Reduced tissue-interface pressure and increased comfort on a newly developed soft-layered long spineboard.

BACKGROUND : Immobilization of the spine in patients with trauma at risk of spinal damage is performed using a rigid long spineboard or vacuum mattress both during prehospital and in-hospital care. However, disadvantages of these immobilization devices in terms of discomfort and tissue-interface pressures have guided the development of a new soft-layered long spineboard. We compared tissue-interface pressure and degree of discomfort during immobilization on a rigid spineboard, a vacuum mattress, and a newly developed soft-layered long spineboard. METHODS : In this randomized crossover trial, 30 volunteers were immobilized sequentially on all three devices for 15 minutes per device. Tissue-interface pressures were measured using an Xsensor pressure mapping device, including the peak pressure and the Peak Pressure Index (PPI). Discomfort was rated on a Visual Analog Scale after 1 minute and after 15 minutes of immobilization. RESULTS : Tissue-interface pressures were significantly higher on the standard long spineboard and the vacuum mattress than on the soft-layered long spineboard. PPI for the sacrum was close to peak pressure on both the spineboard and the vacuum mattress. PPI for the sacrum on the soft-layered long spineboard was significantly lower, with an average PPI close to normal diastolic blood pressures. The participants reported significantly less discomfort on the soft-layered long spineboard compared with the rigid long spineboard, both after 1 minute and 15 minutes (p < 0.0001). CONCLUSIONS : This study revealed a relevant reduction in tissue-interface pressures and discomfort when using a soft-layered long spineboard compared with using a standard rigid long spineboard or a vacuum mattress. Emergency care providers should consider the use of the soft-layered long spineboard to reduce the discomfort and potential tissue damage caused by immobilization and transport on a rigid long spineboard or vacuum mattress.