Sandbags for Head Immobilization?

[Firescueguy]

Just saw an EMS supply catalog the other day that offered sand bags in various sizes for head immobilization...my question is are there agencies out there still using these? When I came into EMS 17 years ago, they were being phased out in favor of the HeadBed which we still use to this day...about the only place I've seen them recently was in the side compartment of our MCI truck (the thinking being that if it's a big enough incident, let's use what we got).

Was just curious if anyone still uses sandbags for immobilizing the head...I'm thinking maybe some rural squads that are cash strapped but otherwise I can't see too many agencies using these (why add 10 more pounds to the board...the pt. is heavy enough already :D)

So, anybody out there still using them in first line service? Not knocking them, they are an old school idea that worked at the time (kinda like MAST pants until they realized the pt. died 3 days later from complications due to the pressure exerted on their internal organs:cool: )

Ok, let's hear your input...Stay Safe.

[LordMedic]

nope and in 14 years in this business, I have never seen nor heard of such a thing, we used to roll a blanket and tape it down but not sandbags

[DrParasite]

We don't use sandbags, nor do we use headbeds (although I think we have a CID on our trick since it's required by the state), we use blanket rolls. cheaper and more disposable.

i think maybe an ED uses sandbags? since they are easy to move and remove and replace. just a thought

[hydrotech]

I've heard my dad using sandbags in the field(army), but never in the rural or urban environment. i agree that they add the weight but they also IMHO add more stability and support. just due to the density factor and they don't allow the patients head too much movement.

[the1141man]

I've heard my dad using sandbags in the field(army), but never in the rural or urban environment.

BING! Steel on target. As a field medic you don't carry an LSB strapped on your back, and oftentimes won't even have a C-collar in your VIII bag...so you use whatever's handy. Sandbags, boots, rocks, blanket rolls, whatever you can find and use... field-expedient medicine is a great thing. ;) :D

[Resq14]

I think the big problem with sand bags is their tendency to shift if you roll the board... not that it's a problem for the gazillion people I see who get boarded "just in case"... more of a problem for the honest-to-god-my-spine-is-compromised patient.

I saw some old ones in a supply cabinet years ago... never seen 'em used in the field here.

[mcaldwell]

We use small sandbags around here for initial C-spine where a second helper is not available, or cannot fit (i.e. industrial or confined space, etc.). No one is ever boarded with them however. They get a headbed after loading on the board or scoop.

They probably get more use in training than the field too.

[jjnner]

I work for a provincial widI work for a provincial wide ambulance service, that has a patient population base of 4,310,452. For spinal patients we are given a ROS/Clam shell and sandbags.

This is unfortunate because most staff roll the patient onto the un-separated clam, and don’t secure the head while in transport.

[JamesL]

I work for a provincial widI work for a provincial wide ambulance service, that has a patient population base of 4,310,452. For spinal patients we are given a ROS/Clam shell and sandbags.

This is unfortunate because most staff roll the patient onto the un-separated clam, and don’t secure the head while in transport.

Are you are referring to British Columbia with your post?

I am pretty sure BC paramedics are given the clamshell (which some recent studies have shown is superior to the spine board for spinal immobilization), the long spine board, the KED, sand bags, head beds, spider straps, and tape for the purposes of immobilization.

As your post seems negative in nature, can you offer any evidence at all that the spinal protocols BC paramedics use have been detrimental to patient care?

In other words, with 30 or 35 years, and well over ten or fifteen million patients treated in the history of their service, can you offer specific evidence that they are treating spinals incorrectly?

If I misread your tone, I apologize.

[jjnner]

I want to stay on track with this post. Of course our ambulances are filled with more equipment then just a ROS/Ferno and sandbags. (no KED though)

My point was that when an ROS is used, we have either a SAM splint or Sandbags to use as spinal immobilization. Moreover staff are either lazy or not aware that its against manufactures directions to spinal roll somebody directly on it.

