executive summary. Resuscitation 2010, 81:1219-76CrossRefPubMed

11.

Stiell IG, Nesbitt LP, Pickett W, Munkley D, Spaite DW, Banek J: The OPALS Major Trauma Study: impact of advanced life-support on survival and morbidity. CMAJ. 2008, 178: 1141-52. 10.1503/cmaj.071154.PubMedCentralCrossRefPubMed

12.

Davis DP, Peay J, Sise MJ, Vilke GM, Kennedy F, Eastman AB: The impact of prehospital endotracheal intubation on outcome in moderate to severe traumatic brain injury. J Trauma. 2005, 58: 933-9. 10.1097/01.TA.0000162731.53812.58.CrossRefPubMed

13.

Berlac P, Hyldmo PK, Kongstad P, Kurola J, Nakstad AR, Sandberg M: Pre-hospital airway management: guidelines from a task force from the Scandinavian Society for Anaesthesiology and Intensive Care Medicine. Acta Anaesthesiol Scand. 2008, 52: 897-907. 10.1111/j.1399-6576.2008.01673.x.CrossRefPubMed

14.

Hauswald M, Ong G, Tandberg D, Omar Z: Out-of-hospital spinal immobilization: its effect on neurologic injury. Acad Emerg Med. 1998, 5: 214-9. 10.1111/j.1553-2712.1998.tb02615.x.CrossRefPubMed

15.

Kwan I, Bunn F, Roberts IG: Spinal immobilisation for trauma patients. Cochrane Database Syst Rev. 2001, 2: CD002803-PubMed

16.

Dodd FM, Simon E, McKeown D, Patrick MR: The effect of a cervical collar on the tidal volume of anaesthetised adult patients. Anaesthesia. 1995, 50: 961-3. 10.1111/j.1365-2044.1995.tb05928.x.CrossRefPubMed

17.

Blake WE, Stillman BC, Eizenberg N, Briggs C, McMeeken JM: The position of the spine in the recovery position--an experimental comparison between the lateral recovery position and the modified HAINES position. Resuscitation. 2002, 53: 289-97. 10.1016/S0300-9572(02)00037-0.CrossRefPubMed

18.

Gunn BD, Eizenberg N, Silberstein M, McMeeken JM, Tully EA, Stillman BC, Brown DJ, Gutteridge GA: How should an unconscious person with a suspected neck injury be positioned?. Prehosp Disaster Med. 1995, 10: 239-244.PubMed

19.

Grol R, Grimshaw J: From best evidence to best practice: effective implementation of change in patients' care. Lancet. 2003, 11: 1225-30.CrossRef

20.

The Laerdal Foundation. The Utstein Formula of Survival. [http://www.laerdalfoundation.org/studier_hypoteser.html]

Title: The lateral trauma position: What do we know about it and how do we use it? A cross-sectional survey of all Norwegian emergency medical services
Authors: Sabina Fattah
Guri R Ekås
Per Kristian Hyldmo
Torben Wisborg
Publication date: 01-12-2011
Publisher: BioMed Central
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine / Issue 1/2011
Electronic ISSN: 1757-7241
DOI: https://doi.org/10.1186/1757-7241-19-45

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The lateral trauma position: What do we know about it and how do we use it? A cross-sectional survey of all Norwegian emergency medical services

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2011

The counterintuitive effect of multiple injuries in severity scoring: a simple variable improves the predictive ability of NISS

Novel rapid infusion device for patients in emergency situations

Alcohol consumption, blood alcohol concentration level and guideline compliance in hospital referred patients with minimal, mild and moderate head injuries

The effect of active warming in prehospital trauma care during road and air ambulance transportation - a clinical randomized trial

Implementation of checklists in health care; learning from high-reliability organisations

Point of care technology or standard laboratory service in an emergency department: is there a difference in time to action? A randomised trial