Abstract
BackgroundUse of backboards as part of routine trauma care has recently come into question because of the lack of data to support their effectiveness. Multiple authors have noted the potential harm associated with backboard use, including iatrogenic pain, skin ulceration, increased use of radiographic studies, aspiration and respiratory compromise. An observational study was performed at a level 1 academic trauma center to determine the total and interval backboard times for patients arriving via emergency medical services (EMS).FindingsPatients were directly observed. Transport time was recorded as an estimate of initiation of backboard use; arrival time, nurse report time and time of removal from the backboard were all recorded. National Emergency Department Overcrowding Study (NEDOCS) score, Emergency Severity Index (ESI) and demographic information were recorded for each patient encounter. Forty-six patients were followed. The mean total backboard time was 54 min (SD ±65). The mean EMS interval was 33 min (SD ±64), and the mean ED interval was 21 min (SD ±15). The ED backboard interval trended inversely to ESI (1 = 5 min, 2 = 10 min, 3 = 25 min, 4 = 26 min, 5 = 32 min).ConclusionPatients had a mean total backboard time of around an hour. The mean EMS interval was greater than the mean ED interval. Further study with a larger sample directed to establishing associated factors and to target possible reduction strategies is warranted.
Highlights
Use of backboards as part of routine trauma care has recently come into question because of the lack of data to support their effectiveness
The mean emergency medical services (EMS) interval was greater than the mean Emergency department (ED) interval
There was no statistically significant difference in total time when compared by National Emergency Department Overcrowding Study (NEDOCS) score grouping (0–100, 101–140, 141–180, ≥181), age group and Emergency Severity Index (ESI) level
Summary
Use of backboards as part of routine trauma care has recently come into question because of the lack of data to support their effectiveness. Multiple authors have brought the utility of backboard use into question because of a lack of data to support their effectiveness in preventing secondary injury and the potential harm associated with backboard use, including iatrogenic pain, skin ulceration, increased use of radiographs, aspiration and respiratory compromise [2,3,4,5,6,7]. These potential risks prompted initiation of a pilot quality assurance observational study to determine
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