*The Backboard*
By: Texan
4 June 2006

A backboard is used as a method of preventing an injured neck/back from getting worse and as a way to move an injured person that is suspected of having a neck/back injury without making the injury worse. You will use symptoms, mechanism of injury (how far did they fall, how fast was the car traveling) and common sense to decide if a backboard is necessary. It is also important to remember that depending upon the injury and estimated time of arrival of medical professionals it is not always necessary for bystanders to put the injured person on a board. If it will be less than an hour or so before help arrives then it is probably best to not attempt to move the injured person to a backboard. A few scenarios that might make you want to use a backboard and move the patient: dangerously cold/hot weather, moving the person out of harms way or you are a medical professional.

 

1st protect yourself

2nd protect the airway

3rd protect the breathing

4th protect the circulation

5th protect the spine

6th protect the rest of the body

 

Once you decide to use a backboard you will either perform the move very quickly because of some danger or very severe injury or you may want to take your time to make the move and placement on the board more comfortable to the patient.

 

At its most basic what is needed is: a cervical collar or some other way of preventing the head from moving such as pillows or rolled up cloth secured to either side of the head, a back board and some straps.

  1. If you have time fold and put a blanket or several sheets on the backboard if the patient will be on the board for more than 30 minutes to decrease the discomfort of laying on a hard board.
  2. Secure the upper torso and hips to the board before the head/neck/arms/legs. It is done in this order because there is commonly some motion to the body before everything is secured.
  3. If you use tape then sticking the tape all the way around the board for a tape to tape connection is important for it to stick well and hold the person onto the board. The tape sticks to the body so it does not have to be too tight; taping the person too tight to the board makes breathing difficult and may impede the circulation of their blood.
  4. If you have seatbelts or rope be sure to not strap them down too tight as this can cause other injures or discomfort.
  5. It may be best to slightly bend the legs at the knees and put some padding under the knees to decrease the chance of increasing hip or back pain, padding under the heals may also help. This presumes you have time and there is no other severe injury that this would worsen.
  6. If you put them on a board you then own them, check them often for signs of any problems and put them in a place that is comfortable and safe, if it is cold the board acts as an ice pack so keep them warm. If the weather is warm watch for ants.
  7. It may decrease the discomfort if you put the board on a slight incline with the head a few inches higher than the feet. Do not let the board sag in the middle if you prop up the head.
  8. When securing the legs onto the board you may want to tape/strap the bottom of their feet to the board to keep them from sliding off of the board incase you need to tilt them or stand them up, tape/secure the bottom of the feet like they will be standing up on the tape.
    1. If there is no chance that you will need to move them then very few straps are needed to keep them on the board. If you intend to move/carry them then you will want to strap:
      1. Over the upper chest but under the arms
      2. Over the belly
      3. Over the groin
      4. Above the knee
      5. Above the ankle
      6. One under the bottom of the feet and connected to the board near the knees
      7. One over the upper arms that is not able to slide onto the neck, secure the hands
      8. One above the shoulders and connected to the board near the hips to prevent them from sliding head first off the board
      9. When in doubt double the number of straps.
    2. Apply padding on either side of the head/neck and tape the forehead to the board. To prevent the head from moving from side to side have the padding be wide enough to reach the edge of the board.
    3. If the person is small (a new rubie) you may want to pad beside their body and under the straps such as a rolled up blanket or towel to prevent them from sliding from side to side. Have the rolls reach all the way to the edge of the board. If you have double stick tape you may want to tape under the body to prevent sliding.

 

Infants and toddlers heads are larger compared to there body than the heads of adults are. This means that securing them to a board is done in a different way than an adult. Securing a small child means you will have to tie them down so they cannot squirm off of the board. It also means that an extra inch or two of padding (1 or 2 inches thick by about 12in wide by the length of there body) is needed under their upper torso and legs to prevent their neck/head from being bent too far forward. The other thing to remember about securing a small child is that it is very very common for a small child to fight and scream to get loose. It is truly amazing how strong their little bodies are. Some times it is just best to let a parent hold the small child in there arms while trying to keep the head and neck straight as they will hurt themselves trying to escape from the board. If they are in a car seat then just secure them in place possibly adding padding to the side of the head. If they are not in a car seat and one is available put them in it.
Texan


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