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Backboards - Disaster Preparedness
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Backboards - Disaster Preparedness

Backboards are necessary to transport a patient with a suspected cervical injury. In a major disaster, you can never have enough of them.

Decades ago, every ambulance had a simply plywood backboard. Patients were stabilized on on the board with a disposable cervical collar, sandbags, and lots of adhesive tape. When the ambulance crew arrived at a hospital, they would leave the patient on the backboard and take another identical wooden one, left by a previous crew. The backboards were cheap and expendible.

Then, something happened.

Special high priced backboards arrived on the scene, along with special straps and imobilization accessories.

All well and good, except this equipment became accountable.

The ambulance crews did not like to leave the high-priced stuff at the hospital because it would disappear. And in a busy hospital you would find a mixture of private, volunteer and municipal ambulances bringing in patients. And crews were not above stealing a fancy board when they showed up to deposit a patient. Sometimes they would leave an old wooden board, other times not. Filching expensive backboards became a badge of honor amongst some crews. Of course at a busy medical facility they have no time to properly store and sequester such equipment.

Since it took a long time for the patients to be evaluated, the crews liked to "hint" they would like their backboards back. And straps. And the various other parts of their stabilization rig. And numerous patients were then removed from the backboards before proper imaging was performed to rule out spinal damage.

The premature removal of the backboards and the special expensive immobilization devices caused, in some cases serious permanant injury to the patients.

With the advent of the newer expensive boards, hospital wooden boards began to disappear.

If the crew waited for their board they would be out of service. If they went out without a board they couldn't handle another patient that required stabilization. And at the end of the day, when they returned to quarters, they would find a supervisor yelling at them regarding the expensive extrication apparatus that has "disappeared".

To cut to the chase:

In the event of a multiple-casualty large scale disaster there is going to be a shortfall of backboards and pressure is going to be exerted by first responders to get back their "own" backboards, and remove them from the patients upon arrival at the treatment facility.

Is this a problem?

You bettcha.

There is no stabilization that can be performed by the expensive rigs that cannot be done with the old standard. Wooden boards. Rolled up blankets and sheets. Sandbags. And ordinary tape. Gaffer tape, however is the tape of choice to immobilize. Not adhesive tape. Not duct tape. TWO-INCH GAFFER TAPE.

Of course there probably isn't an ambulance in the United States that carries or stocks gaffer tape. But they should.

In the various communities that stock disaster supplies if you ask: "how many backboards they have on hand?"

You'll get a blank stare.

Wooden backboards can be easily constructed from 3/4 inch plywood. They are an ideal project for a woodshop at a high-school or elementary school.

Despite the advantage of the modern boards and devices to secure a patient, in many ways the older system, using simple expendable supplies, was superior.
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Backboards are so low on the radar screen of the average FEMA planner, the subject might not as well exist, however, from the standpoint of pre-hospital care and removal of the injured to a treatment facility, they remain a simple, but essential part of the operation.

If I had my druthers we would standardize on wooden backboards, and have a large number of them constructed, either by prison industries, high-school or lower-grade woodshops, hospital carpenters, or ambulance crews.

The first rule would be to forbid, by federal regulation, the painting of a backboard with any elaborate unit insignia.

Is this a problem? You bettcha.

Wooden backboards lend themselves to becoming an artist canvas. Little Susan, who is the cutest member of the volunteer ambulance corps, decides to spend her spare time making an elaborate maltese cross, and a latin motto, and the number of her unit. She is very proud. She even used gold leaf and covers everything with water-resistant urethane.

Everybody likes Susan.

Comes the time to drop off a patient with a backboard in a situation where there are many ambulances and lots of patients.

The backboard ceases to become a disposable "thing". The crew is going to want that specific backboard returned, and will pant like Labradors in a New Mexico sun in from of the triage nurse waiting for it to be removed from the patient.

And since she doesn't own the board, and neither does the hospital, and "it probably won't make much difference anyway", Nancy nurse undoes the straps and Susan's friends get "their" backboard returned.

There is a waiting time to be imaged, and now the patient is no longer stabilized.
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