Assessing attitudes toward spinal immobilization.
BACKGROUND
Prospective studies have improved knowledge of prehospital spinal immobilization. The opinion of Emergency Medical Services (EMS) providers regarding spinal immobilization is unknown, as is their knowledge of recent research advances.


OBJECTIVE
To examine the attitudes, knowledge, and comfort of prehospital and Emergency Department (ED) EMS providers regarding spinal immobilization performed under a non-selective protocol.


METHODS
An online survey was conducted from May to July of 2011. Participants were drawn from the Howard County Department of Fire and Rescue Services and the Howard County General Hospital ED. The survey included multiple choice questions and responses on a modified Likert scale. Correlation analysis and descriptive data were used to analyze results.


RESULTS
Comfort using the Kendrick Extrication Device was low among ED providers. Experienced providers were more likely to indicate comfort using this device. Respondents often believed that spinal immobilization is appropriate in the management of penetrating trauma to the chest and abdomen. Reported use of padding decreased along with the frequency with which providers practice and encounter immobilized patients. Respondents often indicated that they perform spinal immobilization due solely to mechanism of injury. Providers who feel as if spinal immobilization is often performed unnecessarily were more likely to agree that immobilization causes an unnecessary delay in patient care.


CONCLUSIONS
The results demonstrate the need for improved EMS education in the use of the Kendrick Extrication Device, backboard padding, and spinal immobilization in the management of penetrating trauma. The attitudes highlighted in this study are relevant to the implementation of a selective spinal immobilization protocol.
College of William & Mary, Williamsburg, Virginia; Howard County Department of Fire and Rescue Services, Howard County, Maryland; University of Maryland School of Medicine, Baltimore, Maryland.
Andrew J
AJ
Bouland
J Lee
JL
Jenkins
Matthew J
MJ
Levy
D000007:Abdominal Injuries / Q000628:therapy; D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002574:Cervical Vertebrae; D004634:Emergency Medical Technicians; D004636:Emergency Service, Hospital; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007103:Immobilization / Q000295:instrumentation; D013898:Thoracic Injuries / Q000628:therapy; D013997:Time Factors; D014950:Wounds, Penetrating / Q000628:therapy*; D055815:Young Adult
EMS protocols; EMS provider attitudes; EMS providers; selective spinal immobilization; spinal immobilization