Maximizing comfort and minimizing ischemia: a comparison of four methods of spinal immobilization.
OBJECTIVE
To determine which of four methods of spinal immobilization causes the least ischemic pain.


METHODS
A prospective, nonblinded comparative trial was conducted at a statewide emergency medical services training facility using a convenience sample of emergency medical technician students. After lying motionless for 10 minutes, students evaluated each device using a 10-centimeter visual analog scale. Subjective comfort was used as a measure of ischemia.


RESULTS
Comfort scores were significantly different for all methods (F = 101, p < 0.001). A backboard padded with a gurney mattress and eggcrate foam (the equivalent of a spinal rehabilitation bed) caused the least ischemic pain (9.6 cm, 95% CI, 8.9 to 9.8 cm). A backboard padded with a gurney mattress was the second most comfortable device (7.0 cm, 95%/CI, 6.4 to 7.4 cm). A backboard padded with a folded blanket was the third most comfortable (3.3 cm, 95% CI, 2.6 to 4.9 cm). The backboard alone caused the most pain (0.8 cm, 95% CI, 0.7 to 2.1 cm).


CONCLUSIONS
Increasing the amount of padding on a backboard decreased the amount of ischemic pain caused by immobilization.
Hauswald
M
M
Department of Emergency Medicine, University of New Mexico School of Medicine, Albuquerque 87131-5246, USA. mhauswald@salud.unm.edu
Hsu
M
M
Stockoff
C
C
D000704:Analysis of Variance; D001512:Bedding and Linens; D001513:Beds; D004632:Emergency Medical Services / Q000379:methods*; D006801:Humans; D007103:Immobilization / Q000009:adverse effects*; D007511:Ischemia / Q000209:etiology / Q000517:prevention & control*; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D013124:Spinal Injuries / Q000628:therapy*