Document Detail


Effect of spinal immobilization on heart rate, blood pressure and respiratory rate.
MedLine Citation:
PMID:  23522699     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Vital signs remain important clinical indicators in the management of trauma. Tissue injury and ischemia cause tachycardia and hypertension, which are mediated via the sympathetic nervous system (SNS). Spinal immobilization is known to cause discomfort, and it is not known how this might influence the SNS and contribute to abnormal vital signs. Hypothesis This study aimed to establish whether the pain and discomfort associated with spinal immobilization and the maneuvers commonly used in injured patients (eg, log roll) affect the Heart rate (HR), Systolic Blood Pressure (SBP) and Respiratory rate (RR). The null hypothesis was that there are no effects.
METHODS: A prospective, unblinded, repeated-measure study of 53 healthy subjects was used to test the null hypothesis. Heart rate, BP and RR were measured at rest (five minutes), after spinal immobilization (10 minutes), following log roll, with partial immobilization (10 minutes) and again at rest (five minutes). A visual analog scale (VAS) for both pain and discomfort were also collected at each stage. Results were statistically compared.
RESULTS: Pain VAS increased significantly during spinal immobilization (3.8 mm, P < .01). Discomfort VAS increased significantly during spinal immobilization, after log roll and during partial immobilization (17.7 mm, 5.8 mm and 8.9 mm, respectively; P < .001). Vital signs however, showed no clinically relevant changes. Discussion Spinal immobilization does not cause a change in vital signs despite a significant increase in pain and discomfort. Since no relationship appears to exist between immobilization and abnormal vital signs, abnormal vital signs in a clinical situation should not be considered to be the result of immobilization. Likewise, pain and discomfort in immobilized patients should not be disregarded due to lack of changes in vital signs.
Authors:
Stevan R Bruijns; Henry R Guly; Lee A Wallis
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Publication Detail:
Type:  Journal Article     Date:  2013-03-25
Journal Detail:
Title:  Prehospital and disaster medicine     Volume:  28     ISSN:  1049-023X     ISO Abbreviation:  Prehosp Disaster Med     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-21     Completed Date:  2013-08-02     Revised Date:  2013-12-17    
Medline Journal Info:
Nlm Unique ID:  8918173     Medline TA:  Prehosp Disaster Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  210-4     Citation Subset:  T    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Blood Pressure
Female
Heart Rate
Humans
Immobilization*
Male
Middle Aged
Pain Measurement
Prospective Studies
Respiratory Rate
Spinal Injuries / therapy
Spine
Vital Signs*
Young Adult
Comments/Corrections
Comment In:
Prehosp Disaster Med. 2013 Oct;28(5):533-4   [PMID:  23777603 ]
Prehosp Disaster Med. 2013 Oct;28(5):534

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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