Ambulance UK April 2022

FEATURE
Table 2 Maximal movement and travel
Table Table Maximal 2 Maximal movement and and travel travel
Table 2 Maximal movement Maximal movement and travelduring extrication
Travel (total movement) during extrication
Table 2 Maximal Maximal
Roof
Maximal movement off B
movement
post and p travel during
value
during Rapid
extrication
Maximal movement during extricationp value Self p value
Travel
Roof
Travel (total
off
(total
B post
movement)
p value
during during
Rapid extrication
Travel (total movement) during extrication p valve Self p value
Roof Roof off off post B post value p value Rapid Rapid value p value Self Self value p value Roof Roof off off post B post value p value Rapid Rapid valve p valve Self Self value p value
Lumbar A/P[mm] Roof 9.65
Maximal
off B post 10.73
movement
p 0.45 value
during
Rapid 12.47
extrication
p value 0.09 Self 4.47 p value < 0.001 Roof 26.56
Travel
off B
(total
post 30.25
movement)
p value 0.28 Rapid
during
36.07
extrication
p valve 0.02 Self 8.49 p value < 0.001
Lumbar Lumbar A/P[mm] Lat A/P[mm] 9.65 8.63 Roof 9.65 off 10.73 10.79 10.73 B post 0.45 0.27 0.45 p value 12.47 11.62 12.47 Rapid 0.09 p 0.13 value 0.094.47 5.67 Self 4.47 0.03 0.001 p < value 0.00126.56 21.80 26.56 Roof off30.25 30.70 B 30.25 post 0.28 0.06 0.28 p value36.07 37.67 Rapid 36.07 0.02 0.008 0.02 p valve8.49 10.69 Self 8.49 0.001 < p < value 0.001
Lumbar A/P[mm] 9.65 10.73 0.45 12.47 0.09 4.47 < 0.001 26.56 30.25 0.28 36.07 0.02 8.49 < 0.001
Lumbar Cervical Lumbar Lat A/P [mm] Lat [mm] 8.63 5.23 8.63 10.79 5.86 10.790.27 < 0.27 0.001 11.62 6.21 11.62 0.13 < 0.001 0.135.67 2.61 5.67 0.03 < 0.03 0.001 21.80 16.69 21.80 30.70 17.72 30.70.06 0.65 0.06 37.67 20.51 37.67 0.008 0.13 0.008 10.69 4.97 10.69 0.001 < 0.001
Lumbar Lumbar Lat A/P[mm] 8.639.65 10.79 10.730.270.45 11.62 12.47 0.130.095.674.47 0.03< 0.00121.80 26.56 30.70 30.25 0.060.28 37.67 36.07 0.008 0.02 10.698.49 < 0.001 < 0.001
Cervical Cervical A/P Lat A/P [mm] [mm] 5.23 5.11 5.23 5.86 6.88 5.86 0.05 0.001 < 0.0016.21 5.60 6.21 0.001 0.59 < 0.0012.61 2.38 2.61 0.001 < 0.0016.69 14.56 16.69 17.72 19.02 17.72 0.65 0.09 0.65 20.51 17.68 20.51 0.13 0.28 0.13 4.97 4.46 4.97 0.001 < 0.001
Cervical Lumbar A/P Lat [mm] [mm] 5.238.63 5.86 10.79< 0.001 0.27 6.211.62 < 0.001 0.132.615.67 < 0.001 0.03 16.69 21.80 17.72 30.70.650.06 20.51 37.67 0.130.008 4.97 10.69 < 0.001 < 0.001
Cervical Lumbar Cervical Lat roll [mm] Lat [°][mm] 5.11 18.83 5.11 6.88 23.47 6.880.05 0.31 0.05 5.60 25.46 5.60 0.59 0.14 0.592.38 11.25 2.38 0.01 0.001 0.0014.56 47.59 14.56 19.02 66.83 19.02 0.09 0.10 0.09 17.68 82.49 17.68 0.28 0.02 0.28 4.46 21.09 4.46 0.001 < 0.001
Cervical Cervical Lat [mm] A/P [mm] 5.115.23 6.885.860.05< 0.0015.606.21 0.59 < 0.0012.382.61 < 0.001 < 0.0014.56 16.69 19.02 17.72 0.090.65 17.68 20.51 0.280.13 4.464.97 < 0.001 < 0.001
Lumbar Lumbar roll pitch [°] roll [°] 18.83 22.91 18.83 23.47 22.55 23.470.31 0.94 0.31 25.46 22.33 25.46 0.14 0.89 0.1411.25 8.20 11.25 0.01 < 0.01 0.001 47.59 61.63 47.59 66.83 65.59 66.83 0.10 0.74 0.10 82.49 75.97 82.49 0.02 0.38 0.02 21.09 15.63 21.09 0.001 < 0.001
Lumbar Cervical roll [°] Lat [mm] 18.835.11 23.476.880.310.05 25.465.60 0.140.5911.252.38 0.01< 0.00147.59 14.56 66.83 19.02 0.100.09 82.49 17.68 0.020.28 21.094.46 < 0.001 < 0.001
