RE: Backboard/Taping

April 29, 2003

Reference your question about taping a pt. to the backboard. TDH don't say

anything about if it is legal or not but one thing that they really recommend

is that before you put the tape over the forehead make sure you fold it. I

hope this help, Thanks

April 29, 2003

> duct tape not being medical equipment, therefore anything that

> happens, mainly bad is your liability.

Webbing also is not classified " medical equipment " is it? Do you all use

webbing or spider straps--all the time? We use a combination of the 2,

depending on the pt, the crew, etc etc. I know HFD uses tape(not to say

their way is the " right " way!!!)

Good points were brought up--for both techniques. Am still wondering about

the " legality " of the tape though, as these newbies were told it's

prohibited. I do have a question into the state, will let all know what I'm

told!

Thanks!

Kathi

April 29, 2003

but then, I have never had anybody escape from the silver tape god!!!

We dont use the silver duct tape...we use white tape(hey, btw---it is a

" medical device/item " !) It's quite similar to the duct tape, 'cept

white--not the white adhesive type tape.

Anyway...we tape them above the shoulder to opposite hip--on both sides. Then

across hips, above knees, at ankles and often also across chest. Hooking the

tape under and in the hand holds--if that makes sense. They are pretty

secure, when need has arisen, we tape all the way around the board--then

sometimes crisscross with webbing.

Would it withstand a 60mph crash and then suspension from the now top of the

amb.--I wouldnt be the one standing under it! I dont see how 3 straps are

necessarily more secure--or inhibit movement more--but then again, I havent

used straps!

Kathi

April 29, 2003

how about if you use 2' wide " medical tape " ? Is it a function of

what brand or type of tape, or a matter of whether any kind of tape medical

or industrial, is an acceptable securing mechanism?

My personal opinion is how well secured is whatever you are trying to

secure?!! As mentioned in a previous post, our tape is white " medical " duct

tape(ordered from medical supply).... If you are inhibiting movement, does

it really matter what is used? Now, we are talking(at least I am!)---trauma

pts--mvc's etc---not a pt. that is going ballistic and is combative and it's

taking 6 of you to hold down just to attempt to secure---unless you wrap

around the entire board, chances are you havent adequately secured that pt.

Kathi

April 29, 2003

this is one of my pet-peeves. i maintain that if the tape is folded, it

does no good, as the pt can move their head from side to side at will. if

the tape sticks to their forehead, they can't move without some serious

intent. as far as pulling out their eyebrows, make a small cut in the tape

above their nose and remove it from the inside out (with the " grain " of the

eyebrows).

i'm curious to see what others think about this from around the state.

chris

Re: Backboard/Taping

Reference your question about taping a pt. to the backboard. TDH don't say

anything about if it is legal or not but one thing that they really

recommend

is that before you put the tape over the forehead make sure you fold it. I

hope this help, Thanks

April 29, 2003

There are two things that come to mind. First a lawyer in a seminar once

spoke about duct tape not being medical equipment, therefore anything that

happens, mainly bad is your liability. Second, I saw a service use duct

tape on a patient, the tape touched the skin, apparently the chemicals in

the tape's glue burned the skin. I wonder if the patient had the number to

LAW-1000?

A. Ozenberger BS,LP,CHT

Training Specialist III

Education Laboratory

UTMB - Galveston

(409)747-2146

Backboard/Taping

Anyone hear that TDH prohibits taping a pt to the backboard?

One of our folks currently in emt class told us this last night....just

wondering if anyone had heard it, and is everyone else always using webbing

or straps?

Thanks.

Kathi

April 29, 2003

There seems to be a lot of discussion of " duct tape " , especially in the

context of it being medical equipment. I now toss out the worm can and

ask....how about if you use 2' wide " medical tape " ? Is it a function of

what brand or type of tape, or a matter of whether any kind of tape medical

or industrial, is an acceptable securing mechanism?

Ed Strout, RN, CEN, LP

Clinical Practice Coordinator

Austin- County EMS

517 S. Pleasant Valley Rd.

Austin, Tx. 78741

Office

Pager

Fax

e-mail: ed.strout@...

Backboard/Taping

Anyone hear that TDH prohibits taping a pt to the backboard?

One of our folks currently in emt class told us this last night....just

wondering if anyone had heard it, and is everyone else always using webbing

or straps?

Thanks.

Kathi

April 29, 2003

Chris--

A non-TX response:*

On my private service, we've used tape (not duct tape, which we d/n carry)

when we've had to, & still do.

We use 3 individual straps, not spider straps. Until recently, we usually

had to

scrounge straps from other trucks at start of shift. Now, Supply furnishes a

sealed (tagged) C-collar bag with an appropriate selection of C-collars, &

3 straps.

