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Home > Topics > Patient Handling

Mo. policy eliminates long spine board mandate

The new transport procedure recognizes the negative effects of long spine boards and says a cervical collar without immobilization is now acceptable

Sue Sterling
The Daily Star-Journal

WARRENSBURG, Mo. — Johnson County Ambulance District will implement new procedures July 1 for handling patients with suspected spinal injuries, Chief Shane Lockard said.

Lockard told the board research indicates patients with potential for a cervical, thoracic or lumbar spine injury do not have to be immobilized and transported on a long spine board.

Previous protocols mandated board use to transport patients with spinal injuries, he said.

“It is now recognized that securing a trauma patient to an EMS stretcher without a long spine board is acceptable for maintaining spinal precautions during transport,” he said in a letter to emergency department physicians and staff co-signed by district Medical Director Dr. David Gustafson.

Evidence exists indicating the long spine board has negative effects on patients, they said, including restricting respiration, causing tissue trauma, pain and discomfort for patients, delaying transport from the scene and increasing mortality rates.

The new protocols are in line with position statements from the American Academy of Neurological Surgeons, the National Association of EMS Physicians and the American College of Surgeons Committee on Trauma, he said Thursday.

Lockard said more EMS services are adopting the procedures.

He said ambulance attendants now can place a cervical collar on a person with a neck injury and transport the patient without immobilization on a long spine board.

The board will be used to extricate and move a patient to the EMS stretcher, he said.

At the hospital, the patient can be moved to an emergency room bed by use of a slide board or by lifting the patient on a stretcher sheet, he said.

McClatchy-Tribune News Service
The district will monitor the new procedures and seeks feedback from the medical community, the letter said.

