# Doing away with long spine boards?



## NomadicMedic (Mar 1, 2014)

*Spine boards eliminated*

http://www.kctv5.com/story/24856132/johnson-county-paramedics-elimating-long-spine-boards


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## mycrofft (Mar 1, 2014)

Sorry, that web page was over thirty seconds loading on my old netbook. I'll try later.


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## NomadicMedic (Mar 1, 2014)

Okay? Sorry you have old hardware. ... Want me to fax you a copy?


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## MonkeyArrow (Mar 1, 2014)

What do you guys think about full body vacuum splints for immobilization in suspected c-spine injuries?


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## Handsome Robb (Mar 1, 2014)

DEmedic said:


> Okay? Sorry you have old hardware. ... Want me to fax you a copy?




:rofl:


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## Medic Tim (Mar 1, 2014)

I is nice to finally see boards go the way of the mast. It is funny how we embrace new technology and methods yet cling to other unproven ones.


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## chaz90 (Mar 1, 2014)

The promised day is coming my friends...Can't wait for this to make it here.


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## LACoGurneyjockey (Mar 1, 2014)

So I can look forward to this in 10-15 years, better than nothing...


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## mycrofft (Mar 1, 2014)

Got it, DC.

The tite was a red herring.

"AND I QUOTE" (Accents mine)



PARAMEDICS ELIMINATING SPINEBOARDS

OVERLAND PARK, KS (KCTV) - 
Johnson County paramedics* will no longer strap crash victims onto a long spine board.*
After careful consideration, county officials believe the boards are unnecessary and slow down the trip to a hospital. 

The hope is to reduce patient discomfort and the boards themselves can have their own risks, officials say.

For decades, the boards have been standard practice at wreck scenes in which a patient may have had a cervical, thoracic or lumbar spine injury. They immobilize the patient's entire body. 

But county officials say they are used only because of historical dogma and institutional EMS culture, and have no evidence-based justification. 


"There are studies showing putting someone on a long board can cause harm, can cause pressure sores, discomfort, can make it more difficult to assess them and reduce their ability to breathe fully," EMS Chief Brad Cusick said. 

*Paramedics will still have a C-collar to immobilize patients, who will need to remain rigid as much as possible and will be secured to a cot by straps.  

The long boards will remain on the ambulances if needed to get a patient onto an ambulance and a cot but will be removed before transport.* 


So, no, they still have long spine boards and will use them for extrication. Not for transport, which is perfect. No mention of short devices or the fact that C collar alone is insufficient.

Why didn't anyone else spot this media hyperbole?


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## terrible one (Mar 4, 2014)

LSBs were invented only for extrication. I'm not sure why EMS then said 'nope they have to stay on that board or you'll be paralyzed' 
I can't wait for this to become standard practice nation wide. Unfortunately, by then I'll probably be retired.


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## ZombieEMT (Mar 4, 2014)

I have read some good research on the use of a scoop vs long board for spinal immobilization. This also eliminates the need to log roll.


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## emtprincess (Mar 4, 2014)

I don't know if anyone else has posted this, but I recently saw an article about a county getting away from policies for using a long spine board and that there is possible evidence that they may cause more harm than good. Thoughts? 
Here's the article http://www.kctv5.com/story/24856132/johnson-county-paramedics-elimating-long-spine-boards


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## mycrofft (Mar 5, 2014)

terrible one said:


> LSBs were invented only for extrication. I'm not sure why EMS then said 'nope they have to stay on that board or you'll be paralyzed'
> I can't wait for this to become standard practice nation wide. Unfortunately, by then I'll probably be retired.



I'll drink to that!


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## mycrofft (Mar 5, 2014)

ZombieEMT said:


> I have read some good research on the use of a scoop vs long board for spinal immobilization. This also eliminates the need to log roll.



There are other ways around a log roll with a rigid LSB too. Jitterbugging the pt to weasel them onto the scoop always seemed like pretending not to move them, and the scoop's manufacturer says they are not to be considered equipment to perform spinal immobilization. (I think they count if you use them right, and nearly anything is better than a log roll).


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## Tigger (Mar 5, 2014)

mycrofft said:


> There are other ways around a log roll with a rigid LSB too. Jitterbugging the pt to weasel them onto the scoop always seemed like pretending not to move them, and the scoop's manufacturer says they are not to be considered equipment to perform spinal immobilization. (I think they count if you use them right, and nearly anything is better than a log roll).



Both Ferno and Hartwell say otherwise. In fact Ferno authored a study regarding the efficacy of using a scoop for spinal immobilization.

http://www.ncbi.nlm.nih.gov/pubmed/16418091

Not that any of it works anyway...


