Spineboard Medical Studies

American Journal of Emergency Medicine, March 2010 “Revolutionary advances in enhancing patient comfort on patients transported on a backboard: Patients with suspected spinal cord injuries are immobilized to a backboard during ambulance and helicopter air transport. It has been well documented that patients who are immobilized to a backboard experience discomfort and eventually become susceptible to pressure ulcer formation. Because the patient lying on a backboard is subjected to high skin interface pressures, it is imperative to improve patient comfort and prevent pressure ulcer formation. Conclusions of a padded spineboard: ‘significantly reduces discomfort as well as tissue interface pressure in the occipital, scapula, and sacral regions of the back.”

Prehospital Emergency Care, October 2002 “…backboards should be modified to reduce patient discomfort to prevent the iatrogenically induced midline vertebral tenderness, thereby reducing subsequent false-positive examinations.”

Academic Emergency Medicine, September 2008 “Adding closed-cell foam padding to a long spine board significantly improves comfort without compromising c-spine immobilization. Sacral tissue oxygenation does not appear affected by such padding for healthy volunteers.”

Australian Resuscitation Council, July 2012 “Healthy subjects left on spine boards develop pain in the neck, back of the head, shoulder blades and lower back. The same areas are at risk of pressure necrosis. Conscious victims may attempt to move around in an effort to improve comfort, potentially worsening their injury. Paralyzed or unconscious victims are at higher risks of development of pressure necrosis due to their lack of pain sensation. (Accident) victims may be more comfortable on a padded spine board.”

Journal of Emergency Nursing, October 2007 “Both anecdotal and empirical evidence indicates that a significant number of pressure ulcers occur as a result of management provided prior to admission, and that such ulcers are more likely to occur in those patients who have undergone a transfer process from a hospital distal to the specialist unit on a hard spinal board.”

Annals of Emergency Medicine, October 2004 “Rigid spine boards, along with other devices, are commonly used for spinal immobilization by emergency medical services. Research indicates that victims spend an average of 60 minutes immobilized, resulting in prolonged discomfort, which may prompt unnecessary radiographs.”

Annals of Emergency Medicine, January 1994 – “Twenty-one healthy volunteers with no history of back disease were placed in standard backboard immobilization for a 30-minute period. One hundred percent of subjects developed pain within the immediate observation period. Occipital headache and sacral, lumbar, and mandibular pain were the most frequent symptoms. Fifty-five percent of subjects graded their symptoms as moderate to severe. Twenty-nine percent of subjects developed additional symptoms over the next 48 hours.”

Prehospital Emergency Care, Jul, 2000 – “Increasing the amount of padding on a backboard decreased the amount of ischemic pain caused by immobilization.”

Prehospital Emergency Care, September 2000 – “A prospective, nonblinded comparative trial was conducted at a statewide emergency medical services training facility using a convenience sample of emergency medical technician students. After lying motionless for 10 minutes, students evaluated each device using a 10-centimeter visual analog scale. Increasing the amount of padding on a backboard decreased the amount of ischemic pain caused by immobilization.”

Academic Emergency Medicine, August 1995 – “Adding closed-cell foam padding to a long spine board significantly improves comfort without compromising c-spine immobilization.”

Annals of Emergency Medicine, July 1995 – “In a simulated immobilization experiment, healthy volunteers reported significantly less pain during immobilization on a spine board with interposed air mattress than during that on a spine aboard without a mattress. Tissue-interface pressures were significantly higher on spine boards without air mattresses. This and previous studies suggest that immobilization on rigid spine boards is painful and may produce tissue-interface pressure high enough to resulting the development of pressure necrosis (‘bedsores’).”

Prehospital Emergency Care, April-June 1998 – “Pain is frequently reported by healthy volunteers following spinal immobilization.”

Annals of Emergency Medicine, August 1991– “Immobilization on a flat backboard would place 98% of our study subjects in relative cervical extension. Occipital padding would place a greater percentage of patients in neutral position and increase patient comfort during transport.”

Prehospital Emergency Care, July-September 2001 – “Although many pressure point locations were studied, only three had results that appeared statistically significant: the occiput, lower back, and sacrum. The hard board method of spinal immobilization generates higher self-reported pain scale scores than the two vacuum mattresses.”

Emergency Med Journal, January 2001 – “Complications associated with the use of the spinal board were found in five clinically relevant categories: pressure sore development�”

American Journal of Physical Medicine and Rehabilitation 1998 – “59% of patients developed pressure ulcers within 30 days of admission to the hospital, and 58% developed more than one ulcer. The most frequent site of the initial pressure ulcer was the sacral area followed by the heel & time on the spinal board was strongly associated with ulcers. In this prospective study of the development of pressure ulcers in spinal cord-injured patients, we found that 59% of patients developed a grade one pressure ulcer within 30 days of admission to the hospital, most commonly in the sacral area.”

Department of Emergency Medicine; Los Angeles County/ University of Southern California Medical Center, April 1993 – “Standard spinal immobilization may be a cause of pain in an otherwise healthy subject.”

Emergency Medicine and Trauma Center, and Department of Medical Research, Methodist Hospital of Indiana, September 1989 – “Because cervical and lumbar pain and tenderness are the usual criteria for obtaining spine radiographs, the use of spine boards may result in unnecessary radiography. We further conclude that immobilization on rigid spine boards significantly adds to the discomfort of trauma victims.”