The Gathering of Eagles is held in Dallas Texas every year and is a source of many new ideas for the EMS Community. It's members are many of the leading Medical Directors in the country.
In their 2014 conference Dr. Valenzuela and Dr. Fowler discussed the topic "To Spine Board or Not".
We believe this analysis will provide a third way to address this issue other than use them or don't use them.
Backboards are a tool for transport of patients that must remain supine. A subset of this group is patients that require spinal immobilization. These two groups are not equal. There are many instances where patients require transport in the supine position but don't require spinal immobilization. Some examples are;
- patient is unresponsive or has an altered level of consciousness
- patient cannot sit up
- patient is obese, lying on the floor and unable to get to a standing position
- patient can't walk and exit won't allow for stair chair (scissor staircase or tight corner)
- patient is bed confined or bed ridden
- patient is paraplegic
- patient is most comfortable lying down (position of comfort)
- patient requires compressions during transport
If a patient is in a building that does not allow for a cot to be rolled to the location (e.g. upper floor with no elevator, mobile home, etc.) then they must be transported to the cot before placing in the ambulance
In all of these situations a backboard or stretcher is required.
Two additional issues that have been raised.