Evaluating the Routine Use of Cervical Immobilisation in Pre-Hospital Trauma Care: Risks and Benefits

Early cervical spine immobilisation (CSI) has long been a critical component of the pre-hospital management of traumatic injuries with possible spinal cord injury. CSI aims to stabilise the spine to prevent worsening an unstable injury. There is conflicting evidence regarding its effectiveness, and concerns exist about the potential risks, including neurological damage, respiratory compromise, and difficulty performing intubation. This article will review the relevant literature to assess whether CSI should continue to be used routinely in pre-hospital trauma care. A literature review was conducted using the Web of Science, Cinahl, Embase, Medline and Cochrane databases, and manual searches of reference lists. Articles published after 2010 were included. Selection was based on the title and abstract, followed by a full-text review. No studies directly compare outcomes between immobilisation and non-immobilisation, hence, it is difficult to determine whether the benefits outweigh the risks. The potential adverse effects of CSI have been more robustly evidenced than the benefits of CSI. Therefore, CSI may not be appropriate for routine use and should be limited to patients at higher risk of an unstable spinal injury. Further research is necessary to assess whether CSI reduces morbidity and mortality of spinal injuries.