Mike replies,
My opinion - for what its worth is that the trauma board is for exrtication
(as Goat states) and also for transportation.
Patients should be log rolled off the spinal board if MOI has a low index of
suspiscionand onto a nice soft hospital trolley as soon as practical. I see
no problem with log rolling the patient off as soon as they come into A&E by
both ambulance and nursing staff. I would have a problem with nurses
performing the clincial c-spine clearance. Once the ambulance staff have
decided there is a need to place the patient onto the board based on their
protocols, it is the doc who should perfrom the clinical rule out of C-spine
injury and take legal responsibility for such an action.

Prehospital scenarios for placing patients onto boards and log rolling the
patient requires help from by-standers. As long as it is explained precisly
what to do there is never a problem. I recruit fire-fighters, police, first
aiders, off duty doctors and nurses, family and the lay public. I can usuall
get five people but some times have to do it with 4. In those rare
exceptions when there is just the two of us and it is LIFE THREATENING
(don't have time to wait for a second vehicle) then a scoop stretcher is
used if the patient is on there back or rapid extrication methods are used
(as taught at ambulance college) which should only be used when there is a
life threatening factor which overrides spinal care. As I say most of the
time there are others around.

Please, Please, to all A&E depts. When you have log rolled the patient off
the board and onto your nice soft trolley. DO NOT ONLY tape the head down to
the trolley. The body MUST be secured to the trolley as well. If the head is
taped down and the patient moves their body then the point of pressure is on
the very part of the spine you are trying to keep immobile - the C-Spine.
At one hospital I have seen a drunk male with his head taped down and body
not, trying to walk up the wall beside him. At another hospital I witnessed
a patient who was still on a spinal board and head secured but the staff had
taken off the body straps. The staff moved the board across to their xray
trolley but the body stayed on our stretcher.

Mike Bjarkoy
Paramedic
Sussex



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