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Hi, in Germany, at least in my beloved state of Bavaria, we'll see more and more usage of the "spineboard". All new ambulances are equipped with a long backboard since several years and finally the providers apparently found them in the compartments wondering what this thing will do if switched on. And since they start to recognize it as a fancy equipment thingy from THE UNITED STATES OF AMERICA everyone sees on TV series and in movies, it seems to be the greatest gift to german EMS since the invention of wheel(cart)s. As if we never had our beloved vacuum mattresses (since >30 years, probably even lot more) and scoop stretchers (since around 20 years)...on every ambulance by now. Studying various sources and experiencing the backboard in various situations (classroom training, life excercises and rare real calls), I have a certain impression about it's worthiness. In short my point of view is: if used as a "pick up aid" only in situations were a scoop stretcher or other less disturbing techniques don't help, a spineboard is a great thing. Especially in confined space situations and if to carry a patient over sharp edges (where the scoop stretcher usually will hook). However, I really don't see it as a transportation aid in the ambulance. With our vacuum mattresses (required equipment) a patient is more comfortable (one word: lordose) and splinted individually but complete. This includes full protection against sideway movement. But I don't want to really discuss the pro's and con's, so sorry for the long intro, but I wanted you to see where I come from. So, the real questions are: How do you properly fix a patient on a spineboard against side movements? Our backboards seem to be a bit slippery and even if pinned down by a spider strap several body parts can slip sideways. Our modern vacuum mattresses even have a polster between the legs to stabilize them from all sides - how is this adressed in proper spineboard fixing? transport the patient on a backboard in the ambulance? Is there any special hold or something like that? I don't trust a slippery thing simply put on a stretcher...it seems it can go ballistic any time since it could only be fixed with the normal patient straps on the stretcher - which are designed for a patient directly laying on the stretcher including a lot more friction between the fitting surfaces. address the problem of lordose (the "S"-form of the spine), shoulder supporting, and leg supporting (the body is NOT flat!)? Is there a rule about filling those "holes"? make a patient more comfortable for a longer transport? Is there a rule about padding the direct contact parts between board and skin (hip, shoulders, head)? And I mean: "really, according to training books, should be, if done all right and not the quick & dirty solution". How are things really done in US or should be done and how are we influenced by TV over here. I don't like TV to teach me things in EMS...some seem to see it other way round (honestly, i suppose some ITLS/PHTLS trainers just copy things totally unreflected). Any others non-US but using spineboards may be helpful for my understanding of the real thing, too. I sure have made some research, but "padding" and such things are always addressed within a side comment or such in the documents I found. Can't believe that this is just not needed. Thanks for your input, Bernhard P.S.: if someone missed me the last few months - I was still there, but slightly exposed to other things in life. May happen again.