Prevention of neurological injury during extrication of a conscious patient

Abstract

Topic overview: Locally there is no knowledge on self-extrication and therefore, this needs further investigation. The aim of this dissertation is to discuss and evaluate the safest extrication method to prevent secondary neurological injuries. Proposed research question: In patients involved in a road traffic collision, is self extrication more effective than standard extrication in prevention of secondary neurological injury? PICO Elements: P– Patients involved in a road traffic collision. I – Self extrication. C –Standard extrication. O - To prevent secondary neurological injury Inclusion and exclusion criteria: Throughout the search, filters were included to limit the search to the specific study criteria. Journals and peer-reviewed articles were included in the search while magazines, newspapers, letters, dissertations, interviews and editorial reviews were excluded. The studies incorporated by the inclusion criteria were conducted in the English language in the past ten years. All other languages were excluded along with studies which were conducted more than ten years ago. Only literature that evaluated self or standard extrication of individuals following a road traffic collision were included. That is, other extrication methods were excluded. Outcome of the search: This search was achieved using both manual and electronic searches, applying the following databases: CINAHL Complete (EBSCO), PubMed Central (PMC), Medline Complete (EBSCO), Academic search ultimate (EBSCO), MEDLINE ProQuest, Cochrane Central Register of Controlled Trials (EBSCO), Cochrane Database of Systematic Reviews (EBSCO) AND Google Scholar. As a result, two Quasi-Experimental Studies, one Systematic Review, Retrospective Review Cohort Study and one Cross Sectional Study were retrieved. Methods of appraisal used: The CASP and JBI tools were used according to the study design. Main results and conclusion: The overall results showed that self extrication is safer and more effective than standard extrication to prevent secondary neurological injuries. Implications and recommendation: Further research studies are recommended for clearer results. Also, first responders must acquire more knowledge on self-extrication and practice it so that it can be applied to their pre-hospital routine. Making the population accustomed to self extrication is also recommended so that when someone experiences a road collision, the individual would have an idea of what is about to happen and therefore take extra notice to the instructions given from the health professional team. A leader can be arranged to collect the appropriate information regarding self-extrication and so then one can manage this extrication technique and apply into practice.