Removing collars and backboards

Nurses General Nursing

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Hi there! I'm an ED nurse from Italy! I'm looking for an algorythm or a guideline for the triage operations.

I need to understand how do You do when You recieve a trauma patient in your ed, who's lying on a backboard, or just sitting with a collar.

Do You always remove these stuffs or do You wait for the diagnostics?

I found some critaeria like the Canadian C-Spine Rule, but i've never found any hospital who uses it. Can anybody help me?

Thanks

Thomas

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Hard to say. Many times the decision will vary from physician to physician. Generally, I find a big push to get people off of the board as soon as possible because of the serious complications associated with keeping a person on a board.

Many times the board will come off and the collar will stay on while the patient remains supine pending radiology study results. This is very effective if you have a cooperative patient. In fact, I find patients are actually more cooperative when off of the board because they are more comfortable. So, you could make a good argment for taking people off the board as soon as possible.

In addition, I see the board as more of a transport device. Every log roll and patient movement can compromise an unstable spinal fracture. In the field, it is much easier to lug a person around and load/off load with a board; however, we all know that people are not admitted post op (repair of a unstable injury) strapped to a board until their injury heals. So, really, the board is more of a field and transport device.

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Specializes in SICU, EMS, Home Health, School Nursing.

We have to get permission from the doc before removing a board or c-collar. Generally the board is off by the time they reach the ICU, but the c-collar stays on until all diagnostics prove they have no injury and the patient is able to tell us that they don't have neck pain. We do switch the c-collar out to a soft collar instead of the extrication collar they are admitted with.

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We have to remove the backboard within 15 minutes of arrival at our facility. C collars stay on until they are cleared and the Dr writes an order to remove in. Adult pts are moved with log roll precautions and slide boards and peds have to be put back on the backboard prior to moving them anywhere. This is a new policy. I am certain if you do some research you can probably find a great deal that addresses the complication risks of leaving a person on a backboard for extended periods.

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All I can say is that those things are terribly uncomfortable for the patient! I was in one for a total of 5 hours from the time they extracted me "in the field" to the 1st hospital, then air ambulance to the second hospital. It was awful!!! The back board was probably the worst part of my entire experience (except vomiting while on backboard and C-collar....that is a tough one!). Once I got to my "final" hospital they had to to confirm no spinal fractures/problems before they would remove it so it was about another hour which brought the grand total up to 5 hours and even though I was still in some pain the amount of relief that I felt when the back board was FINALLY taken off was ALMOST pleasurable. :)

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Specializes in ITU/Emergency.

There was a thread running a while ago about this in the ER forum:

https://allnurses.com/forums/f18/nurses-taking-patient-s-off-backboards-without-doctor-clearnce-265497.html

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