title: The long spine board does not reduce lateral motion during transport--a randomized healthy volunteer crossover trial.
abstract: OBJECTIVE
  For thirty years, emergency medical services agencies have emphasized limiting spinal motion during transport of the trauma patient to the emergency department. The long spine board (LSB) has been the mainstay of spinal motion restriction practices, despite the paucity of data to support its use. The purpose of this study was to determine reduction in lateral motion afforded by the LSB in comparison to the stretcher mattress alone.
  
  
  METHODS
  This was a randomized controlled crossover trial where healthy volunteer subjects were randomly assigned to either LSB or stretcher mattress only. All subjects were fitted with a rigid cervical collar, secured to the assigned device (including foam head blocks), and driven on a closed course with prescribed turns at a low speed (<20 mph). Upon completion, the subjects were then secured to the other device and the course was repeated. Each subject was fitted with 3 graduated-paper disks (head, chest, hip). Lasers were affixed to a scaffold attached to the stretcher bridging over the patient and aimed at the center of the concentric graduations on the disks. During transport, the degree of lateral movement was recorded during each turn. Significance was determined by t test.
  
  
  RESULTS
  In both groups, the head demonstrated the least motion with 0.46±0.4-cm mattress and 0.97±0.7-cm LSB (P≤ .0001). The chest and hip had lateral movement with chest 1.22±0.9-cm mattress and 2.22±1.4-cm LSB (P≤ .0001), and the hip 1.20±0.9-cm mattress and 1.88±1.2-cm LSB (P≤ .0001), respectively. In addition, lateral movement had a significant direct correlation with body mass index.
  
  
  CONCLUSIONS
  The stretcher mattress significantly reduced lateral movement during transport.
authors.affiliation: University of Texas Health Science Center at San Antonio, San Antonio, TX. Electronic address: wamplerd@uthscsa.edu.
authors.forename: David A
authors.initials: DA
authors.lastname: Wampler
authors.affiliation: University of Texas Health Science Center at San Antonio, San Antonio, TX.
authors.forename: Chloe
authors.initials: C
authors.lastname: Pineda
authors.affiliation: University of Texas Health Science Center at San Antonio, San Antonio, TX.
authors.forename: Joan
authors.initials: J
authors.lastname: Polk
authors.affiliation: University of Texas Health Science Center at San Antonio, San Antonio, TX.
authors.forename: Emily
authors.initials: E
authors.lastname: Kidd
authors.affiliation: United States Army, Fort Sam Houston,Houston, TX.
authors.forename: Dale
authors.initials: D
authors.lastname: Leboeuf
authors.affiliation: San Antonio Fire Department, San Antonio, TX.
authors.forename: Marti
authors.initials: M
authors.lastname: Flores
authors.affiliation: City of Schertz Emergency Medical Services, Schertz, TX.
authors.forename: Mike
authors.initials: M
authors.lastname: Shown
authors.affiliation: Military EMS & Disaster Medicine Fellowship, JBSA Ft. Sam Houston, Houston, TX.
authors.forename: Chetan
authors.initials: C
authors.lastname: Kharod
authors.affiliation: University of Texas Health Science Center at San Antonio, San Antonio, TX.
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Stewart
authors.affiliation: University of Texas Health Science Center at San Antonio, San Antonio, TX.
authors.forename: Craig
authors.initials: C
authors.lastname: Cooley
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D004867:Equipment Design; D005260:Female; D006257:Head / Q000502:physiology; D006615:Hip / Q000502:physiology; D006801:Humans; D007103:Immobilization / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D009068:Movement; D013124:Spinal Injuries; D060726:Torso / Q000502:physiology; D014187:Transportation of Patients / Q000379:methods*