Cooney Derek R, Wallus Harry, Asaly Michael, Wojcik Susan
Department of Emergency Medicine, SUNY Upstate Medical University, 550 East Genesee / EMSTAT Center, Syracuse, NY, 13202, USA.
Int J Emerg Med. 2013 Jun 20;6(1):17. doi: 10.1186/1865-1380-6-17.
Use of backboards as part of routine trauma care has recently come into question because of the lack of data to support their effectiveness. Multiple authors have noted the potential harm associated with backboard use, including iatrogenic pain, skin ulceration, increased use of radiographic studies, aspiration and respiratory compromise. An observational study was performed at a level 1 academic trauma center to determine the total and interval backboard times for patients arriving via emergency medical services (EMS).
Patients were directly observed. Transport time was recorded as an estimate of initiation of backboard use; arrival time, nurse report time and time of removal from the backboard were all recorded. National Emergency Department Overcrowding Study (NEDOCS) score, Emergency Severity Index (ESI) and demographic information were recorded for each patient encounter. Forty-six patients were followed. The mean total backboard time was 54 min (SD ±65). The mean EMS interval was 33 min (SD ±64), and the mean ED interval was 21 min (SD ±15). The ED backboard interval trended inversely to ESI (1 = 5 min, 2 = 10 min, 3 = 25 min, 4 = 26 min, 5 = 32 min).
Patients had a mean total backboard time of around an hour. The mean EMS interval was greater than the mean ED interval. Further study with a larger sample directed to establishing associated factors and to target possible reduction strategies is warranted.
由于缺乏数据支持其有效性，将背板用作常规创伤护理的一部分最近受到质疑。多位作者指出了与使用背板相关的潜在危害，包括医源性疼痛、皮肤溃疡、增加影像学检查的使用、误吸和呼吸功能受损。在一家一级学术创伤中心进行了一项观察性研究，以确定通过紧急医疗服务（EMS）送达的患者使用背板的总时长和间隔时长。
对患者进行直接观察。记录转运时间作为使用背板起始时间的估计值；记录到达时间、护士报告时间和从背板上移除的时间。记录每次患者就诊的国家急诊科拥挤度研究（NEDOCS）评分、急诊严重程度指数（ESI）和人口统计学信息。共跟踪了46名患者。背板总平均时长为54分钟（标准差±65）。EMS平均间隔为33分钟（标准差±64），急诊室平均间隔为21分钟（标准差±15）。急诊室背板间隔与ESI呈负相关趋势（1级=5分钟，2级=10分钟，3级=25分钟，4级=26分钟，5级=32分钟）。
患者背板总平均时长约为一小时。EMS平均间隔大于急诊室平均间隔。有必要进行更大样本量的进一步研究，以确定相关因素并制定可能的减少策略。
