mogumogu.ppt

7/27/2019 mogumogu.ppt

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Comparison of a long spinal board and vacuum

mattress for spinal immobilisation

AUTHORS:Dr M D Luscombe,

Department of Anaesthesia,

The Royal Hallamshire

Hospital, SheffieldTeaching Hospitals NHS

Sister Claire McClelland: Shift ManagerEmergency Department Ulster Hospital

Trust, Sheffield S10 2JF,M D Luscombe and J L Williams

Emerg Med J 2003 20: 476-478

ICEM: Dublin 201228 June 2012Resus/Trauma

MEDICAL FACULTY OF JENDRAL ACHMAD YANI UNIVERSITY

DUSTIRA ARMY HOSPITAL INDONESIA


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BACKGROUND

Current teaching in trauma management in ATLS

and APLS2 system supports the use of the long spinalboard(backboard) for spinal immobilisation, despite knowledge of

pressure problems and poor immobilisation in some patient groups.

Mountain rescue teams in the United Kingdom use the vacuum

mattress predominately as it is believed to provide better overall

protection of an injured casualty and is perceived to be safer and

easier to transport over the terrain encountered in these situations.

There are advantages and disadvantages of the two methods, both

in their extrication abilities and their comfort and stability levelsduring subsequent transport.

This study was designed to assess the stability and comfort of the

two systems.


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METHOD

Nine volunteers wearing standardised clothing and rigid neck

collars were secured on to a backboard and vacuum mattress

using a standard strapping arrangement. An operating department

table was used to tilt the volunteers from 45 degrees head up to

45 degrees head down, and addition- ally 45 degrees laterally.

Movements of the head, sternum, and pubic symphysis (pelvis)

from a fixed position were then recorded. The comfort level

during the procedure was assessed using a 10 point numerical

rating scale (NRS) where 1=no pain and 10=worst pain

imaginable


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RESULTS


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It was shown that the vacuum mattress prevents

significantly more movement in the longitudinal and

lateral planes when subjected to a gradual tilt. Perceived

comfort levels are significantly better with the vacuummattress than with the backboard.


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Spinal boards or vacuum mattresses for immobilisation

Report by Muhammad Ahmad, Specialist Registrar

Checked by John Butler, Specialist Registrar

A 60 year old man was involved in a road traffic accident at high

speed. He was complaining flow back pain at the scene and he was

immobilised on a long spinal board. When the patient arrived at the

emergency department, he was very uncomfortable on the board and he

requested removal. You wonder whether a vacuum mattress is more

comfortable and provides better degree of immobilisation.


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Comfort V safety

Vacum mattress Spinal BoardDifficult to Use

Comfortable

When deflateddecreased spinal

support

Pain to pressure

areas

Greater risk ofpressure sores

Less movement

removing


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Conclusions

In the measured planes the vacuum

mattress provides significantly superior

stability and comfort than a backboard.

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