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In this study, it was aimed to evaluate whether spinal immobilization at 20°, instead of the traditional 0°, affects intracranial pressure (ICP) via the ultrasonographic (USG) measurement of optic nerve sheath diameter (ONSD). 140 healthy, adult, non-smoking volunteers who had no acute or chronic diseases were included this study. Volunteers were randomly divided into two groups; performed spinal immobilization at 0° (Group 1) and at 20° (Group 2). After spinal immobilization (at 0 or 20°), measurements of ONSD were performed at 0, 30, and 60 min in an immobilized position. When evaluating the change in ONSD over time (at 30 and 60 min) as compared to basal measurements at 0 min, it was found that the ONSD values of both sides (the right and left eyes) were significantly increased in Group 1 and Group 2. For Groups 1 and 2, these differences existed both between 0 and 30 min and between 30 and 60 min. In addition, in this study, the amounts of increase in the ONSD measurements from 0 to 30 min and from 30 to 60 min (ΔONSD0–30 min and ΔONSD30–60 min) in both groups were compared. The results showed that there was no significant difference between Group 1 and Group 2 in terms of ΔONSD measurements. Spinal immobilization at 0° as a part of routine trauma management increased ONSD and thus ICP. Secondly, we found that similar to immobilization at 0°, spinal immobilization at 20° increased ONSD.

The aim of the study was to assess whether spinal immobilization with long back board (LBB) and semi-rigid cervical collar (CC) at 20° instead of 0° conserves pulmonary functions in obese volunteers, including forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio. The study included adult volunteer subjects with android-type obesity who were otherwise healthy. First, pulmonary functions were tested in a seated position to obtain baseline levels, than volunteers were immobilized with LBB and CC at 0-degree and measurements repeated at 0th and 30th minute of immobilization. Next day, same procedures were repeated with the trauma board at 20-degree. Changes over time in FEV1, FVC values and FEV1/FVC ratios during spinal immobilization at 0° and 20° were compared to baseline levels. Study included 30 volunteers. Results showed a significant decline in all values for both situations following spinal immobilization (p < .001). We also compared the decrease over time in those values (ΔFEV1, ΔFVC, and ΔFEV1/FVC ratio) during spinal immobilization at 0° and 20°. The decrease in pulmonary functions was similar in both groups (p > .05). The present findings confirm that spinal immobilization reduces pulmonary functions in obese volunteers, and that 20-degree immobilization has no conservative effect on these values when compared to the traditional 0-degree immobilization. It may be that 20° is insufficient to decrease the negative effect of abdominal obesity on pulmonary functions.

The use of a long backboard and cervical collar are commonly recommended by international guidelines for spinal immobilization, but both devices may cause several side effects. In a recent study, it was reported that spinal immobilization at 20° eliminated the decrease in pulmonary function secondary to spinal immobilization performed at 0°. Spinal immobilization at 20° is a new recommendation, but other potential effects need to be explored before it can be implemented in clinical use. Hemodynamic observation is important in the management of trauma patients. The aim of this study was to investigate the effect of spinal immobilization at a 20° position instead of 0° on hemodynamic parameters. This study included 53 healthy volunteers who underwent spinal immobilization in the supine position (00) and in an elevated position (200). Systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), heart rate (HR), left ventricular outflow tract velocity time integral (LVOT-VTI), left ventricular stroke volume (LVSV), cardiac output (CO), inferior vena cava diameter inspiration (IVC diameter insp), IVC diameter expiration (IVC diameter exp), and inferior vena cava collapsibility index (IVC-CI) were measured at the 0th and 30th minutes of spinal immobilization in both positions. The data were compared for demonstrating the efficiency of both positions in spinal immobilization. A statistically significant difference was found in the parameters of the IVC diameter (exp), IVC diameter (insp), LVOT-VTI, LVSV, and CO through the measurements starting in the 0th minute of the transition from 0° to 20° (P <.001). Delta values (∆) of hemodynamic parameters (∆IVC diameter [exp], ∆IVC diameter [insp], ∆LVOT-VTI, ∆SV, ∆CO, ∆IVC-CI, ∆MAP, ∆SAP, ∆DAP, and ∆HR) were similar in spinal immobilization at 0° and 20°. The findings obtained from this study illustrate that spinal immobilization at 20° does not cause clinically significant hemodynamic changes in healthy subjects compared to spinal immobilization at 0°.

The aim of this study was to research the effect of a long backboard (LBB) and cervical collar (CC) devices on neck and/or back pain and changes in the vital signs of healthy subjects. This study was conducted in the emergency department of a training and research hospital with 45 healthy adult volunteers. All the volunteers were asked to lie down on the LBB, and a CC was applied. All the vital signs, including respiratory rate (RR), heart rate (HR), oxygen saturation (SO2), blood pressure (BP) and visual analog scores (VAS) were measured and recorded for all the volunteers at 0, 5, and 30 min. Significant increases in VAS and significant decreases in systolic BP were detected (p-values were <0.001 and 0.01, respectively). However, in terms of diastolic BP, RR, HR, and SO2, no significant changes were detected. Physicians should be aware that spinal immobilization with LBB and CC can cause significant changes in some vital signs, such as SBP and VAS. However, data on this topic is limited; therefore, there is a need for further studies involving a larger cohort population.