Backboarding w/out collar

mycrofft said:
Anyone find a video of an auto extrication using vacuum mattress or device? I'm finding a lot with the "rescue boa" idea, but nothing where the entrapped pt is being immobilized; they are all out and supine.
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I've emailed the author of the Bound Tree article for any resources he has.
 
mycrofft said:
Anyone find a video of an auto extrication using vacuum mattress or device? I'm finding a lot with the "rescue boa" idea, but nothing where the entrapped pt is being immobilized; they are all out and supine.
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No reason to try and extricate someone from a car with a mattress really. Hartwell recommends "traditional" methods substituting a scoop for a board. Lay mattress on ground, place scoped patient on mattress, and then remove scoop.
 
Light at the end of thee tunnel.

There is that awkward period between whatever posture you find them (sitting upright, hanging in straps upside down, shoved under dash board) and when you can get them onto a scoop or any board. The rescue boa looks like an interesting concept except that it ignores thoracolumbar concerns.

I keep hearing people (not Tigger) crying that the LSB is dead, long live the vacuum mattress; yet is is still the LSB used in extrication…which is exactly what, and only what, it was designed for.

That means, once you strip the hyperbole away, it's starting to make sense again! Only took forty +/- years.

Now, if they could only make a soft-topped LSB. And how about a KED with a vacuum headpiece or inflatable head block inserts?

And a drug to keep subjects from going crazy from being tied up like that!


PS: just as Grandfather Charles told me never to trust someone without calluses on his hands and Pappy Miles taught me to never sign a blank receipt (or trust a gun safety), I'll tell you to distrust any extrication device which is always demonstrated in daylight, with the pt sitting up behind the wheel, the car perfectly upright on solid ground, and the passenger cab undeformed. Show me the money: 2 AM, Sunday, and its raining, the car's 3/4 rolled in mud and the door's smashed down/jammed a couple inches.
 
mycrofft said:
There is that awkward period between whatever posture you find them (sitting upright, hanging in straps upside down, shoved under dash board) and when you can get them onto a scoop or any board. The rescue boa looks like an interesting concept except that it ignores thoracolumbar concerns.

I keep hearing people (not Tigger) crying that the LSB is dead, long live the vacuum mattress; yet is is still the LSB used in extrication…which is exactly what, and only what, it was designed for.

That means, once you strip the hyperbole away, it's starting to make sense again! Only took forty +/- years.

Now, if they could only make a soft-topped LSB. And how about a KED with a vacuum headpiece or inflatable head block inserts?

And a drug to keep subjects from going crazy from being tied up like that!


PS: just as Grandfather Charles told me never to trust someone without calluses on his hands and Pappy Miles taught me to never sign a blank receipt (or trust a gun safety), I'll tell you to distrust any extrication device which is always demonstrated in daylight, with the pt sitting up behind the wheel, the car perfectly upright on solid ground, and the passenger cab undeformed. Show me the money: 2 AM, Sunday, and its raining, the car's 3/4 rolled in mud and the door's smashed down/jammed a couple inches.
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I'm pretty sure they have released a vacuum board. I saw one in a trade journal months ago. And I think most people have given up on transporting on a backboard. Even here in NM where we don't board anyome, trucks continue to carry them, specifically for extrication
 
I say, right on.

I've been trying to find you tubes of vacuum extrication devices, but no go. Splints and mattresses.

Back to OP: besides my usual "use protocols", if you are concerned about the back, why not the far more vulnerable neck? Sure, collar away, but do it right and with the right collar.
 
The only time I do not use a collar when boarding is on a code. Load and go.
 
TattooedNay said:
The only time I do not use a collar when boarding is on a code. Load and go.
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Your immediate response to a cardiac arrest is to backboard then immediately "load and go"?
 
TattooedNay said:
The only time I do not use a collar when boarding is on a code. Load and go.
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I use a collar on all of my codes. Best way to keep the head from rolling about and dislodging our airway. (We also don't load and go)

As I teach my EMT's, you should be saying "think and act" instead of "load and go". You'll make mistakes with "think and act", but you're always making a mistake with "load and go".
 
Unless load and go is all you got.
But you do need to decide to load and go, not just bolt.

Custer could have taken some lessons there.
 
Christopher said:
I use a collar on all of my codes. Best way to keep the head from rolling about and dislodging our airway. (We also don't load and go)

As I teach my EMT's, you should be saying "think and act" instead of "load and go". You'll make mistakes with "think and act", but you're always making a mistake with "load and go".
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we have a little wedge to put under the head. Combined with the "sticky" head and chin straps it works just fine.
 
TattooedNay said:
we have a little wedge to put under the head. Combined with the "sticky" head and chin straps it works just fine.
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Why are you backboarding cardiac arrest patients?
 
TattooedNay said:
you're kidding
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No, I'm really not. The floor provides a perfectly stable surface for compressions. If they're on a couch or bed or chair move them to the floor. If you're moving your patients with CPR in progress you're provided substandard care. Read a little bit and figure out why I'm saying that.

Explain to me what a compression fraction is and why it's important. Now, once you've done that explain to me what moving a patient with CPR in progress does to that compression fraction as well as time off the chest and peri-shock pauses. Have you ever seen what happens to a patient's end tidal CO2 levels after stopping CPR to move them to the gurney then to the ambulance? How about once in the ambulance and transporting. Why is that important to pay attention to?

I'm going to take it a step further, explain to me why we do the things we do for a cardiac arrest patient. Also, you never answered my question, why are you routinely back boarding cardiac arrest patients? Your protocol says to isn't a good answer.

Learn why you're doing things and keep up with the times or get the hell out of medicine before you cause more harm to your patients.
 
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TattooedNay said:
you're kidding
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A backboard is good for moving a patient after you get ROSC. That's it. My coded patients stay on scene unless they get pulses back or there's actually a reason to transport. Also that way when I call them, I don't lose a backboard or have to get it out from under the body
 
Maybe Tattooed Nay is referring to Trauma Arrests at a BLS level? Most protocols I have seen include c - spine immobilization + LSB. And then of course rapid transport once the important EMS stuff is taken care of.
 
our most recent trauma code we were back boarding him unconscious but breathing, went down hill fast, ditched doing the c collar and just threw him on the board and started CPR, rapid extract.
 
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