Spinal Board Vs. Orthopaedic Stretch Essay

Spinal Board vs. Orthopaedic Stretcher/Scoop
The following search results were gathered through the use of the University of Bedfordshire’s BREO function known as Discover. With the use of Discover I was able to analyse, search and narrow it down through thousands of results in order to gather the information required for this assignment. The table below shows the search results used – including the search strategies, keywords and Boolean Operators in order to cut down to the three sources that I wanted to base the following assignment for.

In medical practice, it is important to know what procedures should be taken on a patient. Different conditions and scenarios can call for different ways of thinking as well as different uses of equipment. In this day and age, it is important for a medical practitioner to not only knows what is best for their patient, but to also know the importance of equipment – including the right use of said equipment. If a practitioner approaches a patient with a spinal injury, it is essential to know what kind of equipment should be used in order to help the patient, should a Spinal Board be used, or an Orthopaedic Stretcher?
A Spinal Board is a piece of equipment used to extract patients with

spinal injuries onto a stretcher, bed or another place of safety (Moss, R, et al. 2015). The spinal board is a long board that is completely straight in shape, handles and gaps around it allow for practitioners to pick it up and attach belts and to keep the patient secure and safe on the board.
An Orthopaedic Stretcher, also known as a ‘Spinal Scoop’ or ‘Scoop Stretcher’, is a quite similar to the spinal board.

Also used for transferring patients, the scoop stretcher isn’t straight in shape (Moss, R, et al. 2015), but instead has an inverted bend in the middle, as opposed to the straight design of the spinal board. The scoop stretcher can be taken apart, with two halves (referred to as blades) that can split apart, allowing for practitioners to place each blade on either side of the patient, and can thus push it together under the patient – without the need of any other procedures. Much like the Spinal Board, the scoop has multiple handles/gaps around the board to allow for straps to be attached, and for practitioners to carry

patients.
Both the Spinal Board and Orthopaedic Stretcher make use of headboards and a cervical collar in order to secure the patient; this is a vital step in the process of transporting trauma patients (Moss, R, et al. 2015).

Due to the straight shape of the spinal board however, it is not possible to just slide the board under the patient. Instead, a procedure known as the log-roll must be done in order to place the patient on the spinal board. The log roll procedure is where the patient is rotated 90 degrees in order to manoeuvre the spinal board under the patient. The patient may then be pulled and pushed in a V-shape in order to get them on the board properly, before they are restrained to the board. (Moss, R, et al. 2015).
The log-roll procedure involves the need for three to four practitioners at all times, in order to ensure that all parts of the patient are moved equally at the same time through manual handling, however the use of the spinal scoop eliminates this and can be more helpful in a situation where there may not be as many practitioners on-scene (Moss, R. et al. 2015).

The procedure of log rolling is not only uncomfortable for the patient, but puts them at risk of causing even more pain, as well as a risk of a secondary spinal injury - depending on the severity of the patient’s injuries (Rowell, R. 2014). Evidence also suggests that logrolling a patient with a pelvic injury can cause a clot disruption (Porter, K. et al 2015) and can cause internal injuries to start bleeding again (Rowell, R. 2014).

The pain that the patient suffers during the log-roll can be completely avoided by using the spinal scoop, where the blades are taken apart and then put together under the patient - with little-to-no movement of the patient involved (Moss, R. et al. 2015). Use of the log rolling method has also been associated with an increase of patient blood pressure (Moss, R. et al. 2015). As a result of using the spinal board, there is a possibility of further injury of the spine, where-as the scoop allows for a more comfortable procedure with handling an injured patient.

Thinking of patient care, it is always best for a practitioner to keep in mind the best outcome for the patient. Keeping this in mind, it is important to decide which board is more comfortable for the patient. In a hypothetical situation, the patient may already be in pain, but use of the log-roll procedure or even the spinal board’s shape may create even more of an uncomfortable position for the patient due to the straight shape of the board. The curved shape of the spinal scoop allows for better back support, curving into the back as opposed to just a flat board, as patients have reported that they feel not only more comfortable, but more secure (Rowell, R. 2014).