Most crews load 2 back boards. So, after we leave a backboard & our 3

straps at

a hospital, if we have to backboard again on that shift, we use tape.

And I've seen patients, uncomfortable with the tape across the forehead, work

actively to get it loose, or undone.

Conley Harmon

>this is one of my pet-peeves. i maintain that if the tape is folded, it

>does no good, as the pt can move their head from side to side at will.

>

>i'm curious to see what others think about this from around the state.

>

*MO EMT, relocating to TX this summer; now certified in TX.

I really appreciate this listserv; I think it's great.

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April 29, 2003

Go Chris!!!

This is my thought and experience as well, you might as well not secure the

head at all if your NOT going to tape down their forehead.

but then, I have never had anybody escape from the silver tape god!!!

Re: Backboard/Taping

>

> Reference your question about taping a pt. to the backboard. TDH don't say

> anything about if it is legal or not but one thing that they really

> recommend

> is that before you put the tape over the forehead make sure you fold it. I

> hope this help, Thanks

>

April 29, 2003

I don¹t know about that. I¹ve personally been attached to a backboard

for my school. I had the spider set on with a C Collar on my neck. The

tape was folded over my forehead but taped to the backboard. I don¹t recall

any ROM at all. Not even moving my hands for them location.

How are you going to make a small cut? I sure as hell wouldn¹t want to

place any scissors near a pts nose on a moving ambulance.

Other people wrote....

> this is one of my pet-peeves. i maintain that if the tape is folded, it

> does no good, as the pt can move their head from side to side at will. if

> the tape sticks to their forehead, they can't move without some serious

> intent. as far as pulling out their eyebrows, make a small cut in the tape

> above their nose and remove it from the inside out (with the " grain " of the

> eyebrows).

>

> i'm curious to see what others think about this from around the state.

>

> chris

>

> Re: Backboard/Taping

>

> Reference your question about taping a pt. to the backboard. TDH don't say

> anything about if it is legal or not but one thing that they really

> recommend

> is that before you put the tape over the forehead make sure you fold it. I

> hope this help, Thanks

>

April 29, 2003

i don't normally remove the patient from the backboard (and its associated

wrappings) so i meant in the er you can make a small cut. chris

Re: Backboard/Taping

>

> Reference your question about taping a pt. to the backboard. TDH don't say

> anything about if it is legal or not but one thing that they really

> recommend

> is that before you put the tape over the forehead make sure you fold it. I

> hope this help, Thanks

>

April 29, 2003

My experience with both transfer and 911 services that use whatever is available

at the time. Of course whenever it is raining or wet outside tape is not an

option. But, tape with some type of towel rolls in place can secure a patient.

Legal if a patient is paralyzed then it will come into question whether or not

any method was properly utilized. Webbing can come loose if not properly

installed. I feel that it is the medic-in-charges responsibility to determine

how the patient is secured.

Dale Hammerschmidt

EMT

-- Re: Backboard/Taping

>

April 29, 2003

Has been my experience that the medical duct tape we use --the brand by the

name of " Duck Tape " that comes in Blue, White or Red color--does such a

better job at immobilizing a drunk to a backboard. I've seen it used to

restrain people from hurting themselves (but not in a long time) and it

didn't harm the patient, so whats all the fuss about?? Because its

industrial tape to begin with?? I sure don't have a clue.

April 29, 2003

chris hosid wrote:

> If the board was comfortable you would'nt have to worry about voluntary

> movement.

That's a whole 'nother can of worms, but a valid one indeed. I am

really surprised that thirty years into this profession, I am still

watching patients being rolled onto that medieval device we call a

backboard. It is unconscionable that plywood (or polystyrene, or

whatever) is still the " state of the art. "

I have been out of the field for awhile, so pardon my ignorance, but is

it no longer standard for each backboard to have its own set of straps?

Did the cross contamination issue finally do away with that practice?

I know I have used and reused some pretty bloody, nasty straps over

the years.

I remember the 80's being the heyday of our " mother of invention "

period. Every week, some resourceful medic came up with a better

mousetrap. Stiffnecks replaced soft whiplash collars. CID's replaced

sandbags. Sagers replaced half rings. And advancing science

brought us to the realization that MAST pants and ringers weren't going

to save a bleeder, 500 w/s wasn't going to save a fibrillator, bicarb

wasn't going to save an arrest, and Levophed was just a bad idea (well,

unless you were in Dallas). So how in the hell have we still not found

something better than a sheet of plywood for spinal immobilization?

You should all hang your heads in shame. You are failures.

Rob

April 30, 2003

Go to www.newbackboard.com

Re: Backboard/Taping

> chris hosid wrote:

>

> > If the board was comfortable you would'nt have to worry about voluntary

> > movement.

