CERVICAL
SPINE MOVEMENT DURING AIRWAY MANAGEMENT: CINEFLUOROSCOPIC APPRAISAL IN HUMAN
CADAVERS.
Hauswald
M, et al. Am J Emerg Med 1991 Nov;9(6):535-8.
BACKGROUND:
The objective of this study was to determine which airway maneuvers cause the
least cervical spine movement.
DESIGN:
A controlled laboratory investigation was performed in a radiologic suite,
using eight human traumatic arrest victims who were studied within 40 minutes
of death. All subjects were ventilated by mask and intubated orally, over a
lighted oral stylet and flexible laryngoscope, and nasally. Cinefluoroscopic
measurement of maximum cervical displacement during each procedure was made
with the subjects supine and secured by hard collar, backboard, and tape.
RESULT:
The mean maximum cervical spine displacement was found to be 2.93 mm for mask
ventilation, 1.51 mm for oral intubation, 1.65 mm for guided oral intubation,
and 1.20 mm for nasal intubation. Ventilation by mask caused more cervical
spine displacement than the other procedures studied (ANOVA: F = 9.298; P =
.00004).
CONCLUSION:
It was concluded that mask ventilation moves the cervical spine more than any
commonly used method of endotracheal intubation. Physicians should choose the
intubation technique with which they have the greatest experience and skill.