# Backboarding



## Riley (Feb 16, 2012)

I did a quick search and I've done a few searches on the web. 

I am a medic student and I am taking my class out of state due to the cost and the fact that I'd need a license from that state anyway to work at the place I want to work at after I am done. It's forty minutes away and it's 4,500 versus forty minutes away at 8,000-10,000. 

Now, I understand some regional areas do things slightly different. Some have strange devices to splint instead of the SAGER or hare traction. Some swear by the combitube, LMAs, or king airway devices. 

I noticed this area does backboarding by doing a X on the chest, one on the hips, and one on the legs. generally people tell me that they don't want the patient sliding around. In my area and where I took my basic, we do backboarding by the "nipples, nuts, and knees" standard (not exact placement, but general placement). All of the major EMS and privates do the backboarding in this area this way. The students/lab instructor didn't believe me till another guy from my area said he had never seen the X till he came here. 

This particular lab assistant (the usual instructor was out due to illness) claimed it is National Registry Standard to do the X on the chest and my basic school was wrong for teaching the other method. I can't find a single thing that backs that up from National Registry. I've looked in the handbooks online on the NREMT site and the check offs don't say anything (I didn't look at the basic checkoff). There's a mention of providing equipment that the local EMS providers would have, but nothing on placement of straps. He specifically said "it's National Registry standard." 

I'm going to ask my instructor when he returns and sees what he says since he works for a company that provides EMS in both states. He's out due to medical reasons but will return next week. 

So here's my questions:
1. What method do you use for backboarding? 
2. What methods have you seen and how recently? 
3. What geographical area are you located in if you feel comfortable saying?
4. Do you know of any documentation from National Registry that says what placement is preferred or required if there is any?


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## DesertMedic66 (Feb 16, 2012)

I'm pretty sure that the NREMT doesn't have an exact way. If I remember the skills correctly as long as the patient is safely secured to the gurney without excessive movement.


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## bigbaldguy (Feb 16, 2012)

NREMT even allows spider straps.


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## Tigger (Feb 17, 2012)

bigbaldguy said:


> NREMT even allows spider straps.



The goal of backboarding is spinal motion restriction (obviously), and I do not think that the nipples, nuts, knees strapping does a very good of doing that. It does little for longitudinal sliding for one. Our state protocols recommend a "trauma strapping" technique. I have no idea what that is, but I believe it is using an "X" over the shoulders. I was on a board with that method a couple weeks ago and I felt like I was sliding all over the place when the truck took any curve. Spider straps do a better job keeping someone immobile on the board if you ask me.


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## Handsome Robb (Feb 17, 2012)

Tigger said:


> The goal of backboarding is spinal motion restriction (obviously), and I do not think that the nipples, nuts, knees strapping does a very good of doing that. It does little for longitudinal sliding for one. Our state protocols recommend a "trauma strapping" technique. I have no idea what that is, but I believe it is using an "X" over the shoulders. I was on a board with that method a couple weeks ago and I felt like I was sliding all over the place when the truck took any curve. Spider straps do a better job keeping someone immobile on the board if you ask me.



It all depends how you do it. If you get the shoulder straps up and over the shoulders but secured below them along with the chest strap right up under the armpits with spider straps you can get them nice and secured. also I always put at least one of the sets of seat belts through the gaps in the board to keep them from sliding around on the gurney as well. 

I've never used the "X" technique, everywhere I have worked used spider straps except for the pool. Some boards had spiders, others had the seat belt style. Spider straps in the pool are a pain in the butt if your partner doesn't know what they are doing.


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## Mountain Res-Q (Feb 17, 2012)

A. Bring back D Rings and lose the spiders.

B. When using spiders, imho, there is no spine below the pelvis, so why waste straps on the legs and knees?  When I board, all the straps, minus the lowest one, are place from chest to pelvis.  Spinal restriction should have focus on the spine.  If flopping legs are an issue, use something else to hold knees stable.  Save the straps on the spiders for the spine.  MHO.


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## DesertMedic66 (Feb 17, 2012)

Mountain Res-Q said:


> A. Bring back D Rings and lose the spiders.



That is all I have ever used. It can take a little long sometimes to strap them down but you also have soo many different ways of placing the straps securely on the patient.


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## Handsome Robb (Feb 17, 2012)

firefite said:


> That is all I have ever used. It can take a little long sometimes to strap them down but you also have soo many different ways of placing the straps securely on the patient.



Never used it or seen it but I know what d-rings are so I feel like I have a pretty good idea of what you are talking about.

People say spiders "take too long" which I have never understood. Maybe it comes from the high volume system and lots of practice?


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## DesertMedic66 (Feb 17, 2012)

NVRob said:


> Never used it or seen it but I know what d-rings are so I feel like I have a pretty good idea of what you are talking about.
> 
> People say spiders "take too long" which I have never understood. Maybe it comes from the high volume system and lots of practice?



10-15 foot long colored (depending on company) seatbelt straps with 2 metal rings that are in the shape of a D lol.


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## Tigger (Feb 17, 2012)

NVRob said:


> Never used it or seen it but I know what d-rings are so I feel like I have a pretty good idea of what you are talking about.
> 
> People say spiders "take too long" which I have never understood. Maybe it comes from the high volume system and lots of practice?



Everyone that says they take too long also does not use them where they work as far as I can tell. I like them because they work in one way and one way only, that way everyone is always on the same page. 

They would be tough in a pool though I bet.


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## Sodapop (Feb 17, 2012)

Years ago the system I worked used six foot long straps with seat belt style buckles. We used a technique that went over the shoulder, through handle on board, across chest just under armpit, through handle on opposit side, up over second shoulder, diagonal across chest to hip area, through handle, across hip to other side through handle, then diagonal back up to buckle at original shoulder. Sounds complicated buf it was quick and stable from moving in all directions. Usually could be done with two straps and a third was used on legs which we had a way to dk an x and foot wrap. Patients xid not move when turned (ie vomit or prego) or if rig had a sudden stop.

Sent from my mobile on tap talk please excuse the typos


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## Martyn (Feb 17, 2012)

Here's how we were taught. This was taken in class at college. Note the color of my face matches the mat!!! We wanted to 'test' how well the 'X' holds up...er, very well.


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## Sodapop (Feb 17, 2012)

Martyn said:


> Here's how we were taught. This was taken in class at college. Note the color of my face matches the mat!!! We wanted to 'test' how well the 'X' holds up...er, very well.




Hey that is just what I was trying to explain and that makes sense since I worked for PCEMS in Lakeland


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