Spine immobilization with a long spine board

A spinal board,^[1] also known as a long spine board (LSB),^[2] longboard,^[3] spineboard,^[4] or backboard,^[5] is a patient handling device used primarily in pre-hospital trauma care designed to provide rigid support during movement of a patient with suspected spinal or limb injuries.^[3] They are most commonly used by ambulance services, by staff such as emergency medical technicians and paramedics, but are also used by specialist emergency personnel such as lifeguards.^[4]

Indications for use[link]

A spinal board is primarily indicated for use in cases of trauma where the medical or rescue personnel believe that there is a possibility of spinal injury, usually due to mechanism of injury, and the attending team are not able to rule out a spinal injury. Due to the problems associated with extended use, it is designed primarily as an extrication device, especially from vehicles.^[3]

Backboards are almost always used in conjunction with the following devices:

• a cervical collar with occipital padding as needed;
• side head supports, such as a rolled blanket or head blocks made specifically for this purpose, used to avoid the lateral rotation of the head;
• straps to secure the patient to the long spine board, and tape to secure the head

Construction[link]

Spine boards are typically made of wood or plastic, although there has been a strong shift away from wood boards due to their higher level of maintenance required to keep them in operable condition and to protect them from cracks and other imperfections that could harbour bacteria.

Backboards are designed to be slightly wider and longer than the average human body to accommodate the immobilization straps, and have handles for carrying the patient. Most backboards are designed to be completely X-ray translucent so that they do not interfere with the exam while patients are strapped to them. They are light enough to be easily carried by one person, and are usually buoyant.

Clinical issues[link]

Common clinical issues found with spinal boards include pressure sore development, inadequacy of spinal immobilization, pain and discomfort, respiratory compromise and affects on the quality of radiological imaging.^[1] For this reason, some professionals view them as unsuitable for the task, preferring alternatives.^[6]

It is advised that no patient should spend more than 30 minutes on a spine board, due to the development of discomfort and pressure sores.^[3]

Alternatives[link]

The primary alternative, now considered gold standard for trauma care, is the vacuum mattress, which is flexible when soft, but it hardened through evacuation of air. The conforming nature of the vacuum mattress means that patients can be kept immobilised on it for longer periods of time and the immobilisation offers superior stability and comfort to the patient.^[7]

There are also short spine boards, but the short spine board is rarely used now due to the presence of superior devices, such as the Kendrick Extrication Device.

See also[link]

• Spinal injury
• Cervical collar
• Clearing the cervical spine

References[link]