title: The 'Necksafe' head articulation control system: a novel cervical immobilisation device.
abstract: BACKGROUND
  The early application of a semirigid disposable cervical collar following trauma is considered a routine practice. The aim of these devices is to immobilise the cervical spine and minimise the risk of additional neurological damage. However, these collars provide only partial immobilisation, are uncomfortable and are associated with a number of complications. Our team designed and tested a novel cervical immobilisation device that aims to improve immobilisation with reduced complications: the 'Necksafe'.
  
  
  METHODS
  Human volunteers were recruited and consented to test the novel Necksafe device in comparison with a conventional collar (the AMBU Perfit ACE) in a range of evaluations. These included assessments of the cervical range of movement (CROM) that occurred during scripted movements of the head and neck, and the effect of the new and conventional devices on jugular vein dimensions, assessed using ultrasound scanning.
  
  
  RESULTS
  CROM analysis showed that, under standardised testing conditions, the Necksafe device offers cervical immobilisation that is at least equivalent to a conventional collar, and is superior in the planes of extension, lateral flexion and rotation. Ultrasound examination of the jugular veins was inconclusive and did not reveal any differences in jugular venous diameter or flow. Qualitative feedback from ambulance paramedics was highly supportive of the new design, suggesting that it is more comfortable, easier to fit, less confining and better tolerated than a conventional collar, with improved immobilisation effectiveness.
  
  
  CONCLUSIONS
  The results of quantitative and qualitative testing are highly supportive of the new Necksafe design, with improved cervical immobilisation, comfort and access to the airway.
authors.affiliation: South Western Ambulance Service NHS Foundation Trust, Exeter, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Sparke
authors.affiliation: Royal College of Art, London, UK.
authors.forename: Karina
authors.initials: K
authors.lastname: Torlei
authors.affiliation: University of the West of England, Bristol, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Voss
authors.affiliation: South Western Ambulance Service NHS Foundation Trust, Exeter, UK.
authors.forename: Mike
authors.initials: M
authors.lastname: Page
authors.affiliation: University of the West of England, Bristol, UK Academic Department of Emergency Care, Emergency Department, Bristol Royal Infirmary, Bristol, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Benger
authors.affiliation: Royal College of Art, London, UK.
authors.forename: Ed
authors.initials: E
authors.lastname: Matthews
authors.affiliation: Bath Institute of Medical Engineering, Bath, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Hillman
authors.affiliation: Royal National Hospital for Rheumatic Diseases, Bath, UK.
authors.forename: Darren
authors.initials: D
authors.lastname: Hart
authors.affiliation: University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
authors.forename: Ella
authors.initials: E
authors.lastname: McLaughlin
authors.affiliation: Royal National Hospital for Rheumatic Diseases, Bath, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Carter
authors.affiliation: Bath Institute of Medical Engineering, Bath, UK.
authors.forename: Nigel
authors.initials: N
authors.lastname: Harris
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001915:Braces; D002574:Cervical Vertebrae / Q000293:injuries*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007103:Immobilization / Q000295:instrumentation* / Q000379:methods; D007601:Jugular Veins / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000503:physiopathology / Q000628:therapy*; D016544:Patient Simulation; D016059:Range of Motion, Articular; D012039:Regional Blood Flow / Q000502:physiology; D014463:Ultrasonography
keywords: Basic Ambulance Care; Trauma, Research; Trauma, Spine and Pelvis