Lumbar Lumbar pitch yaw pitch [°] [°] [°] 22.91 29.80 22.91 22.55 42.59 22.550.94 0.14 0.94 22.33 31.65 22.33 0.89 0.78 0.898.20 11.23 8.20 0.001 < 0.00161.63 74.73 61.63 65.59 109.69 65.59 0.74 0.12 0.74 75.97 101.09 75.97 0.38 0.27 0.38 15.63 21.13 15.63 0.001 < 0.001
Lumbar Lumbar pitch roll [°] [°] 22.918.83 22.55 23.470.940.31 22.33 25.46 0.890.148.20 11.25 < 0.001 0.01 61.63 47.59 65.59 66.83 0.740.10 75.97 82.49 0.380.02 15.63 21.09 < 0.001 < 0.001
Lumbar Cervical Lumbar yaw roll yaw [°] [°] [°] 29.80 15.55 29.80 42.59 20.54 42.590.14 0.08 0.14 31.65 16.62 31.65 0.78 0.68 0.7811.23 7.07 11.23 0.001 < 0.00174.73 44.52 74.73 109.69 55.79 109.69 0.12 0.16 0.12 101.09 53.92 101.09 0.27 0.28 0.27 21.13 13.31 21.13 0.001 < 0.001
Lumbar Lumbar yaw pitch [°] [°] 29.80 22.91 42.59 22.550.140.94 31.65 22.33 0.780.8911.238.20 < 0.001 < 0.00174.73 61.63 109.69 65.59 0.120.74 101.09 75.97 0.270.38 21.13 15.63 < 0.001 < 0.001
Cervical Cervical roll pitch [°] roll [°] 15.55 14.90 15.55 20.54 16.29 20.540.08 0.48 0.08 16.62 17.55 16.62 0.68 0.21 0.687.07 7.34 7.07 0.001 < 0.00144.52 47.32 44.52 55.79 48.67 55.79 0.16 0.82 0.16 53.92 56.51 53.92 0.28 0.15 0.28 13.31 13.99 13.31 0.001 < 0.001
Cervical Lumbar roll [°] yaw [°] 15.55 29.80 20.542.590.080.14 16.62 31.65 0.680.787.07 11.23 < 0.001 < 0.00144.52 74.73 55.79 109.69 0.160.12 53.92 101.09 0.280.27 13.31 21.13 < 0.001 < 0.001
Cervical Cervical pitch yaw pitch [°] [°] [°] 14.90 20.45 14.90 16.29 26.60 16.290.48 .098 0.48 17.55 22.98 17.55 0.21 0.53 0.217.34 6.10 7.34 0.001 < 0.00147.32 52.46 47.32 48.67 69.31 48.67 0.82 0.07 0.82 56.51 64.41 56.51 0.15 0.25 0.15 13.99 12.14 13.99 0.001 < 0.001
Cervical Cervical pitch roll [°] [°] 14.90 15.55 16.29 20.540.480.08 17.55 16.62 0.210.687.347.07 < 0.001 < 0.00147.32 44.52 48.67 55.79 0.820.16 56.51 53.92 0.150.28 13.99 13.31 < 0.001 < 0.001
Cervical Cervical yaw yaw [°] [°] 20.45 20.45 26.60 26.60 .098 .098 22.98 22.98 0.53 0.536.106.10 0.001 0.00152.46 52.46 69.31 69.31 0.07 0.07 64.41 64.41 0.25 0.25 12.14 12.14 0.001
0.001
Cervical Cervical yaw pitch [°] [°] 20.45 14.90 26.60 16.29.0980.48 22.98 17.55 0.530.216.107.34 < 0.001 < 0.00152.46 47.32 69.31 48.67 0.070.82 64.41 56.51 0.250.15 12.14 13.99 < 0.001 < 0.001
Cervical yaw [°] 20.45 26.60 .098 22.98 0.53 6.10 < 0.001 52.46 69.31 0.07 64.41 0.25 12.14 < 0.001
Roof off
Roof off Roof off
Roof off
B post
Roof off
B post B post
B post
Rapid ex
B post
Rapid Rapid ex ex
Rapid ex
Self ex
Rapid ex
Self ex Self ex
Self ex 0.0 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0
Self Mean excursion (mm) and 95% confidence intervals
0.0ex
0.0 1.0 1.0 2.0 2.0 3.0 3.0 4.0 4.0 5.0 5.0 6.0 6.0 7.0 7.0 8.0 8.0
Fig. 20.0Mean 1.0
excursion Mean Mean excursion 2.0 excursion and (mm) 3.0
confidence (mm) and 4.0 95% and 95% confidence intervals
5.0 confidence for intervals 6.0anterior–
intervals 7.0 8.0
Mean excursion (mm) and 95% confidence intervals
posterior Fig. 2 Mean movement 0.0
excursion
1.0 at the 2.0
and cervical confidence
3.0 spine 4.0
intervals
5.0
for
6.0
anterior–
7.0 8.0
Mean excursion (mm) and 95% confidence intervals
Fig. Mean excursion and confidence intervals for anterior–
Fig.
