Randomised controlled trial of the clinical and cost-effectiveness of cervical spine immobilisation following blunt trauma (SIS trial) (SIS Trial)

Research summary

AIM: To assess whether movement minimisation is no worse than triple spinal immobilisation for patients who have may have or are suspected of having a spinal injury in the pre-hospital and emergency setting. BACKGROUND: Spinal cord damage often occurs as a result of road traffic crashes, sports injury or falls in frail people. Although rare, it can dramatically affect quality of life and lead to long term disability or death. In the UK, when a potential traumatic spinal injury occurs, current practice is for paramedics to strap the patient down on a rigid board/mattress using tape supported by blocks and/or a hard neck collar.. This reduces movement to prevent more damage to the spine during transfer to hospital. This is known as “triple spinal immobilisation”. There is some concern that this can harm more than help patients (e.g. difficulty in breathing, skin or brain injury, aggravate spine injury in rare instances). By altering some of the aspects of triple immobilisation, we can introduce some flexibility, where the patient is more comfortable and may have fewer side effects. This is known as "movement minimisation". Currently, we don’t know if movement minimisation will improve or worsen spinal problems and potential complications such as breathing in vomit, skin problems and brain injury. This research was ranked in the top 10 Emergency Care Research Questions by the James Lind Alliance Emergency Medicine Research Priority Setting Partnership in 2017. DESIGN AND METHODS: In total, about 8316 patients will be randomly assigned one of these immobilisation methods. We will assess their nerve function at injury, when they arrive and leave hospital, see what side effects these patients have had and collect information during and after they have left hospital to assess their well-being. We will initially recruit 800 patients to ensure a larger trial is feasible.

Principal Investigator

Edward Norris-Cervetto

Contact us

Email: sally.beer@ouh.nhs.uk

IRAS number

316755