Yesterday we saw the release of the Louisiana Bureau of EMS Spinal Memo 2015 which concludes that:
…the statement from the American College of Emergency Physicians provides a succinct analysis and a clear recommendation, accepted by the Louisiana Bureau of EMS as a standard of care:
The American College of Emergency Physicians believes that current out-of-hospital management practices of patients with potential spinal injury lack evidentiary scientific support. Practices which attempt to produce spinal immobilization include the use of backboards, cervical collars, straps, tape, and similar devices (e.g., sand bags, head wedges). Evolving scientific evidence demonstrates that some of these current out-of-hospital care practices cause harm including airway compromise, respiratory impairment, aspiration, tissue ischemia, increased intracranial pressure, and pain, and can result in increased use of diagnostic imaging and mortality….
…Backboards should not be used as a therapeutic intervention or as a precautionary measure either inside or outside the hospital or for inter-facility transfers. Spinal immobilization should not be used for patients with penetrating trauma without evidence of spinal injury.
The practice of backboarding continues to lose ground in light of an acute lack of evidence for a positive effect from the practice. The Louisiana Bureau of EMS is leaving it up to local medical directors and Parish Medical Societies to implement any changes in their current protocol, since their change is only to the state educational standards.
Although this is not a state-wide protocol change it is still a major overhaul, especially considering the state is National Registry.