DISCONTINUATION OF CERVICAL-SPINE IMMOBILIZATION IN UNCONSCIOUS PATIENTS WITH TRAUMA IN INTENSIVE-CARE UNITS - TELEPHONE SURVEY OF PRACTICEIN SOUTH AND WEST REGION

Objective: To study ho cv the cervical spine is assessed before discon tinuation of cervical spine immobilisation in unconscious trauma patie nts in intensive fare units. Design: Telephone interview of consultant s responsible for adult intensive care units. Setting: All 25 intensiv e care units in the South and West region that admit victims of major trauma. Main outcome measures: The clinical and radiological basis on which the decision is made to stop cervical spine immobilisation in un conscious patients Results: in 19 units cervical spine immobilisation was stopped in unconscious patients on the basis of radiology alone, a nd six units combined radiology with clinical examination after the pa tient had regained consciousness, Sixteen units relied on a normal lat eral radiological view of the cervical spine alone, five required a no rmal lateral and anteroposterior view, and four required a normal late ral, anteroposterior, and open mouth pig view. Conclusions: There are inconsistencies in the clinical and radiological approach to assessing the cervical spine in unconscious patients with trauma before the rem oval of immobilisation precautions. There is an overreliance on tile l ateral cervical spine view alone, which has been shown to be insensiti ve in this setting.