title: Reduced tissue-interface pressure and increased comfort on a newly developed soft-layered long spineboard.
abstract: BACKGROUND
  : Immobilization of the spine in patients with trauma at risk of spinal damage is performed using a rigid long spineboard or vacuum mattress both during prehospital and in-hospital care. However, disadvantages of these immobilization devices in terms of discomfort and tissue-interface pressures have guided the development of a new soft-layered long spineboard. We compared tissue-interface pressure and degree of discomfort during immobilization on a rigid spineboard, a vacuum mattress, and a newly developed soft-layered long spineboard.
  
  
  METHODS
  : In this randomized crossover trial, 30 volunteers were immobilized sequentially on all three devices for 15 minutes per device. Tissue-interface pressures were measured using an Xsensor pressure mapping device, including the peak pressure and the Peak Pressure Index (PPI). Discomfort was rated on a Visual Analog Scale after 1 minute and after 15 minutes of immobilization.
  
  
  RESULTS
  : Tissue-interface pressures were significantly higher on the standard long spineboard and the vacuum mattress than on the soft-layered long spineboard. PPI for the sacrum was close to peak pressure on both the spineboard and the vacuum mattress. PPI for the sacrum on the soft-layered long spineboard was significantly lower, with an average PPI close to normal diastolic blood pressures. The participants reported significantly less discomfort on the soft-layered long spineboard compared with the rigid long spineboard, both after 1 minute and 15 minutes (p < 0.0001).
  
  
  CONCLUSIONS
  : This study revealed a relevant reduction in tissue-interface pressures and discomfort when using a soft-layered long spineboard compared with using a standard rigid long spineboard or a vacuum mattress. Emergency care providers should consider the use of the soft-layered long spineboard to reduce the discomfort and potential tissue damage caused by immobilization and transport on a rigid long spineboard or vacuum mattress.
authors.affiliation: Trauma Center Limburg , Maastricht University Medical Center, Maastricht, the Netherlands. b.hemmes@mumc.nl
authors.forename: Baukje
authors.initials: B
authors.lastname: Hemmes
authors.forename: Martijn
authors.initials: M
authors.lastname: Poeze
authors.forename: Peter R G
authors.initials: PR
authors.lastname: Brink
mesh_terms: D000328:Adult; D001513:Beds; D049628:Body Size; D018592:Cross-Over Studies; D004867:Equipment Design; D005260:Female; D006244:Hardness; D006801:Humans; D007103:Immobilization / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D055805:Moving and Lifting Patients / Q000295:instrumentation*; D010146:Pain / Q000517:prevention & control*; D011312:Pressure; D016683:Supine Position; D055815:Young Adult