Question on long board

[erodriguez1236]

Hi everyone, this might be a dumb questions but it was asked to me in an interview and I cant quite remember the correct answer.

When extracting a person from a vehicle which way does the long board go in?

My answer was from driver side into the feet and then slide pt into it

Can anyone clarify this for me? thanks

 

[DesertMedic66]

There is no one answer for this question. You can bring the backboard in from the driver side, the passenger side, the windshield (if it's removed), and the roof (if it's removed or at least cut away to get the board in).

Generally it seems that the foot side of the board is placed under the patients butt and then the patient is adjusted to just slide on the board. But the head of the board can also be placed under the patients butt (this is assuming your patient is sitting correctly in the seat).

 

[erodriguez1236]

Thanks I really appreciate the clarification

 

[zmedic]

Cut off the roof, slide the board behind their back, lean the seat back, and slide them up onto the board.

 

[STXmedic]

Cut off the roof, slide the board behind their back, lean the seat back, and slide them up onto the board.

Do this for every MVA. No exceptions.

 

[phideux]

Do this for every MVA. No exceptions.

Especially the little to no damage ones, where the patient was fully ambulatory for 5 minutes prior to arrival, wandering around the scene yelling at everyone "how dey gonna pay fo dis accadent", and talking on their cell, then getting back into the drivers seat when they hear the sirens getting close.
Plus you need to use lots of tape to secure them to the board.

 

[DesertMedic66]

Especially the little to no damage ones, where the patient was fully ambulatory for 5 minutes prior to arrival, wandering around the scene yelling at everyone "how dey gonna pay fo dis accadent", and talking on their cell, then getting back into the drivers seat when they hear the sirens getting close.
Plus you need to use lots of tape to secure them to the board.

It must be pretty bad that my protocols state that duct tape is not to be used.

 

[bw2529]

It must be pretty bad that my protocols state that duct tape is not to be used.

Mine don't.

 

[Scott33]

Cut off the roof, slide the board behind their back, lean the seat back, and slide them up onto the board.

^^^^This^^^^^

 

[exodus]

It must be pretty bad that my protocols state that duct tape is not to be used.

The first time ever seeing d-rings was in my test for AMR. We always duct taped everyone to the board.

 

[DesertMedic66]

The first time ever seeing d-rings was in my test for AMR. We always duct taped everyone to the board.

I remember you saying that. I'm the opposite way. I've only used the D-rings and never seen another type until I ran a TC in Covina.

 

[mycrofft]

The safe end or side.

 

[MS Medic]

Doesn't anyone have a K.E.D. in their protocols for medical extrication of a sitting pt.

 

[Shishkabob]

Actually, the BEST thing to do is use the KED.

Only time a long board is to be used without a KED in an auto extrication is if the patient is unstable and needs to have a rapid extrication.



There is NO reason not to use the KED on anyone complaining of neck/back pain (w/ tingling etc) who are otherwise stable.

 

[beantown native]

Amen to that !!! the KED is soooo under used.

 

[DesertMedic66]

Never used or seen the KED actually used out in the field. I have only heard of it being used once and that was for pelvic instability.

But I get to use the KED in training every week at college.

 

[NYMedic828]

I'm no expert, but it baffles me how the world still thinks long boarding and collaring all these people is such a fantastic idea.

The first thing the hospital does 99% of the time is leave the collar on and give us our board back within 2 minutes of being seen.

Studies have shown that in patients who have legitimate spinal injuries, which are few and far between, we usually do more damage with imperfect application of collars than good. We often apply the collar too large or small causing either further separation/extension the spinal column or allows for too much movement.

Long Boards alone also cause major discomfort to patients. Im sure everyone has been strapped down to one at some point or another.

Have you ever seen a long board that didn't belong to EMS hanging up in the ER to be used a splint if they discovered a spinal injury? Hell no.

Your spine is curved, why in the world would anyone think that strapping someone down on a horribly uncomfortable flat board is an outstanding idea.


And honestly, KEDs are equally moronic. They just waste more time to apply, make the patient more uncomfortable then they already are and don't do much of anything to justify their use. Not to mention inside of a real vehicle its damn near impossible to apply them without causing any movement to the patient.

Again this is just my opinion, please prove me wrong so I don't have to be annoyed every time I have to use these things. If I get into an MVA and someone wants to board me my first question is where do I sign.

(and as someone already said, 95% of the time the patient already got out of the car to see how upset Geico is going to be)

 

[DesertMedic66]

I'm no expert, but it baffles me how the world still thinks long boarding and collaring all these people is such a fantastic idea.

The first thing the hospital does 99% of the time is leave the collar on and give us our board back within 2 minutes of being seen.

Studies have shown that in patients who have legitimate spinal injuries, which are few and far between, we usually do more damage with imperfect application of collars than good. We often apply the collar too large or small causing either further separation/extension the spinal column or allows for too much movement.

Long Boards alone also cause major discomfort to patients. Im sure everyone has been strapped down to one at some point or another.

Have you ever seen a long board that didn't belong to EMS hanging up in the ER to be used a splint if they discovered a spinal injury? Hell no.

Your spine is curved, why in the world would anyone think that strapping someone down on a horribly uncomfortable flat board is an outstanding idea.


And honestly, KEDs are equally moronic. They just waste more time to apply, make the patient more uncomfortable then they already are and don't do much of anything to justify their use.

My understanding of the use of LSB is to minimize(sp?) movement. We have to lift the patient from the ground to the gurney possibly walking over different terrain. Then move the patient from the gurney to the hospital bed.

Yes our hospital normally removes the backboard but not always. And no matter what they leave the collar in place. Once the patient is on the hospital bed s/he doesn't need to be moved to another bed for an X-ray (at least for our hospitals they don't).

 

[NYMedic828]

My understanding of the use of LSB is to minimize(sp?) movement. We have to lift the patient from the ground to the gurney possibly walking over different terrain. Then move the patient from the gurney to the hospital bed.

Yes our hospital normally removes the backboard but not always. And no matter what they leave the collar in place. Once the patient is on the hospital bed s/he doesn't need to be moved to another bed for an X-ray (at least for our hospitals they don't).

The primary concern of the majority of my patients when we get to the ER is when the board will be removed.

The doctors here usually pull it right out and starting rolling the patient every which way to check various things.

 

[exodus]

Never used or seen the KED actually used out in the field. I have only heard of it being used once and that was for pelvic instability.

But I get to use the KED in training every week at college.

Cal-Fire used the KED during my FTO time to extricate a guy that crashed his mustang into the side of the mountain at wash/111 JWO washington at the stoplight. Probably because it was a convertible though...