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Fri, 1 Feb 2002 14:08:29 -0500

I really have to agree with you all in regards to back boarding protocols.
Nothing makes me more crazy than to have to board and collar someone
complaining of "whiplash" neck pain from a minor mva, when the person is
ambulatory, talking on the cell phone and yelling at the other person
involved, no obvious near deficits, no obvious injuries, and minimal damage
to the motor vehicle. It ends up in the long run being a C.Y.A move, than an
actual medical necessity. It also now turns this "medical evaluation" into a
potential truama workup backing up an already overtaxed ER even more.

Regarding a more patient friendly back board, We've been told here that even
the scoop stretcher does not provide adequate spinal immobilization, would
this mean in fact that a cushioned back board or cot mattress with out the
hardness of a board also be inadequate spinal immobilization? That being
said, with the condition of most of our city streets, and the suspension of
our trucks, one would wonder if we infact cause more damage to a patient on
a longboard bumping and banging around enroute to the hospital. 
 Sorry for being so long winded, just a little bored.

                        Ed Ramstrom - Paramedic
                        UMass EMS / Worcester, MA

-----Original Message-----
From: P. Hoffman [mailto:phoffman@freeway.net]
Sent: Friday, February 01, 2002 10:21 AM
To: trauma-list@trauma.org
Subject: RE: Spinal Immobilization question

I, too, have used a long board for patients who most likely did not need
one.  And, KED (or short board device), as well.  Protocol (yes, I know
these are "guidelines.") dictates this.  I have disregarded protocol in
several cases.  And, in only a few of these have I been questioned by the on
duty Doc or nurse (actually, the most serious chastisement was from a
nurse!).

None the less, given that these long boarding protocols will most likely not
go away soon, what about the possibility of working on the other side of the
equation:

Can we work on making the long boards more tissue friendly?  A thick foam
layer on top?  Do any of the in-hospital people on this list have any
(probably anecdotal) views on the vacuum type full body splints?

If our creed includes "First do no harm," then I guess decubitis kinda fails
here!

Phil Hoffman
EMTP

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Spinal Immobilization question