EMS Today: Product Reviews

On the opening day of EMS Today 2011, TOTWTYTR, Kyle David Bates and I attended Dr. Neil Richmond’s lecture, “Neck Immobilization Issues.”

In the interests of brevity, I’ll summarize it for you: There is no scientific evidence – none, nada, zero, zilch – that collaring and boarding patients with spinal injuries does a damn bit of good, and a growing body of evidence that it does harm.

I liked it. Aside from a little more up-to-date research and some really cool spinal fluoroscopes, it was pretty much identical to my lecture on the subject, and I’ll be updating my presentation with those additional resources.

So, for a guy that no longer believes in spinal immobilization for the vast majority of our patients, I find it rather ironic that I choose a couple of pieces of spinal immobilization equipment for my EMS Today 2011 New Product Showcase:

Spencer is an Italian company with quite an extensive catalogue of EMS products. Following the old immobilization maxim of “make the patient as wide as the board or the board as narrow as the patient,” Spencer’s Tango board is a conventional adult spine board integrated with their Baby Go pediatric board.

The Baby Go, an innovative board in itself, is a pediatric-sized spine board that, depending on which side or end you use, has four different heights of occipital step-down to accommodate most sizes of pediatric patients.

Marry that with the shell of an adult-sized board and a good strapping system, and you have what is the most versatile, do-anything board I’ve ever seen.

Although I’m increasingly of the opinion that most of our patients don’t need boards – including the ones with spinal injuries – the fact remains that if I want to remain employed, I’m still going to be strapping a lot of folks to rigid boards. The same is true of EMTs in most systems.

But until street practice catches up with the science, I’m in favor of any doodad that makes it easier. The Tango board makes it far easier to immobilize our pediatric patients without the use of a KED, or the expense of carrying a separate pediatric spine board.

The adult board has a recess molded into it where the Baby Go board nestles, latched into place by a couple of sturdy plastic latches. The entire setup is a bit thicker than a conventional board, but not nearly so much as, say, a Dolphin board.

Chris Kaiser of Life Under the Lights was a bit skeptical about the increased thickness, but as you can see here, it didn’t seem to hinder rescuers positioning some fat guy on it at the show:

[youtube]http://www.youtube.com/watch?v=rv98bQCLWrQ[/youtube]

If you watch the video, you can see where I’m positioning the board much higher than my head, and I’m explaining to Chris Montera why. Unfortunately, I didn’t communicate my reasons to the rest of the team, and they moved the board back down level with my head before log-rolling me onto it.

If you’ll make it a practice to position the head of the board 12-18 inches higher than the patient’s head when you log-roll, when you inevitably have to center the patient on the board, you can push them along the long axis of the spine, rather than laterally against it. It makes for a smoother move, with less potential spinal manipulation.

And in the general category of “not really new or innovative, but probably even more useful than a cool hybrid spine board,” comes Hartwell Medical’s full body vacuum splint:

Vacuum splints mitigate the pain of spinal immobilization, limit the potential for pressure sores, and fill all those voids between body and board.

Since it’s reusable, and priced at less than $100, it looks like Hartwell has finally made vacuum mattresses affordable for most EMS systems. I’ve used their large leg vacuum splints to splint the torso on elderly patients I’ve boarded, and it worked like a charm. The splint molded itself to the body so well that we didn’t need a head immobilizer (or even a cervical collar, really), and you could count the indentations of their spinal vertebrae in the mattress after it was removed.

If you still work in a system where protocols still force you to torture people unnecessarily immobilize most of your trauma patients, these two products may make it a lot easier for both you and your patient.