emDocs - February 10, 2016 - Author: Joseph J and Bucher J
Edited by: Robertson J and Koyfman A
Top 10 Myths About Cervical Spine Injury Management
- Myth #1: Backboards can “neutralize” the cervical spine when used properly
- Myth #2: The trauma surgeons will not support removing backboards from our treatment algorithm
- Myth #3: Use of the LBB is a benign intervention that can only help my patient.
- Myth #4: We should be attempting spinal motion restrictions on all trauma patients
- Myth #5: We extricated the patient with a backboard and therefore, we need to leave the backboard in place until we get to the hospital.
- Myth #6: Well, if I am not using the LBB on trauma patients anymore, then I still need to utilize a cervical collar… right?
- Myth #7: People have come to expect the “board and collar” after an MVC and if I do not use them, then I will be sued.
- Myth #8: Vacuum/inflatable/gel-padded backboards provide better spinal immobilization with increased comfort for our patients.
- Myth #9: A provider should always be present to “clear” an ED patient off a backboard.
- Myth #10: I need to keep long backboards on my ambulances for extrication of patients.
Top 5 Backboard Clinical Pearls
- The LBB should not be used as a therapeutic intervention. Achieving full spinal immobilization is not possible and its use has been shown to cause patient harm and no benefit. Instead, spinal motion restriction should be practiced.
- LBB use has been shown to cause increased pressure ulcers, decreased respiratory function, increased back pain, and result in a false-positive midline vertebral tenderness. This can result in unnecessary testing, radiation exposure and medical costs.
- Penetrating trauma alone does not increase the risk of cervical spine injury and these patients should never be immobilized.
- Attempting spinal motion restriction should not delay life-saving interventions or delay transport to definitive care.
- Consider RN-directed removal of backboards in the emergency department to avoid complications of prolonged, unnecessary immobilization.