SCOOP STRETCHER VS THE LONG BACKBOARD FOR SPINAL IMMOBILIZATION

 

SCOOP STRETCHER VS THE LONG BACKBOARD FOR SPINAL IMMOBILIZATION

COMPARISON OF THE FERNO SCOOP STRETCHER WITH THE LONG BACKBOARD FOR SPINAL IMMOBILIZATION Julie M. Krell, MD, Matthew S. McCoy, MD, Patrick J. Sparto, PhD, PT, Gretchen L. Fisher, NEMT-P, Walt A. Stoy, PhD, David P. Hostler, PhD

Abstract

OBJECTIVES:

Spinal immobilization is essential in reducing risk of further spinal injuries in trauma patients. The authors compared the traditional long backboard (LBB) with the Ferno Scoop Stretcher (FSS) (Model 65-EXL). They hypothesized no difference in movement during application and immobilization between the FSS and the LBB.

METHODS:

Thirty-one adult subjects had electromagnetic sensors secured over the nasion (forehead) and the C3 and T12 spinous processes and were placed in a rigid cervical collar, with movement recorded by a goniometer (a motion analysis system). Subjects were tested on both the FSS and the LBB. The sagittal flexion, lateral flexion, and axial rotation were recorded during each of four phases: 1) baseline, 2) application (logroll onto the LBB or placement of the FSS around the patient), 3) secured logroll, and 4) lifting. Comfort and perceived security also were assessed on a visual analog scale.

RESULTS:

There was approximately 6-8 degrees greater motion in the sagittal, lateral, and axial planes during the application of the LBB compared with the FSS (both p < 0.001). No difference was found during a secured logroll maneuver. The FSS induced more sagittal flexion during the lift than the LBB (p < 0.001). The FSS demonstrated superior comfort and perceived security.

CONCLUSION:

The FSS caused significantly less movement on application and increased comfort levels. Decreased movement using the FSS may reduce the risk of further spinal cord injury.

Few industries have accountability to so many people, from city councils to state and federal organizations, than EMS.  Perhaps more importantly is the responsibility EMS has to the patient and their families. As a decision-maker, you consistently look at ways to improve your team's performance. New technologies and updated equipment have led many like you to reexamine protocols that have been in place for decades. One of those accepted protocols is the use of the long backboard for spinal immobilization. Now an independent study says that the Ferno EXL Scoop Stretcher (FSS) competes at or on the same level as the traditional long backboard, stating the Ferno EXL Scoop Stretcher "to be as effective as, if not superior to the standard of care, a rigid long backboard." LINK TO DOWNLOAD IN PDF  Cortesía EMS España / Emergency Medical Services en España @EMSESP Follow me / INVITA A TUS AMIGOS A SEGUIRNOS @drramonreyesdiaz https://www.facebook.com/drramonreyesdiaz

SCOOP STRETCHER VS THE LONG BACKBOARD FOR SPINAL IMMOBILIZATION

 

SCOOP STRETCHER VS THE LONG BACKBOARD FOR SPINAL IMMOBILIZATION

COMPARISON OF THE FERNO SCOOP STRETCHER WITH THE LONG BACKBOARD FOR SPINAL IMMOBILIZATION Julie M. Krell, MD, Matthew S. McCoy, MD, Patrick J. Sparto, PhD, PT, Gretchen L. Fisher, NEMT-P, Walt A. Stoy, PhD, David P. Hostler, PhD

Abstract

OBJECTIVES:

Spinal immobilization is essential in reducing risk of further spinal injuries in trauma patients. The authors compared the traditional long backboard (LBB) with the Ferno Scoop Stretcher (FSS) (Model 65-EXL). They hypothesized no difference in movement during application and immobilization between the FSS and the LBB.

METHODS:

Thirty-one adult subjects had electromagnetic sensors secured over the nasion (forehead) and the C3 and T12 spinous processes and were placed in a rigid cervical collar, with movement recorded by a goniometer (a motion analysis system). Subjects were tested on both the FSS and the LBB. The sagittal flexion, lateral flexion, and axial rotation were recorded during each of four phases: 1) baseline, 2) application (logroll onto the LBB or placement of the FSS around the patient), 3) secured logroll, and 4) lifting. Comfort and perceived security also were assessed on a visual analog scale.

