Spinal Precautions

Type of full spinal immobilization device

  • Long Spine Board ( LSB )

    Votes: 67 93.1%
  • Scoop

    Votes: 3 4.2%
  • Reeves Sleeves or similar

    Votes: 0 0.0%
  • Other

    Votes: 2 2.8%

  • Total voters
    72
  • Poll closed .

Ridryder911

EMS Guru
5,920
38
48
After teaching a PHTLS course, I am curious on what type of spinal immobilzation device one uses on a trauma with significant injuries?
 
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DBieniek

Forum Crew Member
35
1
0
Rid, we typically use the long spine board. I cannot recall any situation in which I have variated.

I have been hearing a good deal about PHTLS lately, where can one take this course?
 

br16

Forum Ride Along
8
0
0
Id say in response to which we use most, it has to be the long spine board. but each major trauma is different i feel and will never be able to be taught a hard and solid way because sometimes we have used a multitude of different immobilization devices. I liked the phtls course alot, learned alot from it.

In response to where you can take it. You would have to check with your local training center to see if they offer it. Some dont and you may have to travel a little ways away to get it.
 

MSDeltaFlt

RRT/NRP
1,421
32
48
I'll use what I got. Personally, I like the LSB, but if I have more pts than I have LSB's, or LSB's won't fit, I'll use something else.

In EMS, you're trained to think outside of the box. In most protocols, when spinal precautions are needed, extremeties are not mentioned in reference to restrictions. Hence the inventions of SSB's, KED's, and the like as you are aware. Anything of significant length, width, and rigidity that can be strapped and/or taped to a pt's back from their head to their butt will suffice. Radiolucency is not required.

Case in point, I've been on a scene flight where we beat EMS on scene. Our aluminum aircraft cot makes a great LSB in a pinch, however, XRays cannot go through them. Shoulda seen the look on the trauma team's faces when we showed up with that one.^_^

You do what you gotta do. Apologies for the rant.
 

MedicDoug

Forum Crew Member
53
1
0
Generally a long spine board, but since I'm old I'll reach for the scoop more often than some of my partners... an under-rated piece of gear for sure. Sometimes there's less patient movement with a scoop, especially if we're short handed on scene.
MSDeltaFlt is right, though... the EDs do get a little cranky sometimes ;>)
 

Short Bus

Forum Crew Member
63
0
0
usually a long board, but we carry scoops and Reeves as well. KEDs and XP1 are on there too. We can use whatever we feel that we need to. If they go on a KED, they go onto a LBB as well. We also have the peds boards that have the legs seperate. They work well if they kid is the right size.

KEDs work great for the peds since I am guessing that is what the question was talking about.
 
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Summit

Critical Crazy
2,363
884
113
Full body vacuum splint + stokes litter or sked
 

medicdan

Forum Deputy Chief
Premium Member
2,489
14
38
On the street I use the LSB exclusively. I have been thinking a lot about my newly gained wilderness skills and knowledge. There are really some amazing opportunities for improvised spinal immobilization devices, and with some creativity, they can be much more comfortable then LSB+Collar+blocks.
OTOH, I also learned how to clear spines, so I have started thinking about when I really should and shouldn't immobilize a pt.
 

emtwacker710

Forum Captain
263
0
0
Full body vacuum splint + stokes litter or sked
how well do the full body vacuum splints work? we have a set of vac-u-splints for the extremities but I have never had the chance to use a full body one nor does my agency have one..
 

mdkemt

Forum Lieutenant
124
0
0
In most cases we use a Long spine bored with 4 straps a multi-collar and blocks.
Some cases we use a ked and short spine board but that is rare with our service.
Personally I hate vacume splints. Find it wastes to much time on scene but that could also be to the lack to experience I have using them on scene.

MDKEMTB)
 

BossyCow

Forum Deputy Chief
2,910
5
0
Long board, straps, head bed.

I like a scoop for the pelvic fracture at home, because its easier to set under the pt. But the long board is easier to wedge under an MVA pt. for extrication. Different tools for different instances.
 

Summit

Critical Crazy
2,363
884
113
how well do the full body vacuum splints work? we have a set of vac-u-splints for the extremities but I have never had the chance to use a full body one nor does my agency have one..
They work very well but must have a rigid backing to be considered true immobilization. They are very comfortable and warm for the patient. On extended extrications, you may have to repump them to keep the vacuum as they will leak a bit. They are also much easier to carry than a LSB.

It would be interesting if someone could make a collapsible titanium scoop that doubled as a litter.
 
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daedalus

Forum Deputy Chief
1,784
1
0
I tend to use liquid nitrogen to freeze the patient into place, preventing further injury. I saw it once on that TV show SLIDERS which aired on SciFi.

I really like to use LSB. Used it at an accident once and will continue to do so since I made the move to 911. That is unless the paramedic wants something different.
 

Jon

Administrator
Community Leader
7,996
53
48
...but we carry scoops and Reeves as well...
Just to clarify... R/R911 is talking about a Reeves Sleeve - which goes over a backboard and acts in place of the standard CID's and Straps. Proponents say that it does a much better job at immobilizing patients... Detractors say it takes too long to apply (just like the KED:().




And he's not talking about the more common Reeves Flexible Stretcher. On a side note - I was once shown that a 2x8 inside a Reeves is a good MacGuyverism if you are in the middle of nowhere with no backboard. Of course... since I'm usually in the middle of nowhere with a bunch of Boy Scouts... I'll just have them lash a few sticks together and make me a backboard... but quickly, because I want to be back in time for desert (Mmmm... Cobbler).
 

LH4B

Forum Ride Along
2
0
0
LSB. We're supposed to KED a pt every time they are still sitting in the car when we get OS, but if they're in real bad shape, rapid extrication to a LSB with a collar. We have the short spine boards but I have never seen them used nor had need to use one.

Who would use a scoop? We use that primarily for hip injuries.... it doesn't offer any spinal support.

Oh, and call fire for a stokes for sledding accidents.
 

BossyCow

Forum Deputy Chief
2,910
5
0
The new scoops do offer spinal protection. They are also lighter, easier to clean. They re-engineered the hinge mechanism as well as the strapping.
 

TKO

Forum Lieutenant
203
0
0
Here in BC, Canada (again with this start, huh?) we use the scoop or "clamshell" almost exclusively. Coming from Saskatchewan, I trained on LSBs and rarely used the scoop either.

But here we use the LSB for rapid extrications mainly. We can use the KED as well, but few EMS personnel here do. Anyone well trained with the KED can typically extricate just as quickly with it as those with the LSB.

Just some info on the scoop: it is rated for spinal immobilization now and it is also more comfortable for the pt for extended transfer times vs. the LSB. There is also the option to make up a "bed" of blankets on a #9 and then place the immobilized pt onto, then remove the scoop, and replace the scoop under the blanket bed (holding the blankets taught) and restrap. This is a huge benefit to pts with very long transfer times, especially on fixed-wing transports that get real bumpy.

But I do miss the headblocks of the LSB because they were easier than sandbags rolled in towels and taping (or the ridiculous headbed).
 

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