• Tim Nutbeam, Rob Fenwick, Barbara May, Willem Stassen, Jason E Smith, Jono Bowdler, Lee Wallis, and James Shippen.
• Emergency Department, University Hospitals Plymouth NHS Trust, Plymouth, UK; Devon Air Ambulance Trust, UK. Electronic address: timnutbeam@nhs.net.
• Injury. 2022 Nov 1; 53 (11): 3605-3612.

IntroductionFollowing a motor vehicle collision some patients will remain trapped. Traditional extrication methods are time consuming and focus on movement minimisation and mitigation. 'Chain cabling' is an alternative method of extrication used in some countries. The optimal extrication strategy and the effect of extrication methods on spinal movement is unknown. This study compares 'chain cabling' to the established roof removal method of extrication on spinal movement.MethodsBiomechanical data were collected using Inertial Measurement Units on a single healthy volunteer during multiple experiments. The extrication types examined were chain cabling and roof removal. Measurements were recorded at the cervical and lumbar spine, and in the anteroposterior (AP) and lateral (LR) planes. Total movement (travel), maximal movement, mean, standard deviation and confidence intervals are reported.ResultsEight experiments were performed using each technique. The smallest mean overall movements were recorded during roof-off extrication (cervical spine 0.6 mm for AP and LR, lumbar spine 3.9 mm AP and 0.3 mm LR). The largest overall mean movements were seen with chain cabling extrication (cervical spine AP 5.3 mm. LR 6.1 mm and lumbar spine 6.8 mm AP and 6.3 mm LR).ConclusionIn this study of a healthy volunteer, roof-off extrication was associated with less movement than chain cabling. The movement associated with chain cabling extrication was similar to that previously collected for other extrication types.Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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