rumors are that EMS agencies are looking to get rid of backboards
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cprted
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We use them exclusively as an extrication device. If a patient needs SMR, they go on a Clamshell. More and more research is showing that SMR at best, doesn't do anything, and at worst, is actually harming patients.
the_negro_puppy
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We don't even have them here.
We have a small extrication board and a scoop stretcher.
If its an unconscious trauma etc with short transprot time we will leave them on the scoop on the stretcher otherwise its stretcher.
We have a small extrication board and a scoop stretcher.
If its an unconscious trauma etc with short transprot time we will leave them on the scoop on the stretcher otherwise its stretcher.
Brandon O
Puzzled by facies
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You may have to be a little more specific. Where do you live? Denmark?
Christopher
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Rumors? Nope, not a rumor. Truth.
At agencies which stay up with medicine they've been gone for at least a year or two now.
5 years ago: "rumors are that EMS agencies are looking to not stop CPR to intubate".
Melclin
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We still have them and in fact a year or two ago, we all got told to actually use them on account (as far as I can tell) of one of those rubbish bloody studies that shows a little less movement when you have board and collar combined as apposed to collar alone.
Not a great move for a service that has really been making leaps and bounds towards being really evidence based.
I actually wouldn't like to see them go completely. I really like them for no-lift extrications from houses and what not where the pt can't walk. A couple of long straps attached to a long board, few slide sheets on the ground, a strategically placed stretcher and you suddenly haven't lifted your pt at all. Hard to do exactly the same thing on a scoop.
Not a great move for a service that has really been making leaps and bounds towards being really evidence based.
I actually wouldn't like to see them go completely. I really like them for no-lift extrications from houses and what not where the pt can't walk. A couple of long straps attached to a long board, few slide sheets on the ground, a strategically placed stretcher and you suddenly haven't lifted your pt at all. Hard to do exactly the same thing on a scoop.
Melclin
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How are you securing pts to the stretch in way that they won't go AWOL if you stop suddenly but can role them if they vomit?
KellyBracket
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This is a common concern, but I have my reservations about how important it is, realistically. Many patients that are brought in on a board are not secured in a manner that would maintain in-line position if they were rolled.
How about sitting them up (i.e. semi-Fowlers) if they vomit? Also keeps them in place in case of deceleration.
DrParasite
The fire extinguisher is not just for show
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Was discussing this with a Paramedic Educators out of Georgia.... apparently they don't intubate cardiac arrests.... they don't even use a BVM; just put a NRB on their face, and compression only CPR until they get pulses back or they pronounce.
We're doing this as well. NRB initially then intubate or place Combitube @ 10mins in to working an arrest.
I found out last week that in July we'll have a protocol update and the main change will be decreasing spine board use. I've heard a 90% decrease in their use is what to expect. I can't wait and am so freaking excited. I hate spine boards and immobilizing with a passion.
I know a lot of paramedics that have been in the field for years and years, that will not back board patients unless they have to because of MOI/protocol. So they would be happy to see it go out. It is a good way to move patients but their are other ways of doing that to.
mycrofft
Still crazy but elsewhere
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Wow. Do you have a video? Good stuff, potentially.
mycrofft
Still crazy but elsewhere
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They just violated the 2010 standard for professional responders (AmRedCross).
mycrofft
Still crazy but elsewhere
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I think by "AWOL" he meant sliding about if the ambulance quickly decelerated.
Me, I say the spine board regime was not originally meant to be used other than as a means to extricate and can still be of benefit, but not the way it has been corrupted to. Better then to use other means. And an unpadded spine board is silly; we have closed cell foams of varying densities which could be manufactured onto or into a board which could insulate and cushion the patient.
JPINFV
Gadfly
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I'm going to presume that their medical director took a look at the current literature and came to the conclusion that this was the best way to approach cardiac arrest. Just because the ARMC has a standard (well... let's be honest, ARMC just copies the American Heart Association), doesn't mean that it's the standard.
Brandon O
Puzzled by facies
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Could you expand on this?
Melclin
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The question is not, "Can they be rolled with SMR intact?", but, "Can they be safely restrained so they don't fly away if you brake quickly, but still be rolled quickly if needs be". Having the board in place does allow you to do both, although I don't agree that this is a good reason to retain the board.
Sitting up with a collar was common practice until someone decided that it didn't "properly immobilize the entire spine" based on that pretty questionable study I mentioned earlier. So we got told not to do that. Many people didn't listen and still do it, probably for the better, but I do generally like to observe directives from out clinical department.
No video I'm afraid. Its an excepted technique that we were taught as part of our in-service manual handling course and it works pretty well.
mycrofft
Still crazy but elsewhere
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ARC CPRO class teaches ventilation with CPR. Prime reason for this is that, with attempts to inflate the lungs, you cannot detect an airway embarrassment (a leading cause of apparent asystole in children and adults under, say, 50 y/o, so it is the most common etiology for REVERSIBLE apparent asystole). While CPR type management is still the next step for an unconscious patient with layperson, for professionals there may be other avenues such as surgical airways, or perhaps attempting a laryingoscopic removal with suction? (I son't know the protocols).
EDIT "withOUT attempts to inflate"
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Brandon O
Puzzled by facies
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I getcha.
Calling the Red Cross CPR curriculum a "professional standard" for anybody is a bit strong though.
mycrofft
Still crazy but elsewhere
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Flaws aside, yes, ARC is legally and legislatively recognized as an industry professional standard. As is AHA.
(Did I screw anything up that time?)
(Did I screw anything up that time?)