>

> That's a whole 'nother can of worms, but a valid one indeed. I am

> really surprised that thirty years into this profession, I am still

> watching patients being rolled onto that medieval device we call a

> backboard. It is unconscionable that plywood (or polystyrene, or

> whatever) is still the " state of the art. "

>

> I have been out of the field for awhile, so pardon my ignorance, but is

> it no longer standard for each backboard to have its own set of straps?

> Did the cross contamination issue finally do away with that practice?

> I know I have used and reused some pretty bloody, nasty straps over

> the years.

>

> I remember the 80's being the heyday of our " mother of invention "

> period. Every week, some resourceful medic came up with a better

> mousetrap. Stiffnecks replaced soft whiplash collars. CID's replaced

> sandbags. Sagers replaced half rings. And advancing science

> brought us to the realization that MAST pants and ringers weren't going

> to save a bleeder, 500 w/s wasn't going to save a fibrillator, bicarb

> wasn't going to save an arrest, and Levophed was just a bad idea (well,

> unless you were in Dallas). So how in the hell have we still not found

> something better than a sheet of plywood for spinal immobilization?

>

> You should all hang your heads in shame. You are failures.

>

> Rob

>

May 1, 2003

I said I wasn't going to get into this, but I can't help myself. I shall not

comment on the use of tape, but I will issue this challenge:

To anyone who can prove to me that anyone can properly secure an adult

patient to a long spineboard with only 3 straps, so that the patient can be

turned on his side or upside down and there will be no spinal movement, I'll

buy them dinner at the restaurant of their choice.

Please consider how you'd explain your procedure to a jury and demonstrate it

if called upon to do so.

Gene

Gene Gandy, JD, LP

EMS Educator and Consultant

HillGandy Associates

POB 1651

Albany, TX 76430

cell:

wegandy@...

wegandy1938@...

May 1, 2003

Larry,

Your point is well taken in normal circumstances.

What I was getting at, however, is what happens to the patient that suddenly

and without warning vomits and has to be turned on his side; the pregnant

trauma patient; the " large patient; " the patient who finds himself upside

down in an ambulance that has been broadsided and flipped; the patient who

finds himself upside down when the crew makes a mistake and allows the

stretcher to tip over; the patient without shoulder restraints who flies

forward when the ambulance either has to make a panic stop or hits another

object; the patient who will not be still either because of fear, pain, or

chemical ingestion; the patient who is being taken down stairs or down a

slope and slides on the board; and other similar situations.

I have allowed myself to be immobilized on the spineboard many times to

demonstrate that a properly restrained patient can be turned on his side

without movement, and, yes, I have allowed myself to be inverted and stood on

my head in the corner to demonstrate the same thing. During none of those

situations did I feel insecure nor did I experience any appreciable spinal

motion because I had taught my students how to do it properly and I trusted

them.

In none of those situations were only three straps used. So I'll amend my

challenge: show me how a patient can be restrained using only three standard

straps and get through any of the above situations without significant spinal

movement.

I'm open to learning. If there is a method using only three straps that will

achieve a secure immobilization, please describe it to me and be prepared to

demonstrate with me as the patient.

I believe the use of only 3 straps is a disaster waiting to happen and has

happened in the past with catastrophic results both to the patient and, in

some cases, to those struck by a patient that became a missile. I do not

believe it to be defensible either in medicine or law. In my mind there are

only two explanations for this practice, laziness on the part of the medics

and cheapness on the part of the provider. But, as I said, I'm always open

to learning something new.

Best,

Gene

May 1, 2003

In a message dated 5/1/2003 11:17:45 PM Central Daylight Time,

preyn2@... writes:

> Gene - I get your point, but I couldn't resist

> the challenge:

>

> May I use three 30-foot straps?

>

> See you at EMStock?

>

Great. I expect that 90 feet of strapping might be adequate.

GG.

May 1, 2003

On Thu, 1 May 2003 20:00:07 EDT wegandy1938@... writes:

> To anyone who can prove to me that anyone can properly secure an

> adult

> patient to a long spineboard with only 3 straps, so that the patient

> can be

> turned on his side or upside down and there will be no spinal

> movement, I'll

> buy them dinner at the restaurant of their choice.

Anyone who inverts a patient (or victim..er..student) on a backboard

DESERVES whatever is inflicted on them. It is totally unsafe, IMHO.

" I cannot and will not cut my conscience to fit this year's fashions. "

- Lillian Hellman

Larry RN / Paramedic

May 1, 2003

The use of 3 straps does not follow national standards as taught in PHTLS

courses. 4 straps (minimum), across the patient (not criss crossed), arms

inside the straps.