The comments below are member-generated and do not necessarily reflect the opinions of or its staff. If you cannot see comments, try disabling privacy and ad blocking plugins in your browser. All comments must comply with our Member Commenting Policy.
Randy Denby Randy Denby Tuesday, June 17, 2014 7:25:37 AM Hope Georgia will start this. I hate spine boards they cause more suffering than there worth if you ever been on one long anuff to feel the effects you know what I'm talking about feel like mid evil torture device and in combative patients them pulling and fighting will do more damage than just letting them be most times they stay calm and not move until you put them on a board then the fight is on. and i really hate putting them on the nursing home patients with the curved back and boney spines it hurts like hell to these older people only time spine board should be used is in moving patients in hard places to get. using one just because is a kin to patient abuse in my opinion and by protocols I have no choice but to use it.
Ray Kemp Ray Kemp Tuesday, June 17, 2014 7:50:30 AM "Ambulance attendants"? Never thought I'd hear an EMS director coin that term in this day and age.
Greg Natsch Greg Natsch Tuesday, June 17, 2014 7:57:43 AM This is local policy and protocol
Matthew Cushman Matthew Cushman Tuesday, June 17, 2014 8:37:47 AM He didn't us the word attendant as it would be in quotes. That is probably the reporters paraphrase.
Tom Antrim Tom Antrim Tuesday, June 17, 2014 8:44:15 AM Is it not the same as they handle injured people in the movies?
Susan Carlson Susan Carlson Tuesday, June 17, 2014 9:31:25 AM Some of Georgia has instituted this. Yes, the long spine boards are terrible for nursing home patients or any elderly patient. I agree.
Audrey Dixon Audrey Dixon Tuesday, June 17, 2014 10:05:26 AM In San Joaquin County. We have been doing this for over a year. Like everything, it has good and bad going for it. We have to use Keds and soft collars. No backboards or hard collars. Which does not keep any patient stable unless they are unconscious. Which is a moot point. This is great for older patients but horrible for a real injury. BYW, the ked is not a one size fits all. They want us to use D rings on bigger patients and the head piece always wiggles itself way above the head. Also the soft collars absorbs blood. So if your patient is bleeding this will suck the blood right out of them. Now your probably thinking. Everyone in the field knows this. The head of our EMS has no field experience.
Jebb Sifu Jebb Sifu Tuesday, June 17, 2014 10:34:40 PM 2nd day in the ems world (just started school) very helpful info I'd like to talk to my instructor about... Thanks have a great day
Gary Weaner Gary Weaner Wednesday, June 18, 2014 3:26:57 AM Hello guys im EMT in Montréal for 31 years and thats the frist time i hear that dont use the spine boards foe transporting pt or to trsansfert theme we have a matresse its good but in the winter its not good at all
Shirley Gastler Shirley Gastler Wednesday, June 18, 2014 5:05:07 AM SSM has been doing this since Jan 1 and research is spot on.
Michael Fox Michael Fox Wednesday, June 18, 2014 5:38:31 AM Better than ambulance "driver" lol
Renee Grimes Renee Grimes Wednesday, June 18, 2014 5:54:15 AM North Egypt System in Illinois and Parts of Southeastern Mossuri started this January 1. The research shows it has little to no positive effect and pts are much more comfortable during transport.
Ron Simonson Ron Simonson Wednesday, June 18, 2014 6:25:56 AM How many more injuries we be had becsuse trying to take them off the board?
Raymond P Smith Raymond P Smith Wednesday, June 18, 2014 11:15:21 AM I love it! great news
Teresa Maria Doesnot Teresa Maria Doesnot Wednesday, June 18, 2014 11:17:21 AM So when you have a spinal injury, broken bones, and lots of pain it its ok to grab you by your arms and legs aka extremeties without a long board to further injur by lifting you off the floor allowing the weight to bare and cause more pain... lol if my back hurts and u lift me by my arms and legs and I happen to scream and punch someone in there chest , it must be just reflex and should not get charged for assault!
Pamela Huff-Cottrill Pamela Huff-Cottrill Wednesday, June 18, 2014 11:51:58 AM What does a soft cervical collar do for a c spine injury? Why are you using something like a Vista collar taht is comfortable and immoblizes the c spine?
Michael Regan Michael Regan Wednesday, June 18, 2014 2:15:09 PM Scoop, scoop scoop scoop scoop scoop!!!! Use the damn thing! Fast and secure with no pressure on the spine.
Michael Regan Michael Regan Wednesday, June 18, 2014 2:17:15 PM There should be 3 scoops, and one long board. Not the other way around.
Audrey Dixon Audrey Dixon Wednesday, June 18, 2014 7:08:24 PM I wish we had input. We have tried to talk to our EMS agency. He makes bad policies. If you don't agree with him and talk about him in a public form. He will go after you. He is now the President on the Governors board in California. Just hope he doesn't come to your state.
Matt Perry Matt Perry Wednesday, June 18, 2014 11:05:10 PM Little behind the times. Australia/NZ have been transporting safely without spinal boards for 15 years.
Morgan Young Morgan Young Thursday, June 19, 2014 8:00:28 AM More and more agencies are doing it, or a version of it.
Morgan Young Morgan Young Thursday, June 19, 2014 8:01:31 AM Not the same, I hope they will help you to move in a way that does not cause pain, or give you pain medicine.
Greg Natsch Greg Natsch Thursday, June 19, 2014 8:17:28 AM Morgan Young , I realize this. My point was clarification. Just because more do it does not make it a "state;policy". In fact I agree with NAEMSP, ACEP and WMS.
Morgan Young Morgan Young Thursday, June 19, 2014 8:22:49 AM Understood. We just changed our protocol about it as well, and I believe Mercy did. Ours is new enough I am still looking it up on the way to trauma calls. How is retirement?
Teresa Maria Doesnot Teresa Maria Doesnot Thursday, June 19, 2014 1:15:47 PM Spinal injury pts should be moved with a carrying deviced secured in poc point blank to prevent further movements and injury. Let the hospital clear them if they have a problem moving the patients off of it cause it causes them not removing it from under them with caution tough luck. Ive seen people get cleared off a lb by drs just pulling the board out from under them while patient screams in pain... sweet agony. .. deuces
Dwayne Womack Dwayne Womack Wednesday, June 25, 2014 10:05:28 AM Teresa, the protocols that I'm aware of for eliminating common use of LBBs state that they are in fact used for moving patients, extrication, etc, just not for immobilizing them. There's no huge change in the movement of patients, only continuing to cause them injury by keeping them on the LBBs.
Becky Weliver Becky Weliver Monday, June 30, 2014 8:58:24 AM We are trained, we are tested, we are licensed, we are there in the field, we need to be able to decide the best device to use given the situation.

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