Spineboard Types

[mycrofft]

Or, in a disaster, a door or tabletop with three distraught relatives.

 

[KellyBracket]

Loving the policy, btw -- saw it on your blog! I wish you could make it part of protocols for services bringing in to St. V's, too, to clear them ASAP...

Thanks for trying out the policy! Just try to make my life easier at work, and avoid calling it clearance. We passed the policy because it is (correctly) viewed as board removal, but not clearance. Perhaps it seems like a small point, but it's a world of difference to many of the staff.

As for the risk in people with severe pain, even ATLS, as conservative as they are, recommend that a trauma patient with paraplegia be removed from a board ASAP. Again, they aren't cleared, they just have the dangerous board removed, using log-rolling, etc.

I apologize if I chime in with this topic often, but it's pretty darn interesting. See you in room 4!

 

[NomadicMedic]

I spend more time calling the doc at the ED for a "board and collar deferral" than I do actually putting people on boards.

If I had my druthers, we'd have no boards, just a scoop and reeves for moving patients.

 

[Veneficus]

If I had my druthers, we'd have no boards, just a scoop and reeves for moving patients.

That is my opinion as well.

 

[mycrofft]

Thanks for trying out the policy! Just try to make my life easier at work, and avoid calling it clearance. We passed the policy because it is (correctly) viewed as board removal, but not clearance. Perhaps it seems like a small point, but it's a world of difference to many of the staff.

As for the risk in people with severe pain, even ATLS, as conservative as they are, recommend that a trauma patient with paraplegia be removed from a board ASAP. Again, they aren't cleared, they just have the dangerous board removed, using log-rolling, etc.
!

Yeah, clearance means making a decision, removal means specifically a technical skill which can be following a prompt order or a delayed one (e.g., protocol).

Paraplegics, didn't think about them. I'd also consider burns, elderly, hypothermia, positioned on flank, cachectic, obtunded, airway embarrassed (positional asphyxia), nauseated....in other words, nearly everyone. I guess in the old days, with the NHTSA fixation, everything was secondary to preserving spine alignment (even if it was wrong for a particular patient's spine insult).

 

[EpiEMS]

Metal boards (and scoops) are cold. If you don't have a plastic scoop, try and get one!

Hmm, that's true. Maybe I can throw a hospital blanket on there? Unfortunately, all I have is the metal scoop... <_<

We passed the policy because it is (correctly) viewed as board removal, but not clearance. Perhaps it seems like a small point, but it's a world of difference to many of the staff.

As for the risk in people with severe pain, even ATLS, as conservative as they are, recommend that a trauma patient with paraplegia be removed from a board ASAP. Again, they aren't cleared, they just have the dangerous board removed, using log-rolling, etc.

I apologize if I chime in with this topic often, but it's pretty darn interesting. See you in room 4!

Pardon my mistake Removal, not clearance. I don't usually transport to Bridgeport, but I'll say hi if I'm there!

(I'll have to take a quick look at ATLS to better understand what the MDs do)

 

[mycrofft]

I once heard someone say aluminum boards are" like mylar space blankets so they reflect the pt's heat back to them".

That is true IF they are not in physical contact. Even the reflective plastic mylar films (and maybe BECAUSE they are vacuum metalized to reflect) will conduct heat off you by contact while still being good reflectors of radiant heat. Aluminum is one of the very best conductors of heat, including away from you.

I saw an aluminum board left on freezing snow melt in and stick once, had to kick it loose.

 

[Veneficus]

I once heard someone say aluminum boards are" like mylar space blankets so they reflect the pt's heat back to them".

That is true IF they are not in physical contact. Even the reflective plastic mylar films (and maybe BECAUSE they are vacuum metalized to reflect) will conduct heat off you by contact while still being good reflectors of radiant heat. Aluminum is one of the very best conductors of heat, including away from you.

I saw an aluminum board left on freezing snow melt in and stick once, had to kick it loose.

In my younger days i worked at a pizza shop that had stainless steel rings with aluminum grating as what the pizza actually sat on. I used to impress people by grabbing the aluminum part with my fingers right out of the oven without touching the steel rim.

Had to stop doing that though, not everyone saw exactly what I was doing, and the imitators did not fare so well. The owner got really pissed when he ended up paying out of pocket for some ED visits for burns so he didn't have to report it to workman's comp.

 

[mycrofft]

Has anyone heard of a carbon fiber board? Just asking.

 

[VFlutter]

Has anyone heard of a carbon fiber board? Just asking.

http://www.frsa.com.au/index.php/carbon-fibre-spineboard.html

FWIW when I was a patient I was taken off the LSB immediately upon arrival to the ER and then went through CT with just a C-collar.