RESULTS:

There was approximately 6-8 degrees greater motion in the sagittal, lateral, and axial planes during the application of the LBB compared with the FSS (both p < 0.001). No difference was found during a secured logroll maneuver. The FSS induced more sagittal flexion during the lift than the LBB (p < 0.001). The FSS demonstrated superior comfort and perceived security.

CONCLUSION:

The FSS caused significantly less movement on application and increased comfort levels. Decreased movement using the FSS may reduce the risk of further spinal cord injury.

Few industries have accountability to so many people, from city councils to state and federal organizations, than EMS.  Perhaps more importantly is the responsibility EMS has to the patient and their families. As a decision-maker, you consistently look at ways to improve your team's performance. New technologies and updated equipment have led many like you to reexamine protocols that have been in place for decades. One of those accepted protocols is the use of the long backboard for spinal immobilization. Now an independent study says that the Ferno EXL Scoop Stretcher (FSS) competes at or on the same level as the traditional long backboard, stating the Ferno EXL Scoop Stretcher "to be as effective as, if not superior to the standard of care, a rigid long backboard." LINK TO DOWNLOAD IN PDF

Paramedics eliminating long spine boards at Johnson County, Kansas City

Paramedics eliminating long spine boards at Johnson County, Kansas City

Johnson County paramedics eliminating long spine boards

VIDEO

Posted: Mar 01, 2014 12:47 AMUpdated: Mar 01, 2014 1:47 AM

By DeAnn Smith, Digital Content Manager - email

By Jamie Oberg, News Reporter - email

OVERLAND PARK, KS (KCTV) -

Johnson County paramedics will no longer strap crash victims onto a long spine board.

After careful consideration, county officials believe the boards are unnecessary and slow down the trip to a hospital.

The hope is to reduce patient discomfort and the boards themselves can have their own risks, officials say.

For decades, the boards have been standard practice at wreck scenes in which a patient may have had a cervical, thoracic or lumbar spine injury. They immobilize the patient's entire body.

But county officials say they are used only because of historical dogma and institutional EMS culture, and have no evidence-based justification. 

"There are studies showing putting someone on a long board can cause harm, can cause pressure sores, discomfort, can make it more difficult to assess them and reduce their ability to breathe fully," EMS Chief Brad Cusick said.

Paramedics will still have a C-collar to immobilize patients, who will need to remain rigid as much as possible and will be secured to a cot by straps. 

The long boards will remain on the ambulances if needed to get a patient onto an ambulance and a cot but will be removed before transport.

Johnson County's change is effective Saturday and is expected to shave off two minutes from the trip to the hospital. Kansas City, KS, firefighters are training and phasing out their long boards as well.

Physician groups including the American Academy of Neurological Surgeons and the Kansas Medical Advisory County support the change. 

Copyright 2014 KCTV (Meredith Corp.) All rights reserved.

Long Spine Board out of services?

Johnson County's new trauma protocol effective March 1

February 28

Q&A about the Johnson County Emergency Medical Services System new trauma protocol with Dr. Ryan Jacobsen, Medical Director of Johnson County EMS System

What is the change in trauma protocol in Johnson County?

Johnson County’s new procedures go into effect March 1 and relate to how EMS providers care for pre-hospital patients with potential spine injuries. Historically, protocol mandated EMS providers in Johnson County transport any patient with a potential cervical, thoracic or lumbar spine injury on a Long Spine Board. Under the new protocol, excellent spine care will be accomplished without transporting a patient on a Long Spine Board.

So ambulance responders won’t use the Long Spine Boards anymore?

The Long Spine Board will still be used to extricate and transfer patients to the EMS cot, but then the EMS provider will generally remove the board for transport.

Isn’t that risky for someone with a spine injury?

Research shows that excellent spine care is accomplished utilizing the cervical collar and the ambulance cot. The new technique is expected to improve patient comfort and enable better airway care.

Is Johnson County the only EMS System making this switch?

While we will be the first in the region, there are multiple other agencies both nationally and internationally that have adopted similar changes.

Does this change the way the lay person should handle someone with a suspected spinal injury before the ambulance arrives?

No, it doesn't change how the lay public should deal with trauma patients. This change only applies to trained professional responders.

http://www.jocogov.org/article/2014/02/28/2907