2015: The Death of Longboards (Hopefully)

Myths in medicine take too long to go away.  Longboards are yet another modality that serve no purpose except to harm our patients.  Luckily this unnecessary tool used by EMS is going away around the world.  Many states and cities have completely stopped using longboards for ALL patients.  These places include areas within Connecticut, Los Angeles, Kansas, Oregon, Missouri, Houston, New Mexico,.etc.  No matter what your injuries are, in many regions throughout the world, you will not be placed on a longboard, because they are not being used at all.

These devices have hurt our patients since they offer no benefit, yet we continue to use them in our region.  The misconceptions about these devices are enormous, yet the science tells us the following...

Longboards:

1.      Worsen the pain of patients resulting in more unnecessary imaging tests and more radiation exposure.

2.      Cause respiratory compromise/decreased pulmonary function by lying patients flat.

3.      Delay on-scene time for trauma patients.

4.      Result in pressure sores for patients by rapid tissue breakdown from the board.

5.      Increase the risk of aspiration.

Unfortunately, we continue to have folks who spread misconceptions about these devices, which prevent us from moving forward with evidence based medicine.  Luckily, a lot of places are ignoring these folks and moving forward.  Some of the incorrect EMS statement that we have heard are:

1.      The DOT makes me put everyone on a longboard.

2.      I will get my license/certification taken away if I don’t use a longboard.

3.      The DHSS does not allow patients to be brought to hospitals without a longboard.

4.      If someone else puts a patient on a longboard, I cannot take the patient off.

5.      It splints the back.  (No, in fact it was only designed to help extricate patients.)

6.      I will get sued if I don’t put someone on a longboard

These are all ridiculous, and it is great that many places around the country are moving forward with the science.  Lets make 2015 the year we get rid of these terrible devices in New Jersey and around the country.

Following the science, in January 2015, we will be telling EMS providers that they do not need to place anyone on a longboard that is brought into our hospital.  Please join us in getting rid of this outdated modality and provide the same information to EMS.

References:

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14. Kaups KL, Davis JW. Patients With Gunshot Wounds To The Head Do Not Require Cervical Spine Immobilization And Evaluation. J Trauma. 1998; 44:865– 867.

15. Haut ER,  Efron DT,  Adil H, Haider AH et al. Spine Immobilization in Penetrating Trauma: More Harm Than Good? The Journal of Trauma. 2010;  68.

16. Cornwell EE, Chang DC, Bonar JP, et al. Thoracolumbar immobilization for trauma patients with torso gunshot wounds: is it necessary? Arch Surg. 2001;136:324 –327.

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18. Kaups KL, Davis JW. Patients with gunshot wounds to the head do not require cervical spine immobilization and evaluation. J Trauma. 1998;44:865–867.

19. Mark Hauswald, MD, Darren Braude, MD, MPH .Diffusion of Medical Progress: Early Spinal Immobilization in the Emergency Department. Academic Emergency Medicine 2007; 14:1087–1089.