Alternative spinal immobilization?

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@El Solis

On top of a trauma kit, what options are out there for spinal immobilization in lieu of a backboard? Are there devices that fold up small enough to pack in a tote yet are long enough for a 6ft tall person and rigid enough to maintain immobilization?
 

RedRob

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EDIT - Sorry, after posting I see that you have directed this question to Dr Solis. I didn’t know one could do that. I’m leaving my answer up anyway. Sorry if I have screwed this up.


I hope Dr. Solis or another more informed person will weigh in with a more expert and informed opinion, but I’m going to jump in anyway. As an emergency department nurse I can tell you that for several years now the trend has been very strongly away from backboards and C-collars. As I understand it, in a nutshell, unstable spinal injuries are actually fairly unusual, the mechanism to create spinal injury virtually has to be much more severe than the subsequent movement of the patient if reasonable care is exercised, and the use of immobilization, especially on a backboard, has significant risk for causing further injury.

I would say that if you feel someone needs spinal immobilization you need to forget about moving them yourself and instead use the means that you have made sure to have available to you to summon EMS or SAR.
 
EDIT - Sorry, after posting I see that you have directed this question to Dr Solis. I didn’t know one could do that. I’m leaving my answer up anyway. Sorry if I have screwed this up.


I hope Dr. Solis or another more informed person will weigh in with a more expert and informed opinion, but I’m going to jump in anyway. As an emergency department nurse I can tell you that for several years now the trend has been very strongly away from backboards and C-collars. As I understand it, in a nutshell, unstable spinal injuries are actually fairly unusual, the mechanism to create spinal injury virtually has to be much more severe than the subsequent movement of the patient if reasonable care is exercised, and the use of immobilization, especially on a backboard, has significant risk for causing further injury.

I would say that if you feel someone needs spinal immobilization you need to forget about moving them yourself and instead use the means that you have made sure to have available to you to summon EMS or SAR.

No worries, I welcome all input. El solis started the medical thread so i addressed him, but if anyone has suggestions, i'm all ears.

For clarification purposes, I am an emt with 3 years in ems, and numerous years with trauma experience in the military. I cringe when I see people backboards patients for the sake of mechanism. If the patient is negative smr, then there is no reason to fully immobilize them.

But for those of us that are trained, are there products out there that are packable?
 

Jedi

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To me it just looks like a ruggedized transfer sheet. If it was a truly unstable spinal injury, I don't think that rescue litter will provide enough stabilization to do any good.
 

Lunch Box

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To me it just looks like a ruggedized transfer sheet. If it was a truly unstable spinal injury, I don't think that rescue litter will provide enough stabilization to do any good.
Gotcha. I keep a couple lengths of marston mat in the back of my rig. That could be pressed into service as a backboard if needed. Not nearly as sexy as MaxTrax, but pretty damn versatile.
 

JeepEveryDay

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We use the EVAC-U-SPLINT® on our Fire Department. They are not super packable, but much better than a backboard. Here’s part of the description from their website:

“The EVAC-U-SPLINT® vacuum mattress provides fast, effective and comfortable immobilization for the entire patient. Molding to the specific contours of the patient's body without applying pressure, the vacuum mattress reduces pressure point tenderness.”
 
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FireMedicPQ1

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Howdy all, I would advise not to worry about a backboard. I have been in EMS for over 20 years and the industry is changing. In our fire department, and in departments in our area (Albuquerque metro), nobody uses backboards anymore for spinal immobilization. We will use them for an "extrication device," strictly to carry someone from point-A-to-point-B. Research has shown that backboards, which were never really intended for the purpose in which U.S. EMS used them, actually can cause harm. Injuries including pressure sores, nerve damage, and decreased comfort can inhibit a patient's recovery. We use a cervical collar to immobilize the C-Spine, which is the area that is most vulnerable. A sturdy mattress will suffice in getting somebody transported from the back country, as long as a C-collar is in place (if suspected spinal injury). You can find C-collars at any EMS supply vendor. Stay safe out there.
 
Howdy all, I would advise not to worry about a backboard. I have been in EMS for over 20 years and the industry is changing. In our fire department, and in departments in our area (Albuquerque metro), nobody uses backboards anymore for spinal immobilization. We will use them for an "extrication device," strictly to carry someone from point-A-to-point-B. Research has shown that backboards, which were never really intended for the purpose in which U.S. EMS used them, actually can cause harm. Injuries including pressure sores, nerve damage, and decreased comfort can inhibit a patient's recovery. We use a cervical collar to immobilize the C-Spine, which is the area that is most vulnerable. A sturdy mattress will suffice in getting somebody transported from the back country, as long as a C-collar is in place (if suspected spinal injury). You can find C-collars at any EMS supply vendor. Stay safe out there.
We avoid them in most cases, however, I had an incident recently where someone fell 15 feet into a lava tube. Fortunately, no injuries, but it got me thinking that a foldable board would have been nice for extrication had there been spinal injury.
 

El Solis

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Sorry i'm a little late to the party. This is a great question and the standards of care are changing. I agree with what everyone has said, backboards and C collars are going away. They can cause pressure sores and other issues besides being really uncomfortable. If the patient is able to walk, self extricate (get themselves out) of a vehicle or situation, and there are no neurological signs then you don't need to immobilize them. If you did, I'm sure we can all improvise something. The Boy Scout handbook shows how to make a litter with tree branches and shirts so I'm sure we all have something in our rigs that would work.

Chris
 
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Jean-Yves Hudon

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Just finished an adventure medic class and we used thermarest air pad a lot from splinting aid, getting people off the ground or immobilize as needed, etc. I have a new appreciation for this piece of gear.