I am a huge fan of college football and love watching games all day on Saturdays. Watch enough football and you’ll unfortunately be a witness to some rather gruesome injuries. For example this past Saturday Seth Russel (QB for Baylor) dislocated his ankle and was carted off the field (praying for a speedy recovery bud). Other times you’ll see a player be spine boarded when there is a suspected cervical spine injury. Usually this is done for precaution and it is always good to be prepared for this type of injury. With that being said there has been some recent debates over the best way to spine board someone or even to spine board someone at all with a suspected cervical injury. The National Association of EMS Physicians (NAEMSP) and the American College of Surgeons Committee on Trauma (ACS-COT) have published a new position paper on “EMS Spinal Precautions and the Use of the Long Backboard.”
The change in protocol comes from lack of research support for using the long backboard technique. The position statement outlines the benefits and risks for using a spine board. The side effects for using the spine board include increasing pain, pressure ulcers, patient agitation and comprised respiratory system. People who are recommended to be spine boarded include someone with:
- Blunt trauma and altered level of consciousness
- Spinal pain or tenderness
- Neurologic complaint (e.g., numbness or motor weakness)
- Anatomic deformity of the spine
- High-energy mechanism of injury and any of the following:
- Drug or alcohol intoxication
- Inability to communicate
- Distracting injury
People who are no longer needing to be spine boarded include someone with:
- Normal level of consciousness (Glasgow Coma Score [GCS] 15)
- No spine tenderness or anatomic abnormality
- No neurologic findings or complaints
- No distracting injury
- No intoxication
- Patients with penetrating trauma to the head, neck, or torso and no evidence of spinal injury should not be immobilized on a backboard
The National Athletic Trainer’s Association (NATA) has also done some research into spine boarding techniques. A study published in the Journal of Athletic Training compared the different spine boarding techniques with the amount of spine movement. The lifts the study looked at include the traditional Log Roll, Lift and Slide technique, and the 6+ Person Lift. Researchers measured axial rotation, flexion-extension, lateral flexion, anteroposterior displacement, distraction, and medial-lateral translation at the C5-C6 spinal segment.The results from this study concluded that the there is ultimately going to be some spinal movement regardless of the lift technique. The researchers also concluded that the 6+ Person technique minimized the extent of motion generated across a globally unstable spinal segment (1). There was also significantly more lateral flexion and axial rotation during the log roll technique when compared with the two others.
Sport medicine is constantly changing and more research is occurring daily to help make sure the best possible care is available for athletes. The new spine boarding techniques should start being visible within the next year if they haven’t been seen already. As an athletic trainer I am going to do everything I can to help make sure the athlete is cared for safely. Spine boarding is an intense situation for everyone involved and ultimately can save someones’ life and/or limbs! AT’s have your back…literally!
This is only one of many life and limb saving stories! Tommy was indeed back boarded and had a full recovery. His story could have ended very differently had the right protocol not been taken by his athletic trainer!
*Disclaimer: Please use this information only for personal use and only perform actions within your scope of practice*
- Del Rossi, G., Horodyski, M. H., Conrad, B. P., Di Paola, C. P., Di Paola, M. J., & Rechtine, G. R. (2008). The 6-Plus–Person Lift Transfer Technique Compared With Other Methods of Spine Boarding. Journal of Athletic Training, 43(1), 6–13.