{"id":86527,"date":"2024-12-11T13:19:31","date_gmt":"2024-12-11T18:19:31","guid":{"rendered":"https:\/\/www.ottawahospital.on.ca\/?p=86527"},"modified":"2025-01-20T12:01:21","modified_gmt":"2025-01-20T17:01:21","slug":"does-this-backboard-look-comfortable-to-you","status":"publish","type":"post","link":"https:\/\/www.ottawahospital.on.ca\/en\/healthy-tomorrows\/does-this-backboard-look-comfortable-to-you\/","title":{"rendered":"Does this backboard look comfortable to you?"},"content":{"rendered":"\n

Paramedic Commander Shannon Leduc (left) and emergency medicine researcher Dr. Christian Vaillancourt (right) hold up a backboard and cervical collar, which provide rigid support during movement of trauma patients. Unfortunately, they\u2019re not most people\u2019s idea of comfortable.\u00a0<\/em><\/p>\n\n\n\n

<\/div>\n\n\n\n

When Shannon Leduc was a primary care paramedic in the early 2000s, she responded to a call for someone who may have suffered a cervical spine injury.<\/p>\n\n\n\n

When she arrived, the patient was mobile but couldn\u2019t remember whether he had a fall. And because he possibly had a very serious neck injury, the protocol at the time dictated that Shannon had to immobilize him and carry him out. This means she had to put a cervical collar around his neck and strap him to a rigid backboard to prevent any movement of his spine.<\/p>\n\n\n\n

But there were a few problems.<\/p>\n\n\n\n

\u201cThe patient was in a rooming house, in a half-basement,\u201d recalls Shannon, who\u2019s now a paramedic commander with the Ottawa Paramedic Service. \u201cThe stairs were so narrow that the backboard couldn\u2019t fit. We had to carry the patient up these rickety old wood stairs on an angle.\u201d<\/p>\n\n\n\n

If Shannon faced this same situation today, she would be able to do things a lot differently.<\/p>\n\n\n\n

\u201cThe patient could have walked out on his own two feet,\u201d she says, \u201cwhich would have been safer for both the patient and the paramedics.\u201d <\/p>\n\n\n\n

Today, the vast majority of low-risk trauma patients across Ontario can be transported to hospital without the awkward and uncomfortable backboard. And plans are underway for most to be transported without the collar either.<\/p>\n\n\n\n

Shannon, her paramedic colleagues across Ontario and researchers at The Ottawa Hospital all played a big role in making these changes happen. As their truly epic, years-long story finally comes to a close, discover how researchers and paramedics make for a powerful team that can completely transform patient care.<\/p>\n\n\n\n

\"Left
Here\u2019s a closer look at a backboard and cervical collar.<\/figcaption><\/figure>\n\n\n\n

Responding to the concerns of patients<\/h3>\n\n\n\n

Back in the days when Shannon was on the road, paramedics had to immobilize all patients with a potential cervical spine injury, even patients who had no visible signs of injury. The rationale was that paramedics had to play it safe and allow emergency room physicians and nurses to make the call whether to remove the patient\u2019s immobilization equipment, which is usually only after completing diagnostic imaging.<\/p>\n\n\n\n

But patients without a cervical spine injury were often spending hours unnecessarily strapped to a backboard, leading to significant discomfort \u2014 and even pain, as the backboard can cause pressure points on the spine.<\/p>\n\n\n\n

\u201cMore and more, we understood the discomfort and pain experienced by patients, as well as the resulting increase in health-care resources, such as unnecessary medical imaging and time delays for paramedics,\u201d explains Dr. Christian Vaillancourt, emergency medicine researcher and Senior Scientist with The Ottawa Hospital\u2019s Acute Care Research Program. \u201cThe best-case scenario would be that paramedics could use a clinical decision rule to determine whether to immobilize their patients in the first place.\u201d<\/p>\n\n\n\n

\"Dr.
Dr. Christian Vaillancourt\u2019s research focuses on improving prehospital care for trauma and cardiac arrest patients.<\/figcaption><\/figure>\n\n\n\n

Re-thinking an old Rule<\/h3>\n\n\n\n

Dr. Vaillancourt and his research team collaborated with paramedic services across Ontario for two studies that showed that paramedics could accurately determine which patients were at low risk for a spinal injury and therefore didn\u2019t require immobilization or medical imaging.<\/p>\n\n\n\n

