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Prehospital spinal immobilization and the backboard quality assessment study
Charles Andrew Peery1, Jane Brice, William D White
1Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina 27710, USA. andrew.perry@duke.edu
Prehospital Emergency Care
|July 7, 2007
Summary
Prehospital spinal immobilization quality is often poor. Many patients arrive at the emergency department with loose straps and unattached head restraints, indicating inadequate spinal immobilization.
Area of Science:
- Emergency Medicine
- Trauma Care
- Patient Safety
Background:
- Prehospital spinal immobilization (PSI) has been a standard for suspected spinal injuries since the 1970s.
- Research in PSI is challenged by difficulties in assessing proper application.
- This study addresses the need to evaluate the quality of PSI.
Purpose of the Study:
- To assess the quality of spinal immobilization using long spine boards by emergency medical services (EMS).
- To identify common deficiencies in prehospital spinal immobilization techniques.
Main Methods:
- Evaluated non-critically ill patients immobilized on long spine boards by EMS.
- Assessed the number, location, and tightness of restraining straps.
- Examined head immobilization methods.
Main Results:
- 30% of patients had unattached head restraints.
- 88% of patients had excessive slack (>2 cm) in at least one strap.
- An average of 3.4 loose straps were found per inadequately immobilized patient.
Conclusions:
- Many patients receive suboptimal spinal immobilization during prehospital transport.
- Deficiencies in PSI may compromise patient safety and treatment effectiveness.
