title: Efficacy of prehospital spine and limb immobilization in multiple trauma patients.
abstract: BACKGROUND
  Injuries are a major cause of mortality and disability worldwide and are estimated to become the third leading cause of death by 2020. Most traffic deaths occur during the prehospital phase; consequently, prehospital trauma care has received considerable attention during the past decade. However, there is no study on the prehospital immobilization of spine and limbs in patients with multiple trauma in Iran.
  
  
  OBJECTIVE
  This study aimed to investigate the epidemiology of trauma and the quality of limb and spine immobilization in patients with multiple trauma transferred to Shahid Beheshti Medical Center via emergency medical services (EMS).
  
  
  METHODS
  This cross-sectional study was conducted in 2013. The study population consisted of all patients with multiple trauma who had been transferred by EMS to the Central Trauma Department of the Shahid Beheshti Medical Center, Kashan, Iran. The study used a checklist and we recruited a convenience sample of 400 patients with multiple trauma. Data were described by using frequency tables, central tendency measures, and variability indices. Moreover, we analyzed data using SPSS.
  
  
  RESULTS
  The study sample consisted of 301 (75.2%) males and 99 (24.8%) females. The most common mechanism of trauma was traffic injuries (87.25%). Motorcyclists constituted 52.25% of the road traffic injuries victims. Overall, the quality of immobilization was at an undesirable level in 95.8% of patients with spine and limbs injuries. A significant association was observed between the quality of spine and limbs immobilization and the EMS workers' education level (P = 0.005).
  
  
  CONCLUSIONS
  The quality of spine and limb immobilizations was undesirable in more than 90% of cases. Due to the importance of good spine and limb immobilization in patients with multiple trauma, prehospital EMS technicians should be retrained for proper immobilization in patients suspected of spine or limb injuries. Developing evidence-based protocols and strengthening the regulatory and supervisory system to improve quality of prehospital emergency care in patients with multiple trauma is recommended.
authors.affiliation: Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Adib-Hajbaghery
authors.affiliation: Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Farzaneh
authors.initials: F
authors.lastname: Maghaminejad
authors.affiliation: Department of Anesthesiology, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Rajabi
keywords: Emergency Care, Prehospital; Epidemiology; Healthcare Quality; Immobilization; Multiple Trauma