title: Should suspected cervical spinal cord injuries be immobilised? A systematic review protocol.
abstract: BACKGROUND
  Cervical spinal cord injuries may result in life-threatening situations and long-term disability. Prehospital spinal immobilisation is the standard of care for patients with potential spinal cord injury (SCI). It aims to prepare patients for transport, achieve neutral spinal alignment, and reduce movement and secondary injuries in potentially unstable spines. However, there is a lack of evidence on its clinical benefits and its overall effect on patient outcomes.
  
  
  OBJECTIVE
  To identify the reported outcomes following immobilisation of suspected cervical SCI, to compare the effects of spinal immobilisation versus no immobilisation on the reported outcomes, and to provide recommendations for prehospital cervical immobilisation.
  
  
  METHODS
  A search of the literature will be conducted using relevant online databases. This will include all types of human studies that were published in English from the earliest record available to the first week of October 2013. One author will conduct the search and two independent authors will screen the titles and the abstracts identified by the search and critically appraise the selected papers. A third author will be available to resolve any disagreement. The findings will be reported according to Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. Critical appraisal as well as the level and the strength of evidence will follow the National Health and Medical Research Council (NHMRC) guidelines.
  
  
  CONCLUSIONS
  Evidence-based practices should be pursued to further improve the prehospital care for suspected cervical SCI. This systematic review will contribute to the body of knowledge regarding the spinal immobilisation effects on the SCI patient's outcomes.
authors: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors: Ala'a O
authors: AO
authors: Oteir
authors: Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Victoria, Australia Ambulance Victoria, Melbourne, Victoria, Australia.
authors: Paul A
authors: PA
authors: Jennings
authors: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia Ambulance Victoria, Melbourne, Victoria, Australia Department of Emergency Medicine, University of Western Australia, Perth, Western Australia.
authors: Karen
authors: K
authors: Smith
authors: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors: Johannes
authors: J
authors: Stoelwinder
mesh_terms: D003657:Decision Making; D055416:Evidence-Based Emergency Medicine / Q000379:methods*; D006801:Humans; D007103:Immobilization / Q000379:methods; D011379:Prognosis; D011788:Quality of Life; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000628:therapy*; D013123:Spinal Fusion / Q000379:methods*; D000078202:Systematic Reviews as Topic; D013997:Time Factors