Long Backboard versus Vacuum Mattress Splint to Immobilize Whole Spine in Trauma Victims in the Field: a Randomized Clinical Trial

Vacuum mattress splint shown in intubated prehospital trauma patient

Hi folks. Interesting journal reading in September!
Here is the article abstract!

Long Backboard versus Vacuum Mattress Splint to Immobilize Whole Spine in Trauma Victims in the Field: a Randomized Clinical Trial

The Iranian authors claim this is the first RCT study of actual trauma patients , looking at performance of long hard backboard with vacuum mattress splint . IN their discussion they cite several past studies comparing the two methods of spinal immobilisation but note that these were only on healthy volunteers. They also state that as their RCT refutes all the findings of previous studies then further research to try to confirm their findings is warranted!

Surprisingly their findings claim that a hard backboard is SIGNIFICANTLY MORE COMFORTABLE than a vacuum mattress splint!

Not surprisingly, the vacuum mattress splint took longer to apply than the backboard.
The method to measure spinal immobilisation was also crude. Essentially an observer asked the patient to move their cervical and thoracolumbar spine in various directions and a guesstimate of the range of motion from VL ( very low) to VH ( Very high) was recorded ( 5 grades were used )

The major limitation of the study, indeed when comparing any medical device, is the familiarity with the users in the study. It was noted that the long backboard is the traditional method used in prehospital care in Iran. Lack of familiarity with actual prehospital use of the vacuum splint may have biased the recorded observations especially the time to apply as well as the immobilisation degrees measured.

The vacuum mattress splint in my view is more comfortable as its padded and holds the patient more securely in line. It definitely produces more of a sense of being cocooned in and this may elicit claustrophobic feelings in some patients. Perhaps this is the reason why patients rated the vacuum splint less comfortable? Also the unanswered question is how long were these transported patients on the backboard for? I suspect not long as we all know that the longer you spend on a hard surface the less comfortable it gets!

But kudos to our Iranian prehospital colleagues for trying to answer a question that is relevant to our PHARM community. Vacuum splints are expensive and break easily so it is no mean cost to have and use them.

  1. I was wondering if the “discomfort” experienced by the patients related to the temperature accumulation inside the plastic splint and little chance for it to escape, in contrast with the wide-open long spinal board?

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