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BACKBOARDING

THE STANDING PATIENT

 

 

Studies show that approximately 17 - 25% of patients with spinal injuries are walking at the scene of the motor crash.1-3  The following technique shown, which is often referred to as the  ‘Standing Long Board’, allows Officers to place the patient in the lying position with little movement of the spine when compared to other methods currently practiced.  Either a Long Spine Board (LSB) or Scoop Stretcher can be used for this procedure.  It should also be noted that a patient in a standing position will still be up to 5 cm shorter as the weight of the head and torso compress the patient’s vertebra together.  It is therefore essential that the patient be placed in a supine position as soon as possible to uncompress the spinal column. 

The Standing Long Board technique is not just limited to use in the traumatic SCI patient, but can also be used with other patients such as those with back pain or other injuries who find it too painful to get to a lying position without assistance.

 By reversing the procedure, the Standing Long Board is an effective way of standing a patient up from the lying position and uses a safe lifting technique.  Such cases may include the ‘floor-to-bed’, chronic C.V.A. or M.S. patient who has fallen and simply requires assistance to stand up.

 

 
 
 

Training Requirements:

3 x Staff
1 x Patient
1 x Cervical Collar
1 x Long Spine Board
1 x Blanket
1 x Towel
1 x Hand / Wrist Airsplint

 
 
 

Step 1

Officer 2 maintains Manual In-Line Stabilisation until the patient is properly immobilised onto the LSB2-5, 11 Officer 1 applies a Cervical Collar.  The Manual  In-Line Stabilisation is maintained as best as possible until full spine immobilisation is achieved11  as a Cervical Collar will at best provide only 50% immobilisation2-5

Officer 1 then inserts a LSB  behind the patient.

 

 
 
 

Step 2

Officer 3 inserts blanket between patient and the LSB for improved patient comfort,6-10 and places a towel for padding between the patient’s head and LSB as required to prevent hyperextension of the patient’s head.

 

 

 
 
 

Step 3

Officers 1 & 3 stand on either side of the patient, with each Officer placing their inner arm under the patient’s armpits. Officers 1 & 3 grip the handles of the LSB slightly higher than armpits.  This will help prevent the patient sliding down the LSB when the LSB is lowered.  Officers 2 & 3’s other hand should hold the LSB at the top handle to give additional support and stability whilst the LSB is lowered to the ground.

 

 
 
 

Step 4

Slowly the lower the LSB backwards until on the ground.

 
 

Step 5

Finally immobilise the patient to the LSB for transport.11

 
 
Bibliography

 

1. Shriger
Annals Of Emergency Medicine  20:878-81  1991
Spinal Immobilisation On A Flat Board: Does It Result In Neutral Position Of The Cervical Spine
 

2. Cline
Journal Of Emergency Medicine 1990
Comparison Of Rigid Immobilisation Collars
 

3. Cline
Journal Of Trauma  25:649-653  1985
A Comparison Of Methods Of Cervical Spine Immobilisation Used In Patient Extrication And Transport
 

4. Graziano
Annals Of Emergency Medicine  October 1987
Radiological Comparison Of Prehospital Cervical Immobilisation Methods
 

5. Podolsky
Journal Of Trauma
Efficacy Of Cervical Spine Immobilisation Methods
 

6. Gianluca Del Rossi
Journal Of Atheletic Training   September  2003      38 (3):  204 - 208
A Comparison Of Spine Board Transfer Techniques And The Effects Of Training On Performance
 

7.           Walton R, DeSalvo JF, Ernst AA, Shahane A.
  Acad Emerg Med 1995 Aug;2(8):725-
  Padded vs unpadded spine board for cervical spine immobilization.
 

8.           Hauswald M, Hsu M, Stockoff C.
  Prehosp Emerg Care 2000 Jul-Sep;4(3):250-2
  Maximizing comfort and minimizing ischemia: a comparison of four methods of spinal immobilization.
 

9.           Cordell WH, Hollingsworth JC, Olinger ML, Stroman SJ, Nelson DR.
  Ann Emerg Med 1995 Jul;26(1):31-6
  Pain and tissue-interface pressures during spine-board immobilization.
 

 10.         Hann
  www.neann.com
  Does proper padding reduce pain on Long Spine Boards
 

11.          Victorian Ministerial Task Force on Trauma
   Review Of Trauma And Emergency Services     Report 1999

 

 
 
 

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