A spinal board, is a

patient A patient is any recipient of health care services that are performed by Health professional, healthcare professionals. The patient is most often Disease, ill or Major trauma, injured and in need of therapy, treatment by a physician, nurse, op ...

handling device used primarily in pre-hospital trauma care. It is designed to provide rigid support during movement of a person with suspected spinal or limb injuries. They are most commonly used by

ambulance An ambulance is a medically-equipped vehicle used to transport patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to ...

staff, as well as lifeguards and ski patrollers. Historically, backboards were also used in an attempt to "improve the posture" of young people, especially girls. Due to lack of evidence to support long-term use, the practice of keeping people on long boards for prolonged periods of time is decreasing.

Extrication uses

The spinal backboard was originally designed as a device to remove people from a vehicle. After a time people were simply kept on the spine board for transport without evidence supporting this need.

Medical uses

A spinal board is primarily indicated for judicious use to transport people who may have had a

spinal injury A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. It is a destructive neurological and pathological state that causes major motor, sensory and autonomic dysfunctions. Symptoms of ...

, usually due to the mechanism of injury, and the attending team are not able to rule out a spinal injury. The person should be transferred from the board to a hospital bed as soon as possible. For comfort and safety reasons, it is recommended to transfer the person to a vacuum mattress instead, in which case a scoop stretcher or long spine board is just used for the transfer. Despite its history of use, there is no evidence that backboards immobilize the spine, nor do they improve the person's outcomes. Additionally, cervical spine motion restriction has been shown to increase mortality in people with penetrating trauma and can cause pain, agitation, respiratory compromise, and can lead to the development of bedsores.National Association of EMS Physicians and American College of Surgeons Committee on Trauma. January 15, 201
Position Statement: EMS Spinal Precautions and the Use of the Long Backboard
/ref>

Adverse effects

Common clinical issues found with spinal boards include

pressure sore Pressure ulcers, also known as pressure sores, bed sores or pressure injuries, are localised damage to the skin and/or underlying tissue that usually occur over a bony prominence as a result of usually long-term pressure, or pressure in comb ...

development, inadequacy of spinal motion restriction, pain and discomfort, respiratory compromise and effects on the quality of radiological imaging. For this reason, some professionals view them as unsuitable for the task, preferring alternatives. It is advised that no patient should spend more than 30 minutes on a spine board, due to the development of discomfort and pressure sores. Backboards were invented to be a "highly polished surface" to move a person to an EMS bed, not to be used as spinal securing device.

Construction

Backboards are almost always used in conjunction with the following devices: * a

cervical collar A cervical collar, also known as a neck brace, is a medical device used to support and immobilize a person's neck. It is also applied by emergency personnel to those who have had traumatic head or neck injuries, although they should not be rou ...

with occipital padding as needed; * side head supports, such as a rolled blanket or head blocks (head immobilizer) made specifically for this purpose, used to avoid the lateral rotation of the head; * straps to secure the patient to the long spine board, and tape to secure the head Spine boards are typically made of wood or plastic, although there has been a strong shift away from wood boards due to their higher level of maintenance required to keep them in operable condition and to protect them from cracks and other imperfections that could harbor bacteria. Backboards are designed to be slightly wider and longer than the average human body to accommodate the immobilization straps, and have handles for carrying the patient. Most backboards are designed to be completely

X-ray An X-ray (also known in many languages as Röntgen radiation) is a form of high-energy electromagnetic radiation with a wavelength shorter than those of ultraviolet rays and longer than those of gamma rays. Roughly, X-rays have a wavelength ran ...

translucent so that they do not interfere with the exam while patients are strapped to them. They are light enough to be easily carried by one person, and are usually buoyant.

Alternatives

The vacuum mattress may reduce sacral pressures compared to backboards. The conforming nature of the vacuum mattress means that people can be kept immobilized on it for longer periods of time and the immobilisation offers superior stability and comfort. The

Kendrick extrication device A Kendrick extrication device (KED) is a device used in vehicle extrication, extrication of victims of traffic collisions from motor vehicles. Commonly carried on ambulances, a KED is typically used by an emergency medical technician, paramedic, ...

is another alternative.

References

{{Emergency medical services Rescue equipment Medical transport devices Emergency medical equipment