RecruitingNot ApplicableNCT06983873

IPSTRAUC : Impact on Care Pathways of a New Management of Cervical Trauma in Conscious Patients Stable in Pre-hospital Care

Impact on Care Pathways of a New Management of Cervical Trauma in Conscious Patients Stable in Pre-hospital Care


Sponsor

Rennes University Hospital

Enrollment

840 participants

Start Date

Apr 1, 2026

Study Type

INTERVENTIONAL

Conditions

Summary

The aim of the study is to evaluate the application of Canadian C-Spine rules adapted to pre-hospital settings in France in order to improve the appropriateness of cervical spine immobilisation, reduce unnecessary imaging examinations and optimise patient care pathways.


Eligibility

Min Age: 18 YearsMax Age: 65 Years

Inclusion Criteria16

  • PATIENTS
  • GCS 15
  • Stable (no organ failure, SBP ≥ 90 mmHg, DBP ≥ 65 mmHg, RF between 10 and 24 cycles/min)
  • Cooperative (calm and obedient to instructions)
  • Victim of a closed cervical spine trauma treated in the pre-hospital setting (fire brigade and/or Mobile Emergency and Resuscitation Service (SMUR)).
  • Recent trauma (< 48 hours).
  • Care regulated by the Emergency Medical Service (SAMU).
  • Beneficiary of a social security scheme.
  • Who can be contacted by telephone
  • Have received oral and written information and have not objected to taking part in the study.
  • PROFESSIONAL
  • Age ≥ 18 years
  • Professional firefighter or EMS regulating doctor
  • Professional who has received training in the protocol and, in the case of the experimental group, in the CCRa rules
  • Fluency in French
  • Having received oral and written information and not having objected to their participation in the study.

Exclusion Criteria13

  • PATIENTS
  • Life-threatening organ damage
  • Cardiorespiratory arrest since the traumatic event in question
  • Polytrauma patient
  • Penetrating trauma or a supra-clavicular wound following a knife or firearm injury
  • Known spinal disease or previous spinal surgery (ankylosing spondylitis, rheumatic fever, spinal stenosis, cervical spine surgery).
  • Acute paralysis (paraplegia, tetraplegia, hemiplegia, hemiparesis or documented sensory or motor deficit)
  • Diagnosed osteogenesis imperfecta.
  • Patients not regulated by EMS or transported to a hospital not participating in the study
  • Pregnant or breast-feeding women
  • Known situation of deprivation of liberty (safeguard of justice), guardianship or curatorship
  • PROFESSIONALS
  • \- Persons referred to in articles L. 1121-5 to L. 1121-8 and L. 1122-1-2 of the Public Health Code (e.g. minors, protected adults, persons deprived of their liberty, persons under guardianship, curatorship, etc.).

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Interventions

BEHAVIORALadapted Canadian C-Spine rules

The CCRa are decision rules for pre-hospital cervical spine collar immobilization. They include three high-risk criteria indicating imaging, 5 low-risk criteria allowing assessment of cervical spine rotation, and finally the ability of patients to achieve limited active rotation. They have been designed and validated to avoid immobilization during transport to the emergency department without any significant cervical injury being missed.


Locations(12)

CHU Amiens-Picardie

Amiens, France

CHRU Besançon

Besançon, France

Centre Hospitalier Sud-Francilien

Corbeil-Essonnes, France

Hôpitaux La Rochelle Ré Aunis

La Rochelle, France

AP-HM Timone

Marseille, France

CHRU Nancy

Nancy, France

CHU Nice

Nice, France

CHU Poitiers

Poitiers, France

CHU Reims

Reims, France

CHU Rennes

Rennes, France

CHU Toulouse

Toulouse, France

Centre hospitalier Bretagne Atlantique

Vannes, France

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NCT06983873