POSITION STATEMENT EMS SPINAL PRECAUTIONS AND THE USE OF THE LONG BACKBOARD updated August 2018

POSITION STATEMENT EMS SPINAL PRECAUTIONS AND THE USE OF THE LONG BACKBOARD National Association of EMS Physicians and American College of Surgeons Committee on Trauma. 2013

RESTRICCIÓN DE MOVIMIENTO ESPINAL EN EL PACIENTE DE TRAUMA Agosto 2018

http://emssolutionsint.blogspot.com/2016/09/es-necesario-inmovilizar-todos-los.html

ABSTRACT

This is the official position of the National Association of EMS Physicians and the American College of Surgeons

Committee on Trauma regarding emergency medical services spinal precautions and the use of the long backboard.

Key words: spine; backboard; EMS; position statement; NAEMSP; ACS-COT.

PREHOSPITAL EMERGENCY CARE 2013;Early Online:1–2

The National Association of EMS Physicians and the American College of Surgeons Committee on Trauma believe that:

• ·   Long backboards are commonly used to attempt to provide rigid spinal immobilization among emergency medical services (EMS) trauma patients. However, the benefit of long backboards is largely unproven.

• ·   The long backboard can induce pain, patient agitation, and respiratory compromise. Further, the backboard can decrease tissue perfusion at pressure points, leading to the development of pressure ulcers.

·     Utilization of backboards for spinal immobilization during transport should be judicious, so that the potential benefits outweigh the risks.

• Appropriate patients to be immobilized with a backboard may include those with:

 Blunt trauma and altered level of consciousness

Spinal pain or tenderness

Neurologic complaint (e.g., numbness or motor weakness)

Anatomic deformity of the spine High-energy mechanism of injury and any of the following:

 Drug or alcohol intoxication

Inability to communicate

Distracting injury

• Patients for whom immobilization on a backboard is not necessary include those with all of the following: 

 Normal level of consciousness (Glasgow Coma Score [GCS] 15)

 No spine tenderness or anatomic abnormality

 No neurologic findings or complaints

 No distracting injury

 No intoxication

• Patients with penetrating trauma to the head, neck, or torso and no evidence of spinal injury should not be immobilized on a backboard.

• Spinal precautions can be maintained by application of a rigid cervical collar and securing the patient firmly to the EMS stretcher, and may be most appropriate for:

Patients who are found to be ambulatory at the scene

Patients who must be transported for a protracted time, particularly prior to interfacility transfer

Patients for whom a backboard is not otherwise Indicated

• ·Whether or not a backboard is used, attention to spinal precautions among at-risk patients is paramount. These include application of a cervical collar, adequate security to a stretcher, minimal movement/transfers, and maintenance of inline stabilization during any necessary movement/ transfers.

• Education of field EMS personnel should include evaluation of the risk of spinal injury in the context of options to provide spinal precautions.

• Protocols or plans to promote judicious use of long backboards during prehospital care should engage as many stakeholders in the trauma/EMS system as possible.

•  Patients should be removed from backboards as soon as practical in an emergency department.

POSITION STATEMENT EMS SPINAL PRECAUTIONS AND THE USE OF THE LONG BACKBOARD National Association of EMS Physicians and American College of Surgeons Committee on Trauma. 2013

PREHOSPITAL EMERGENCY CARE JULY/SEPTEMBER 2013 VOLUME EARLY ONLINE / NUMBER 3

http://degreesofclarity.com/emsbasics/library/NAEMSP%20-%20EMS%20SPINAL%20PRECAUTIONS%20AND%20THE%20USE%20OF%20THE%20LONG%20BACKBOARD.pdf

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