No, this is not an April fools prank, just another example of reason and sanity prevailing over EMS dogma.
Another large region in Kansas has stopped using backboards to transport trauma patients. 😀
The Wichita-Sedgwick County Emergency Medical Services System is no longer keeping patients on long spineboards when transporting them to the hospital, officials say.[1]
More people are realizing that manipulating patients onto boards does not protect patients from manipulation.
This is EMS, so dogma dies hard, but now that some EMS systems have pointed out that this EMS dogma is naked, it is just a matter of time until most of the country abandons this witchcraft.
We don’t quite have 150 years of tradition, unimpeded by progress, but we can eliminate tradition earlier than others.
I do have a problem with one statement –
The change was prompted by scientific studies that showed most patients do not need the boards during transport, officials said.[1]
There is no evidence that any trauma patient needs a board during transport.
“The issue of backboards has become more prominent in the last couple of years,” said Sabina Braithwaite, EMS System medical director. “We found that ‘Wow, we don’t have anything that shows this helps people,’ and there’s more and more evidence that it hurts people potentially.”
“Realistically, when you break your neck and go into the hospital they don’t keep you on a board there either.”[1]
Exactly.
Agencies/EMS Systems Minimizing LSB use –
Let me know if I should add your agency to this list.
Alameda County
CA
Albuquerque-Bernalillo County Medical Control Board
NM
Bernalillo County Fire Department
NM
CentraCare Health
Monticello, MN
Connecticut, State of
CT
Durham County EMS
NC
Eagle County Ambulance District
CO
HealthEast Medical Transportation
St. Paul, MN
Johnson County EMS
KS
Kenosha Fire Department
Kenosha, WI
Maryland, State of
MD
MedicWest Ambulance
NV
Milwaukee EMS
WI
North Memorial Ambulance & Aircare
Minneapolis, MN
Rio Rancho Fire Department
NM
SERTAC (Southeast Regional Trauma Advisory Council)
WI
Wichita-Sedgwick County EMS System
KS
Xenia Fire Department
Xenia, OH
Outside of the US –
St. John Ambulance
New Zealand
Norway
QAS
Queensland, Australia
Here are some articles on the problems with backboards –
EMS spinal precautions and the use of the long backboard.
[No authors listed]
Prehosp Emerg Care. 2013 Jul-Sep;17(3):392-3. doi: 10.3109/10903127.2013.773115. Epub 2013 Mar 4.
PMID: 23458580 [PubMed – in process]
Free Full Text in PDF Download format from NAEMSP.
EMS Spinal Precautions and the Use of the Long Backboard – Resource Document to the Position Statement of the National Association of EMS Physicians and the American College of Surgeons Committee on Trauma.
White Iv CC, Domeier RM, Millin MG; and the Standards and Clinical Practice Committee, National Association of EMS Physicians.
Prehosp Emerg Care. 2014 Feb 21. [Epub ahead of print]
PMID: 24559236 [PubMed – as supplied by publisher]
A re-conceptualisation of acute spinal care.
Hauswald M.
Emerg Med J. 2013 Sep;30(9):720-3. doi: 10.1136/emermed-2012-201847. Epub 2012 Sep 8.
PMID: 22962052 [PubMed – indexed for MEDLINE]
Free Full Text in PDF Download format from emsinternational.org
Out-of-hospital spinal immobilization: its effect on neurologic injury.
Hauswald M, Ong G, Tandberg D, Omar Z.
Acad Emerg Med. 1998 Mar;5(3):214-9.
PMID: 9523928 [PubMed – indexed for MEDLINE]
Free Full Text from Academic Emergency Medicine.
The Evidence Against Backboards – What does the spinal science say?
Bryan E. Bledsoe, DO, FACEP, FAAEM
August 1, 2013
EMS World
Article
For You Disciples of Spinal Immobilization…
… Bryan Bledsoe debunks your religion in the August issue of EMS World Magazine. And in that same issue, I take a dump on your altar. Our karma ran over your dogma.
August 1, 2013
by Kelly Grayson
A Day in the Life of an Ambulance Driver
Article
Why We Need to Rethink C-Spine Immobilization
By Karl A. Sporer, MD, FACEP, FACP
Created: November 1, 2012
EMS World
Article
Board to Death – The state of prehospital spinal injury care in 2013
Rommie L. Duckworth, LP
Created: July 15, 2013
EMS World
Article
In order to protect the c-spine, should we stop helping?
Mill Hill Ave Command
Saturday, December 15, 2012
December 15, 2012
Article
Another Nail in the Board
StreetWatch: Notes of a Paramedic
January 17, 2013
Peter Canning
Article
Does Spinal Immobilization Help Patients? – Who needs c-spine clearance?
Steven “Kelly” Grayson, NREMT-P, CCEMT-P AND William E. “Gene” Gandy, JD, LP
August 1, 2013
EMS World
Article
Plastic Snake Oil – EMS Spinal Immobilization
February 24, 2014
Life Under the lights
Article
Here is what I have written about other systems that do not require backboards for the transport of trauma patients –
More EMS Agencies Eliminating Backboards
Another System Eliminates Backboarding for Potential Spinal Injuries
The Slow, Agonizing Death of Conventional Spinal Immobilization
Stop the Madness! Reducing Unnecessary Spinal Immobilizations in the Field – Part I
The Lateral Trauma Position: What do we know about it and how do we use it
–
Footnotes:
–
[1] New Kan. EMS policy limits use of backboards – They will use backboards when moving patients to the ambulance, but then roll them onto a cot during transport to the hospital
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March 21, 2014
EMS1.com from The Wichita Eagle
By Kelsey Ryan
Article
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Is Norway referring to Bergan? They aren’t going to be using collars either most of the time per http://www.scancrit.com/2014/04/02/cervical-collar-r-i-p/.
State of Maine, going back at least a decade. New Hampshire, within the last couple of months.