The aim of the study is to evaluate the application of Canadian C-Spine rules adapted to pre-hospital settings in France in order to improve the appropriateness of cervical spine immobilisation, reduce unnecessary imaging examinations and optimise patient care pathways.
GCS 15
Stable (no organ failure, SBP ≥ 90 mmHg, DBP ≥ 65 mmHg, RF between 10 and 24 cycles/min)
Cooperative (calm and obedient to instructions)
Victim of a closed cervical spine trauma treated in the pre-hospital setting (fire brigade and/or Mobile Emergency and Resuscitation Service (SMUR)).
Life-threatening organ damage
Cardiorespiratory arrest since the traumatic event in question
Polytrauma patient
Penetrating trauma or a supra-clavicular wound following a knife or firearm injury
Parallel
adapted Canadian C-Spine rules
BehavioralThe CCRa are decision rules for pre-hospital cervical spine collar immobilization. They include three high-risk criteria indicating imaging, 5 low-risk criteria allowing assessment of cervical spine rotation, and finally the ability of patients to achieve limited active rotation. They have been designed and validated to avoid immobilization during transport to the emergency department without any significant cervical injury being missed.
Proportion of patients admitted to emergency service
Proportion of patients admitted to emergency following pre-hospital management of the traumatic event.
Proportion of patients with cervical spine trauma admitted to emergency departments for a reason other than cervical spine trauma
Proportion of patients with cervical spine trauma admitted to emergency departments for a reason other than cervical spine trauma: Upper limb trauma, lower limb trauma, head trauma, chest pain, abdominal pain, pelvic pain, suture wound.
Rate of relevant management strategy
number of collars fitted and not fitted in a relevant manner in relation to the number of patients included in each of the two groups compared at day 14
Proportion of patients with cervical imagery at 14 days
Proportion of patients having undergone : \- at least one cervical imaging within 14 days of the trauma (cervical X-rays, cervical CT or cervical MRI) and number of examinations carried out.
Proportion of patients with at least one consultation for neck pain
Proportion of patients having had at least one consultation for neck pain in the 30 days following the trauma (general practitioner in town or visit to the emergency department), number of consultations per patient and delay in relation to the initial treatment.
Click on the lead sponsor to view all of their trials.
