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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EOne million spine injuries occur annually, and 2% to 3% are spinal cord injuries. For patients with suspected spinal injury, the use of spinal boards for spine immobilization confers no benefit and may cause harm. This article reviews the current evidence on the use of spinal boards for spinal immobilization.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ETrauma\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ESpine Conditions Trauma\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ETrauma\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ESpine Conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EEmergency Medicine\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EOne million spine injuries occur annually, and 2% to 3% are spinal cord injuries [Hauswald M. \u003Cem\u003EEmerg Med J.\u003C\/em\u003E 2013]. For patients with suspected spinal injury, the use of spinal boards for spine immobilization confers no benefit [Oteir AO et al. \u003Cem\u003EPrehosp Disaster Med.\u003C\/em\u003E 2014] and may cause harm [Goldberg W et al\u003Cem\u003E. Ann Emerg Med.\u003C\/em\u003E 2001]. Christopher B. Colwell, MD, Denver Health Medical Center, Denver, Colorado, USA, reviewed the current evidence on the use of spinal boards for spinal immobilization.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EDr Colwell noted that the traditional use of spinal boards for spinal injuries is based on a set of beliefs that additional movement in people with suspected spinal injuries may exacerbate or cause injury and that immobilization can prevent further injury.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EHowever, data used to support this dogma are not based on solid evidence. Dr Colwell highlighted the lack of evidence from randomized clinical controlled trials to support the recommendation to use backboards and cervical-collars (c-collars) for trauma patients with signs and symptoms of spinal injury made in the 1971 guidelines by the American Academy of Orthopedic Surgeons.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EFor patients with a penetrating trauma, such as a gunshot wound, Dr Colwell emphasized that the evidence clearly shows that spinal immobilization is harmful and doubles the mortality rate [Haut ER et al. \u003Cem\u003EJ Trauma\u003C\/em\u003E. 2010]. Because of the increased mortality rate due to delayed resuscitation, the American Academy of Neurological Surgeons recommended against spinal immobilization in patients with penetrating trauma [Theodore N et al. \u003Cem\u003ENeurosurgery\u003C\/em\u003E. 2013]. Dr Colwell provided further evidence that spinal boards have harmful consequences, such as respiratory compromise and increased pain (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E).\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/15524\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/15524\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/15524\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-6\u0022 class=\u0022first-child\u0022\u003EEvidence for Harm With Spinal Boards\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-7\u0022\u003EHarm is also associated with c-collars [Ben-Galim P et al. \u003Cem\u003EJ Trauma\u003C\/em\u003E. 2010], and there is evidence to suggest that routine use of c-collars can be safely avoided [Sundstr\u00f8m T et al. \u003Cem\u003EJ Neurotrauma\u003C\/em\u003E. 2014].\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EFor those looking for a way to safely transfer a patient from the pram to the hospital bed, research has shown that scoop stretchers can restrict motion as well as long boards [Del Rossi G et al. \u003Cem\u003EAmJ Emerg Med.\u003C\/em\u003E 2010]. Evidence has demonstrated that controlled self-extrication had up to 4 times less spine movement [Dixon M et al. \u003Cem\u003EEmerg Med J.\u003C\/em\u003E 2013].\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EGiven the evidence, Dr Colwell concluded that change is needed regarding the traditional use of spinal boards for spinal immobilization and emphasized that if a medication had the same risk\/benefit ratio as spinal boards, it would no longer be used.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/46\/12.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzogxp\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzogxp\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}