The ROS/Ferno scoop stretcher has some great literature on the net. I have read the comparison studies to that and the long backboard, and agree, while some reports come up negligible in which device is superior….. its if and how the device is used that determines its effectiveness.

Your equipment is only as good as the staff that knows how to properly use it.

Please no debating about British Columbia's Ambulance Service!! This post will never end!!


Quotes about sandbags use!

CIDs (Cervical immobilization device) were invented to take the place of sandbags which were the most common form of lateral stabilization device used in the 1970s and 1980s”

http://www.emsresponder.com/features/article.jsp?siteSection=20&id=3437

[JamesL]

I want to stay on track with this post. Of course our ambulances are filled with more equipment then just a ROS/Ferno and sandbags. (no KED though)

My point was that when an ROS is used, we have either a SAM splint or Sandbags to use as spinal immobilization. Moreover staff are either lazy or not aware that its against manufactures directions to spinal roll somebody directly on it.

The ROS/Ferno scoop stretcher has some great literature on the net. I have read the comparison studies to that and the long backboard, and agree, while some reports come up negligible in which device is superior….. its if and how the device is used that determines its effectiveness.

Your equipment is only as good as the staff that knows how to properly use it.

Please no debating about British Columbia's Ambulance Service!! This post will never end!!


Quotes about sandbags use!

CIDs (Cervical immobilization device) were invented to take the place of sandbags which were the most common form of lateral stabilization device used in the 1970s and 1980s”

http://www.emsresponder.com/features/article.jsp?siteSection=20&id=3437

Hey,

I don't think we are off topic at all. First off, I am a big fan of BCAS, and hold the people who work for it in high regard. Secondly, any ambulance service that does 500,000 - 600,000 calls per year has a plethora of anecdotal evidence in it regarding practice and procedure. While some consider the spinal methods used in BC different from the way they do it in other areas (and they are to an extent)... you can't argue with success. If an organization has done something a certain way for 33 years, with hundreds of thousands of calls per year, that says something to me.

Cheers!

p.s. And, if you don't have a KED on your ambulance, you can order one. Most BCAS units have one.

[algoma44]

I haven't personally heard of anyone around Wisconsin using sandbags in the field, and i haven't been around long enough to know if they used them in the past. Mostly i think they're avoided because of the space constraints with a longboard. The other is during transferring board to cot in the field (especially when being carried long distances, uphills, etc) or board to table when you get to the ED I wouldn't want to take the risk with the potential of the weight shifting. The whole point of CIDS devices is that it's one solid unit and seems to provide for less chances of moving during transfer. I even have gone away from using towels because, even though they are taped down, they can tend to migrate because they're not conneted to the board in the same fasion as the CIDS device.

I've never really had the desire to research its safeness/effectiveness, of the various immoblization devices, but the times we've used sand bags in they ED they've worked well. It could be more effective in the ED because we don't have the space restriction as on a long board. A trauma table is a bit wider and we have a larger area to secure to. When we send patient's up to the floor with them on, i don't know exactly what they end up doing with them, but i bet they probably would take them off because I wouldn't expect sand bags sit very well in a soft bed, and they probably have more high tech devices to immobilize.

In what situations do we use sandbags? flat out, pretty rarely.. but when they were used it was with confused patients i.e. dementia/suspected alzheimers or drunks with unstable C-spine, and more specifically C1 or C2 fx's. When they're used, they're usualy taped so securely that even if they were drunk or confused they would have a hard time moving reguardless.

In reference to the comment about taking things off when you get to the ED, 1) we don't do as much weight shifting laying in bed as an ambulance does going mach 90 down the road, and 2) I guess a good reason is that the majority of patients who have c-spine injuries often have alot of pain associated with the injury, and even most that are confused or drunk simply avoid moving becuase it hurts.

[wvavff]

They used to carry sand bags here, but in the 12 years I've been on the truck they haven't been around. The state OEMS prohibits there use.