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martes, 10 de mayo de 2016

Vacuum Mattress Splint versus Long Backboard

Vacuum Mattress Splint versus Long Backboard


Long Backboard versus Vacuum Mattress Splint to Immobilize Whole Spine in Trauma Victims in the Field: a Randomized Clinical Trial

The Iranian authors claim this is the first RCT study of actual trauma patients , looking at performance of long hard backboard with vacuum mattress splint . IN their discussion they cite several past studies comparing the two methods of spinal immobilisation but note that these were only on healthy volunteers. They also state that as their RCT refutes all the findings of previous studies then further research to try to confirm their findings is warranted!
Surprisingly their findings claim that a hard backboard is SIGNIFICANTLY MORE COMFORTABLE than a vacuum mattress splint!
Not surprisingly, the vacuum mattress splint took longer to apply than the backboard.
The method to measure spinal immobilisation was also crude. Essentially an observer asked the patient to move their cervical and thoracolumbar spine in various directions and a guesstimate of the range of motion from VL ( very low) to VH ( Very high) was recorded ( 5 grades were used )
The major limitation of the study, indeed when comparing any medical device, is the familiarity with the users in the study. It was noted that the long backboard is the traditional method used in prehospital care in Iran. Lack of familiarity with actual prehospital use of the vacuum splint may have biased the recorded observations especially the time to apply as well as the immobilisation degrees measured.
The vacuum mattress splint in my view is more comfortable as its padded and holds the patient more securely in line. It definitely produces more of a sense of being cocooned in and this may elicit claustrophobic feelings in some patients. Perhaps this is the reason why patients rated the vacuum splint less comfortable? Also the unanswered question is how long were these transported patients on the backboard for? I suspect not long as we all know that the longer you spend on a hard surface the less comfortable it gets!
But kudos to our Iranian prehospital colleagues for trying to answer a question that is relevant to our PHARM community. Vacuum splints are expensive and break easily so it is no mean cost to have and use them.
Information from prehospitalmed.com

Vacuum Mattress Splint versus Long Backboard

 2013 Oct;28(5):462-5. doi: 10.1017/S1049023X13008637. Epub 2013 Jun 10.

Long backboard versus vacuum mattress splint to immobilize whole spine in trauma victims in the field: a randomized clinical trial.

Abstract

INTRODUCTION:

Patients with possible spinal injury must be immobilized properly during transport to medical facilities. The aim of this research was comparing spinal immobilization using a long backboard (LBB) with using a vacuum mattress splint (VMS) in trauma victims transported by an Emergency Medical Services (EMS) system.

METHODS:

In this randomized clinical trial, 60 trauma victims with possible spinal trauma were divided to two groups, each group immobilized with one of the two instruments. Speed and ease of application, immobilization rate, and the patients' comfort were recorded.

RESULTS:

In this survey, LBB was faster to apply: 211.66 (SD = 28.53) seconds vs 654.00 (SD = 16.61) seconds. Various measures of immobilization were better by LBB. Also, LBB offered a significant improvement in comfort over a VMS for the patient with possible spinal injury. All of the results were statistically significant.

CONCLUSION:

The results of this study showed that immobilization using LBB was easier, faster, and more comfortable for the patient, and provided additional decrease in spinal movement when compared with a VMS.

Comment in

PMID:
 
23746392
 
[PubMed - indexed for MEDLINE]  http://www.ncbi.nlm.nih.gov/pubmed/23746392

Original Research

Long Backboard versus Vacuum Mattress Splint to Immobilize Whole Spine in Trauma Victims in the Field: a Randomized Clinical Trial

Babak Mahshidfara1, Mani Mofidia1 c1, Ali-Reza Yaria1 and Saied Mehrsorosha2

a1 Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
a2 Tehran Emergency Medical Service System, Tehran, Islamic Republic of Iran
Abstract
Introduction Patients with possible spinal injury must be immobilized properly during transport to medical facilities. The aim of this research was comparing spinal immobilization using a long backboard (LBB) with using a vacuum mattress splint (VMS) in trauma victims transported by an Emergency Medical Services (EMS) system.
Methods In this randomized clinical trial, 60 trauma victims with possible spinal trauma were divided to two groups, each group immobilized with one of the two instruments. Speed and ease of application, immobilization rate, and the patients’ comfort were recorded.
Results In this survey, LBB was faster to apply: 211.66 (SD = 28.53) seconds vs 654.00 (SD = 16.61) seconds. Various measures of immobilization were better by LBB. Also, LBB offered a significant improvement in comfort over a VMS for the patient with possible spinal injury. All of the results were statistically significant.
Conclusion The results of this study showed that immobilization using LBB was easier, faster, and more comfortable for the patient, and provided additional decrease in spinal movement when compared with a VMS.
B Mahshidfar, M Mofidi, A Yari, S Mehrsorosh. Long backboard versus vacuum mattress splint to immobilize whole spine in trauma victims in the field: a randomized clinical trial. Prehosp Disaster Med. 2013;28(5):1-4 .
(Received July 29 2012)
(Revised November 24 2012)
(Accepted December 02 2012)
(Online publication June 10 2013)
Keywords
  • immobilization; 
  • long backboard; 
  • prehospital; 
  • trauma; 
  • vacuum mattress splint
Abbreviations
  • EMS:Emergency Medical Services; 
  • LBB:long backboard; 
  • VMS:vacuum mattress splint
Correspondence
c1 Correspondence: Mani Mofidi, MD Tehran University of Medical Sciences Rasoul Akram Hospital, Emergency Department Sattarkhan Ave, Nyaiesh St. Tehran, Islamic Republic of Iran E-mail m-mofidi@sina.tums.ac.ir
Footnotes
  Conflicts of Interest: None.
http://journals.cambridge.org/action/displayAbstract;jsessionid=BCEF11F96C0358D8F329416C0658D559.journals?aid=9030584&fileId=S1049023X13008637


Dr. Ramon REYES DIAZ, MD