It is important to recognise that the log-roll procedure is, in some cases, is more harmful than helpful. Whilst it helps place the spinal board under the patient, in some cases where it is not known what kind of injuries are not one hundred percent known – practitioners may perform the roll, and as mentioned previously – injuring the patient even more.

The spinal scoop can be adjusted in order to compensate for taller patients. Two switches on both blades allow for the lower half of the scoop to be adjusted. On the spinal board however, there are no options to do so – this isn’t a problem however as the height of a spinal board is larger than a scoop – allowing for patients of different heights to be able to fit on one.
Although some advantages may come with the curved blades of the spinal scoop, there also come a few disadvantages. Moss, R. et al (2015) points out that a problem that is relevant to the spinal scoop, saying that patients wearing certain pieces of clothing may be more uncomfortable with them, suggesting that it’s better for the patient to have “scoop-to-skin”, instead of clothing. Removal of clothing for the spinal scoop can lead to a potential risk of hypothermia – in the case of a cold environment and additional measures must be taken to prevent heat loss (Moss, R. et al. 2015). This also leads into the patient’s dignity, where removing their clothing in order to place them on the spinal board, especially in a public place, can lead to some breaches within dignity – a very important factor when it comes to a patient.
The weight limit is where the spinal scoop can struggle, due to the design of having a large space down the middle as opposed to the solid block of the spinal board; this makes the spinal scoop weaker in terms of weight restrictions (Moss, R. et al. 2015). The restriction of weight can vary between models/types, but weight of the spinal scoop can sit at 35.7st/500lbs. This means that heavier patients or patients in wearing heavy gear/equipment can create a bit of a problem with transportation. Certain models of the spinal board can allow up to 71st/1000lbs of weight.
According to Moss, R. et al (2015), another disadvantage found with the spinal scoop is the cost, as it is newer than its competitor – it’s more costly, which may affect whether practitioners are given the ability to access the equipment, instead deciding that it is better to stick with the spinal board.
From the three sources that I have found, they have provided me with a large selections of information that have argued for and against with both the spinal board and spinal scoop. All three sources have made mention of different scenarios, e.g. Porter, K. et al (2015) focuses more on the use of a spinal board during a pelvic injury.
Rowell, R. (2014) found that after multiple tests of both the spinal board and the spinal scoop, the spinal scoop was more efficient when it came to reducing the movement of the spine during its application – as well as the time it takes to put the scoop together being less than the spinal board – being due to the ‘blades’ design completely eliminating the log-rolling technique. Rowell, R. (2014) concluded that actually, an air-assisted mattress was more efficient as it can “cause less lateral cervical-spine motion than any other device”.
Moss, R. et al (2015) was also more supportive towards the use of the spinal scoop as opposed to the spinal board – however its conclusion hints towards the use of a Vacuum Mattress being the better device between the spinal scoop and spinal board.
The Vacuum Mattress is a newer piece of equipment that hasn’t been brought into all forms of practice – the mattress shapes around the patient, it is then pumped up with oxygen where the soft material of the vacuum mattress hardens around the patient or the patient’s wound, creating a mould around the patient. Moss, R. et al (2015) suggests that the vacuum mattress should be used in a situation that the patient is immobilised for over 45 minutes – as opposed to the scoop or spinal board, as it provides “the most comfortable method of immobilising the trauma patient with the lowest incidence of pressure tissue injury”.
Porter, K. et al (2015) focuses less on the question of Spinal Board vs. Spinal Scoop - focusing more on pelvic fractures and pelvic binders. However it does criticise the use of a spinal board, claiming that the use of the spinal board and the log-rolling technique is not only ineffective, but also dangerous for a patient with a pelvic injury.
In conclusion, evidence suggests that the Orthopaedic Stretcher (Spinal Scoop) is much more efficient and effective towards the clinical care of the patient. The design of the spinal scoop has built upon what the Spinal Board was, creating a more efficient shape that’s considerably more comfortable than the straight-board design of the spinal board. The design of the re-attachable blades completely eliminates the need for the controversial log-rolling technique. The spinal scoop may be considerably more expensive in price, but when it comes to the care for the patient and creating the best care for them – it is definitely worth the price.