posterior posterior
2 Mean excursion
movement at
and
the at the cervical
confidence
cervical spine spine
intervals for anterior–
posterior Fig. 2 movement Mean excursion at the and cervical confidence spine intervals for anterior–
posterior movement at the cervical spine
Roof off
Roof off Roof off
Roof off
B post
Roof off
B post B post
B post
Rapid ex
B post
Rapid Rapid ex ex
Rapid ex
Self ex
Rapid ex
Self ex Self ex
Self ex 0 2 4 6 8 10 12 14 16
Self 0ex
0 2
Mean
2 4
excursion
4 6
(mm)
6
and
8
95%
8 10
confidence
10 12
intervals
12 14 14 16 16
0 2 4 6 8 10 12 14 16
Fig. 4 Mean excursion Mean Mean excursion and excursion confidence (mm) (mm) and 95% and intervals confidence 95% confidence for intervals anterior– intervals
Fig. posterior Mean movement 0
Mean
2
excursion
Fig. 4 Mean excursion excursion at and the 4
(mm)
and lumbar 6
and 95%
confidence spine8 confidence
10
intervals
12 14 16
intervals intervals for anterior– for anterior–
posterior
Fig.
posterior
4 Mean excursion Mean
movement at
and excursion
the at the lumbar
confidence (mm) and
lumbar spine spine
intervals 95% confidence for anterior– intervals
posterior Fig. 4 movement Mean excursion at the and lumbar confidence spine intervals for anterior–
posterior movement at the lumbar spine
Roof off
AMBULANCE UK - APRIL
Roof off
Roof off Roof off
Roof off
B post
Roof off
B post B post
B post
Rapid ex
B post
Rapid Rapid ex ex
Rapid ex
Self ex
Rapid ex
Self ex Self ex
Self ex 0.0 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0
Self 0.0ex
0.01.0 1.0
Mean
2.0
excursion
2.03.0 3.0
(mm)
4.0
and
4.05.0 95%
5.0
confidence
6.0 6.07.0 intervals
7.0 8.0 8.09.0
9.0
0.0 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0
Fig. 3 Mean excursion Mean Mean excursion and excursion confidence (mm) (mm) and 95% and intervals confidence 95% confidence for intervals lateral intervals movement
Fig. at Fig. the Mean cervical 0.0
Mean
3 Mean excursion spine 1.0
excursion
2.0
(mm)
3.0
and
4.0
95% confidence
5.0 6.0
intervals
7.0 8.0 9.0
excursion and and confidence intervals intervals for lateral for lateral movement
Fig.
at the at
3
the cervical
Mean
cervical
excursion Mean
spine spine
and excursion confidence (mm) and intervals 95% confidence for lateral intervals movement
at the Fig. cervical 3 Mean spine excursion and confidence intervals for lateral movement
at the cervical spine
Our volunteers were uninjured, fully conscious and had not recently
experienced a motor vehicle collision and did not have ‘true’
entrapment requiring disentanglement, as such the applicability of
these results to the injured post collision population needs careful
consideration. The volunteers were subjected to multiple extrications
across a short time; we could find no evidence of ‘learning’ in the
movements recorded but this could have influenced our results
unknowingly. The rescue personnel also performed multiple
Roof off Roof off
Roof off
B post
Roof off
B post B post
B post
Rapid ex
B post
Rapid Rapid ex ex
Rapid ex
Self ex
Rapid ex
Self ex Self ex
Self ex 0 2 4 6 8 10 12 14 16
Self 0ex
0 2
Mean
2 4
excursion
4 6
(mm)
6
and
8
95%
8 10
confidence
10 12
intervals
12 14 14 16 16
0 2 4 6 8 10 12 14 16
Fig. 5 Mean excursion Mean Mean excursion and excursion confidence (mm) (mm) and 95% and intervals confidence 95% confidence for intervals lateral intervals movement
Fig. at the Mean lumbar 0
Mean
Fig. 5 Mean excursion spine 2
excursion
4
(mm)
6
and 95%
8
confidence
10
intervals
12 14 16
excursion and and confidence intervals intervals for lateral for lateral movement
at
Fig.
the at
5
the lumbar
Mean
lumbar
excursion Mean
spine spine
and excursion confidence (mm) and intervals 95% confidence for lateral intervals movement
at the Fig. lumbar 5 Mean spine excursion and confidence intervals for lateral movement
at the lumbar spine
extrications over the day—a far greater exposure than in operational
practice. We did see faster extrications as the teams became
increasingly familiar both with the techniques and working together
as a team. Fatigue of the extrication team may also have influenced
our results.
Further work: Additional biomechanical work could evaluate
alternative extrication techniques (such as Scandinavian chain
44
For more news visit: www.ambulanceukonline.com