Effects of unconsciousness during spinal immobilization on tissue-interface pressures: A randomized controlled trial comparing a standard rigid spineboard with a newly developed soft-layered long spineboard☆
Section snippets
Background
Spinal immobilization with long spineboards and cervical collars for extrication and transfer of trauma patients is a standard precaution in both prehospital and in-hospital protocols [1]. Especially for unconscious trauma patients, who are unable to maintain spinal alignment by muscular tone, these methods are considered essential to protect the spine from further injury.
Although there is a general consensus that the patient should be removed from the spineboard as soon as reasonably possible,
Study design
We conducted a prospective, randomized, single-blinded, comparative study on tissue-interface pressures and redness of the skin using a standard rigid long spineboard and a soft-layered long spineboard in patients undergoing surgery under general anaesthesia. Tissue interface pressures were compared with those of a group of awake healthy volunteers. The study has been assigned ISRCTN96064657.
Recruitment of participants
A sample of 30 patients (25 men and 5 women) was recruited at the outpatient department of the
Patients
Characteristics of anaesthetized subjects and awake controls are described in Table 1. No differences in demographics or baseline characteristics were found between the patients randomized for rigid spineboard or soft-layered spineboard. Participants in the patient group were on average older and more often male than in the awake volunteers group. No relationship was found between pressure values and age or gender.
Tissue-interface pressures
In both awake volunteers and anaesthetized patients, peak pressures for scapula
Discussion
This study showed that unconscious subjects placed on a soft-layered spine board had lower tissue-interface pressures than conscious subjects, while no differences between these two groups were found when using a rigid spine board. Patients under anaesthesia and awake controls both had significantly lower tissue-interface pressures on the soft-layered spineboard than on the rigid spineboard.
Despite a growing body of evidence that immobilizing patients on a rigid spineboard can cause a number of
Conflict of interest
The authors state there are no conflicts of interest. No external funding was received for this study.
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Results of this study were presented at the 2nd Focus meeting of the EPUAP on skin health and the microclimate, Southampton, UK, April 9, 2014.