The death watch for spinal immobilization on a long backboard continues to gain steam. There are two excellent articles in EMS World magazine questioning the evidence behind this ancient EMS torture custom.
The Evidence Against Backboards
Does Spinal Immobilization Matter?
Rogue Medic has had two recent articles on the issue.
Where is the Evidence for Spinal Immobilization?
NAEMSP Position Paper on Spinal Immobilization
Here in Connecticut, the Connecticut EMS Medical Advisory Committee (CEMSMAC) has passed a sweeping guideline change modeled largely after the Alameda County (California) Spinal Motion Restriction Guidelines. The guideline still needs to be approved by the statewide EMS Advisory Board, which is scheduled to meet next in September, and then with the expected approval there, needs only the signature of the state Public Health Commissioner. I also hear that New Hampshire may be close to approving a similar guideline.
In the meantime in Connecticut we have been, in our region and in many of the stateâ€™s systems, utilizing a new guideline that eliminates the need to use a long backboard for ambulatory patients. If a patient is in a car crash or falls down some stairs and are up and walking on your arrival, they only need a cervical collar (if they have neck or back pain or meet immobilization criteria), and can then sit more comfortably on the stretcher. No need for a backboard. This has been quite successful and there have been no patient care issues that I have heard about.
I will keep you posted.
Alameda County Spinal Injury Assessment
Alameda County Spinal Motion Restriction
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