Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

New Kansas EMS policy limits use of backboards

 


 

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
EmailPrintCommentRSS
March 21, 2014
EMS1.com from The Wichita Eagle
By Kelsey Ryan
Article

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Comments

  1. 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/.

  2. State of Maine, going back at least a decade. New Hampshire, within the last couple of months.

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