On Tuesday, our region voted to adopt a spinal board policy similar to the Yale-New Haven Sponsor Hospital document that came out a few months back as a first step toward eliminating the use of the long backboard for anything but extrication and movement. Today, the state EMS medical advisory committee (CEMSMAC) is expected to begin reviewing a guideline based on the National EMS Physician’s October draft that recommended eliminating long boards for spinal immobilization. Earlier, the state committee voted to develop guidelines based on that position paper.
At the meeting on Tuesday we debated a stronger document, but ultimately decided it would cause too many problems to be out of whack with what CEMSMAC might develop, so we decided to go in unison with New Haven, and then adopt the more comprehensive state document when it is ready. Hopefully, the state document will be ready for implementation soon.
Our limited policy will start on April 22. We again debated an implementation time ranging from waiting for the textbooks to be rewritten to opening up the window of the committee room and shouting. “Free at Last! Free at Last! Unboard My People Now!” Or perhaps, immediately adjourning the meeting, joining arms and skipping down Blue Hills Avenue, arm in arm, singing “Ding Dong! The board is dead! The wicked board is dead!” In the end we went with a two week notice to give the EDs and first responders time to be advised in order to prevent conflict, shouting, rioting and chaos.
Text of North Central position:
“Effective April 22, 2013, long backboards will no longer be utilized for spinal immobilization of ambulatory patients. Patients who are ambulatory at the scene, but who require cervical immobilization based on our regional spinal immobilization guidelines, will be placed in the position of comfort, limiting movement of the neck during the process. This change in procedure is the first step toward eventually using long boards only when needed to facilitate extrication, and not during transport.”