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## mycrofft (Mar 5, 2014)

Tigger said:


> Both Ferno and Hartwell say otherwise. In fact Ferno authored a study regarding the efficacy of using a scoop for spinal immobilization.
> 
> http://www.ncbi.nlm.nih.gov/pubmed/16418091
> 
> Not that any of it works anyway...



Hm, wonder where I got that then? Maybe my backside. I thought I read it on the materials with a long scoop we had for CERT a couple years ago, but as it also appears I forgot I had an echocardiogram in 2010, maybe I'm just loony.

I always love scientific studies done solely by the people who make the product being tested. Like the 18 month postop studies of bariatric surgery M&M done by the folks who make the instruments and supplies. (At 24 months the M&M went UP).


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## emtprincess (Mar 5, 2014)

Woops, sorry everyone. I tried making a thread, but I didn't realize there was one already talking about this subject so they automatically moved it as a comment into here.


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## mycrofft (Mar 5, 2014)

http://www.ncbi.nlm.nih.gov/pubmed/20837250

AND I QUOTE:
"Although not statistically significant, the execution of the log roll maneuver created more motion in all directions than either the lift-and-slide technique or with scoop stretcher application. The scoop stretcher and lift-and-slide techniques were able to restrict motion to a comparable degree."
*BUT...*​
"The effectiveness of the scoop stretcher to limit spinal motion in the destabilized spine is comparable or better than manual techniques currently being used by primary responders." 

Only C5-6 was evaluated and the difference was "not statistically significant", yet it is stated flatly that scoop is "comparable or better".  And the lift and slide was essentially the same.

I just got a dose of "be a careful consumer of NIH".
===========
Another study, traditional spine board versus scoop litter, er, stretcher:

http://www.fernonorden.no/ferno/fro...5EXL-vs-Backboard---Univ-Pittsburgh-Study.pdf

Comparable or better, more comfortable.

PS: if not logrolling, how am I assessing the pt's backside for trauma etc.? (Lift the pt as a unit and I'll crawl under like a car, with my headlamp).


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## mycrofft (Mar 5, 2014)

*Copied without royalty from FW Model 65 scoop stretcher owner's manual*

AND I QUOTE:


The Model 65 Scoop™ Stretcher (stretcher) is
an emergency patient-handling device. It is
designed to aid in moving a patient when space
is limited or when the patient needs to be moved
with little change of body position.

End quote. The official owner's manual's statement of the use for the device. Anyone see spinal immobilization on there? (Not that it doesn't work, but FW is *not* presenting this product as a spinal immobilization product _per se_).

Awaiting email from FW.

I'm done.


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## mycrofft (Mar 5, 2014)

*Naw, NOW I'm done. (Supper time)*



Tigger said:


> Both Ferno and Hartwell say otherwise. In fact Ferno authored a study regarding the efficacy of using a scoop for spinal immobilization.
> 
> http://www.ncbi.nlm.nih.gov/pubmed/16418091
> 
> Not that any of it works anyway...



Sounds like an extension of the NIH I read, same use of electromagnetic indicators.

Looks as much a trial of logroll versus scoop to me. But there are times a pt cannot be readily lifted and the board slid under (say, they're undressed?) and a log roll will have to occur with a traditional LSB.


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## socalmedic (Mar 5, 2014)

Robb said:


> :rofl:



what is a fax?


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## mycrofft (Mar 5, 2014)

Robb and I have this secret communications channel.

I'm kidding, except that businesses, ESPECIALLY healthcare, use faxes A LOT.


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## mycrofft (Mar 6, 2014)

mycrofft said:


> AND I QUOTE:
> 
> 
> The Model 65 Scoop™ Stretcher (stretcher) is
> ...



FW rep replied quite promptly and attached the owner's manuals for the model 65 (current) and model 61 (1985 short spine board). While I cold not find the phrase "spinal immobilization", they sell a unit with pins for quick attaching straps; they market head blocks etc. They also illustrate patients being moved with manual head immobilization and with a cervical collar. SO if it isn't being explicitly marketed as a spinal immobilizer, it is being market as such implicitly.


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## Tigger (Mar 7, 2014)

That's one model you're referring to. The EXL scoop is the one in the study I believe. 

Hartwell also markets the Combicardier II for similar purposes.


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## mycrofft (Mar 7, 2014)

I found a picture of a FW plastic scoop spineboard in Britain.


This is a litter we're talking about, but they call it a stretcher, and the Google results for Scoop litter….




ANYWAY, it'll do the job although they fall a millimeter short of calling it a spinal immobilizer. I cannot find  any reference to my imagined warning not to use it as a spine board.

And, no, the article says they are keeping their LSB's for extrication.


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