 

[Clare]

We are supposed to be switching to the hybrid scoop/LSBs here soon. At least one per truck plus a couple of the boards we have now.

This is the Combi-Carrier II and what NZ will be switching too as we phase out the old metal scoop stretchers.

Our spinal immobilisation consists of a well fitted hard collar and securing the patient to the stretcher in a supine position with their spine in alignment.

Combi-carriers and scoop stretchers are for extrication only, not transport.

 

[Veneficus]

Combi-carriers and scoop stretchers are for extrication only, not transport.

The same used to be said about long boards.

 

[Tigger]

The same used to be said about long boards.

St. John is very good about not transporting patients on it on the stretcher, or at least as I saw it.

 

[Clare]

St. John is very good about not transporting patients on it on the stretcher, or at least as I saw it.

Correct, combi carriers and scoops are for extrication and not transport. I can't see the point of transporting somebody on an uncomfortable, flat, rigid device, how is that going to help?

 

[mycrofft]

Since boards are so deeply engrained into US EMS culture and protocols, let's make boards more comfortable. It is almost the only splint used without padding.

 

[EpiEMS]

Since boards are so deeply engrained into US EMS culture and protocols, let's make boards more comfortable. It is almost the only splint used without padding.

I could totally get behind boarding if it weren't so darn uncomfortable -- if it's harmless (and certainly useful for extrication), I wouldn't mind it so much.

 

[MIT]

We use spine boards and split stretchers and don't really transport on either. They're both too slippery and uncomfortable. I believe we're allowed to transport on the spine boards if we have to but it's not advised because they're so slippery!

I would happily transport on a board if it meant that the patient was comfortable and stable on the board.

 

[med109]

I swear everytime I come to this website, I feel like we are more and more behind the times lol. It sounds like many of you don't backboard, or don't agree with it. We backboard EVERYTHING! SO I am curious about this, is there a thread that elaborates on it. If you have a suspicion of needing spinal protection what do you do? Someone even mentioned the board is dangerous, why?

The ER does seem to remove the board almost immediatley upon our arrival, but we darn sure better have them on it when we bring them in. Last night we had a 1 vehicle roll over, with 3 minor patients. We had to transport because they were minors, but they had no injuries or complaints (some minor cuts from glass, no bleeding was the worst). They had all climbed out of the vehicle on their own and walked around trying to find their cell phones for 45 mins before we arrived. I was pretty sure they didn't need boarded. I called in before leaving the scene and the Dr asked why they wern't boarded. I explained everything and asked if he wanted them boarded, he said yes. I told him that would slow our responce because I would need a second ambulance. He finally agreed if I felt the board was not needed we could just transport.

To stay on topic we use ferno backboards, and for head immobilization we use a c-collar and towel rolls with tape.

 

[Handsome Robb]

This is the Combi-Carrier II and what NZ will be switching too as we phase out the old metal scoop stretchers.

Our spinal immobilisation consists of a well fitted hard collar and securing the patient to the stretcher in a supine position with their spine in alignment.

Combi-carriers and scoop stretchers are for extrication only, not transport.

Well, I like my job and my certification so I'll continue to transport patients on them who meet spinal motion restriction requirements until something changes.

As to what Vene said about being translucent for imaging, we are supposed to remove them and take them with us at the ER if at all possible. Our ERs are pretty good about getting people off boards relatively quickly. We are supposed to use standard backboards for the most part but "if the scooping action will benefit the patient" we can use them for spinal motion restriction. That's interesting about the hinges. Ours break-away from both sides if I'm not mistaken so I'm not sure if they have a different hinge or no matter which way you position the patient it'll be an issue. I was told there isn't a "head" or "foot" end.

I swear everytime I come to this website, I feel like we are more and more behind the times lol. It sounds like many of you don't backboard, or don't agree with it. We backboard EVERYTHING! SO I am curious about this, is there a thread that elaborates on it. If you have a suspicion of needing spinal protection what do you do? Someone even mentioned the board is dangerous, why?

The ER does seem to remove the board almost immediatley upon our arrival, but we darn sure better have them on it when we bring them in. Last night we had a 1 vehicle roll over, with 3 minor patients. We had to transport because they were minors, but they had no injuries or complaints (some minor cuts from glass, no bleeding was the worst). They had all climbed out of the vehicle on their own and walked around trying to find their cell phones for 45 mins before we arrived. I was pretty sure they didn't need boarded. I called in before leaving the scene and the Dr asked why they wern't boarded. I explained everything and asked if he wanted them boarded, he said yes. I told him that would slow our responce because I would need a second ambulance. He finally agreed if I felt the board was not needed we could just transport.

To stay on topic we use ferno backboards, and for head immobilization we use a c-collar and towel rolls with tape.

Google "NEXUS" and "The Canadian C-spine Rule"