Once a spine board has been used, it must be sterilized and prepared for the next emergency. The plaque should be cleaned with an antibacterial solution or wipes. Straps should be wiped or soaked in an antibacterial solution. Some boards are also occasionally depilated to support the patient`s positioning on the board. It is recommended that no patient spend more than 30 minutes on a spinal board due to the development of discomfort and pressure ulcers. [5] The time it takes to develop pressure injury varies, but at least one study has shown that tissue damage can begin in as little as 30 minutes in healthy volunteers. [19] During this time, the average time spent immobilized on a long spine board is approximately 54 to 77 minutes, of which approximately 21 minutes are spent in the emergency room after transport. [20] [21] With this in mind, all providers should try to minimize the amount of time patients spend either on long rigid spinal planks or immobilized with nuvical collars, which can lead to pressure injury. Team four member will push the long spine board under the patient, and the rest of the technique will be followed as described above. Spine panels are usually made of wood or plastic, although there has been a strong abandonment of wood panels due to the higher maintenance required to keep them in working order and protect them from cracks and other imperfections that could harbor bacteria. The patient`s head should be assigned to a team leader who performs manual in-line stabilization by grasping the patient`s shoulders with his fingers on the posterior side of the trapezius and thumb on the front side, with the forearms firmly pressed against the lateral aspects of the patient`s head to restrict movement and stabilize the cervical spine. If available, a cervical collar should be applied at this time, without lifting the patient`s head off the floor. If there is none, maintain this stabilization during the wood roller technique.
When implementing spinal restriction of movement, all members of the interprofessional care team should know their preferred technique and practice good communication to properly perform the technique and reduce excessive movements of the spine. Medical professionals should also realize that time spent on a long spine board should be minimized to reduce complications. During handover, the EMS team must communicate the total time spent on the long board of the spine. A long spine plank is used when a doctor believes that a patient has suffered trauma to the back or spine. Signs that a back panel is needed include pain in the back or neck, loss of sensation in the limbs, or when a person is unconscious and cannot convey to the doctor the possibility of damage to the spine. The time a patient spends on a spinal board should be minimized. These back restraints sometimes contribute to the patient`s pain and discomfort, causing breathing difficulties and bedsores. The vacuum mattress can reduce the sacred pressure compared to the back walls. The compliant nature of the vacuum mattress means that people can be immobilized longer and immobilization provides superior stability and comfort. [15] The Kendrick Recovery Device is another alternative. [16] The most common and well-documented complication of restricting movement of the long spine is pain that lasts only 30 minutes.
The pain is most often manifested by headaches, back pain and mandibular pain. [25] Again, and now a recurring theme, time spent on a long, rigid barbed wire board should be minimized for pain relief. Indications for restriction of spinal movement depend on the protocol developed by local emergency department managers and may vary accordingly. While there may be some variations, they usually include the NEXUS C-Spine rule or the Canadian C-Spine rule. However, the American College of Surgeons Trauma Committee (ACS-COT), the American College of Emergency Physicians (ACEP), and the National Association of EMS Physicians (NAEMSP) developed a joint statement on spinal restriction in adult blunt trauma patients in 2018, listing the following indications:[10] The back panel of the spine was originally designed as a device for removing people from a vehicle. After a while, people were simply kept on the back panel for transportation, without any evidence of this necessity. [5] [10] The rear panels are designed to be slightly wider and longer than the average human body to accommodate immobilizers and have handles to carry the patient.
