Recently, research and critical thinking has been slowly revising the way we think about and use backboards (spine boards) both in the pre-hospital and ED environments. Are you guys seeing this change out there? Are you seeing less patients just backboarded based on silly criteria ("they fell") and more based on strict guidelines? If your patients DO arrive on backboards, do you have a procedure or protocol to remove just the spine board while the patient is waiting to see the MD/NP/PA?
1. No change that I have seen. The c-collar I can understand but the backboard baffles me.
2. Nurses in my ED don't clear boards - PAs/NPs/Docs do. Usually when someone comes in boarded, there is a comment note from triage on the tracking board alerting the fact that the pt. is 'boarded/collared'. If we're super busy, the RN assigned to pt./pod area will grab a mid-level/doc "hey, can we atleast clear the pt. off the board/collar?" - even if they haven't picked up the pt.
By and large however, our pts. are cleared (or remain immobilised post assessment) within about 10-15 mins. of arrival. There are very rare exceptions.
I am intrigued by this thread though and would like to research more! I'd appreciate more data. Given that we currently lack a protocol for 'clearing spinal immobilisation', I'm sure it would be of interest to the chaps running the department... and us nurses too :)
Check out ENAs website you say?
And on a side note:
*shudder* If there is one thing worse than board/collaring someone - it's board/collaring the chronic alcoholic combative due to "MoI".
Talking/reasoning with 'em is fruitless. Restraining 'em just riles 'em up more. *sigh*
Roy Fokker, BSN, RN
1 Article; 2,011 Posts
1. No change that I have seen. The c-collar I can understand but the backboard baffles me.
2. Nurses in my ED don't clear boards - PAs/NPs/Docs do. Usually when someone comes in boarded, there is a comment note from triage on the tracking board alerting the fact that the pt. is 'boarded/collared'. If we're super busy, the RN assigned to pt./pod area will grab a mid-level/doc "hey, can we atleast clear the pt. off the board/collar?" - even if they haven't picked up the pt.
By and large however, our pts. are cleared (or remain immobilised post assessment) within about 10-15 mins. of arrival. There are very rare exceptions.
I am intrigued by this thread though and would like to research more! I'd appreciate more data. Given that we currently lack a protocol for 'clearing spinal immobilisation', I'm sure it would be of interest to the chaps running the department... and us nurses too :)
Check out ENAs website you say?
And on a side note:
*shudder* If there is one thing worse than board/collaring someone - it's board/collaring the chronic alcoholic combative due to "MoI".
Talking/reasoning with 'em is fruitless. Restraining 'em just riles 'em up more. *sigh*
cheers,