title: Prehospital spinal immobilization and the backboard quality assessment study.
abstract: BACKGROUND
  Prehospital spinal immobilization (PSI) for patients with suspected spinal injury has been the universal standard of practice for emergency medical services (EMS) in the United States since the early 1970s. PSI research has faced numerous methodological difficulties, including an inability to evaluate whether the immobilizations being studied were carried out appropriately. The purpose of this study was to assess the quality of spinal immobilization to a long spine board in patients presenting via EMS to an emergency department (ED).
  
  
  METHODS
  All noncritically ill patients presenting to a tertiary care academic trauma center who had been immobilized on a long spine board for EMS transport were approached for enrollment. Each subject was evaluated for the number and location of restraining straps and their degree of tightness.
  
  
  RESULTS
  Of 50 consenting subjects, 15 (30%) had at least one unattached strap or piece of tape that should have attached their head to the board. Of 50 subjects, 44 (88%) were found to have greater than 2 cm of slack between their body and at least one strap. Among those with any straps looser than 2 cm, the average number of loose straps was 3.4.
  
  
  CONCLUSIONS
  This study suggests that many patients are not well immobilized on arrival at the Emergency department.
authors.affiliation: Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina 27710, USA. andrew.perry@duke.edu
authors.forename: Charles Andrew
authors.initials: CA
authors.lastname: Peery
authors.forename: Jane
authors.initials: J
authors.lastname: Brice
authors.forename: William D
authors.initials: WD
authors.lastname: White
mesh_terms: D001835:Body Weight; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D009657:North Carolina; D011446:Prospective Studies; D011787:Quality of Health Care; D012149:Restraint, Physical / Q000295:instrumentation* / Q000592:standards*; D013131:Spine