To assess their patients, paramedics used the Canadian C-Spine Rule, a set of criteria developed by Dr. Ian Stiell of the Ottawa Hospital Research Institute more than 20 years ago. Before Dr. Vaillancourt\u2019s first study with the Ottawa Paramedic Service between 2010 and 2015, only emergency physicians and nurses could assess patients with the Rule, which they used to determine if the backboard and collar could be removed.<\/p>\n\n\n\n

But that study was such a success that the Ontario Ministry of Health allowed Ottawa paramedics to continue to transport patients without immobilization as long as they passed the Rule \u2014 a win for both patients and Shannon\u2019s colleagues. \u201cParamedics have told me this is the single most influential thing that has happened to make their career better,\u201d reports Shannon, who helped train Ottawa paramedics to assess their patients with the C-Spine Rule.<\/p>\n\n\n\n

And in 2017, before Dr. Vaillancourt wrapped up a successful second study with paramedic services across the province, the Ministry of Health introduced a new protocol allowing most low-risk patients in Ontario to be transported without the backboard. \u201cInspired and informed by the research we\u2019ve done, the Ministry got rid of the most painful part of immobilization,\u201d reports Dr. Vaillancourt.<\/p>\n\n\n\n

And plans are now underway at the Ministry to allow all Ontario paramedics to nix the collar if the patient passes the C-Spine Rule. Dr. Vaillancourt is currently working with the Ministry to iron out the details and develop a training program for paramedics.<\/p>\n\n\n\n

\"Shannon
Shannon Leduc has more than 20 years of experience as both a paramedic and an instructor.<\/figcaption><\/figure>\n\n\n\n

The Ottawa Hospital empowers paramedicine research<\/h3>\n\n\n\n

The Ottawa Hospital has collaborated with paramedics on research for more than 25 years, but the relationship between researchers and paramedics has gotten much closer over time.<\/p>\n\n\n\n

\u201cHistorically, researchers would come up with the research questions and then approach the paramedics to help us answer them,\u201d explains Dr. Vaillancourt. \u201cNow, we have paramedic champions on our research studies, and we consult with them to come up with these questions. Nobody understands prehospital care better than they do. There is a growing number of paramedic researchers in Canada.\u201d<\/p>\n\n\n\n

Shannon, herself a trained paramedic researcher, has long been one of those champions, participating in an array of paramedicine research projects with the hospital over the years. \u201cWhat The Ottawa Hospital has done is help foster our own ability to do research within the paramedic profession,\u201d she says. \u201cOur collaboration has set us paramedics up for future research that will help a lot of patients over time.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Imagine this: You\u2019re flat on your back, strapped tight to a rigid backboard, unable to move at all. Fortunately, this is no longer the reality for most low-risk trauma patients when they\u2019re brought to hospital in our province. Find out how researchers at The Ottawa Hospital teamed up with paramedics across Ontario to make the journey a lot more comfortable.<\/p>\n","protected":false},"author":25,"featured_media":86528,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[9],"tags":[92,407],"class_list":["post-86527","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-healthy-tomorrows","tag-research","tag-trauma-care"],"acf":[],"wps_subtitle":"","_links":{"self":[{"href":"https:\/\/www.ottawahospital.on.ca\/en\/wp-json\/wp\/v2\/posts\/86527","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ottawahospital.on.ca\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.ottawahospital.on.ca\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.ottawahospital.on.ca\/en\/wp-json\/wp\/v2\/users\/25"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ottawahospital.on.ca\/en\/wp-json\/wp\/v2\/comments?post=86527"}],"version-history":[{"count":0,"href":"https:\/\/www.ottawahospital.on.ca\/en\/wp-json\/wp\/v2\/posts\/86527\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.ottawahospital.on.ca\/en\/wp-json\/wp\/v2\/media\/86528"}],"wp:attachment":[{"href":"https:\/\/www.ottawahospital.on.ca\/en\/wp-json\/wp\/v2\/media?parent=86527"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.ottawahospital.on.ca\/en\/wp-json\/wp\/v2\/categories?post=86527"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.ottawahospital.on.ca\/en\/wp-json\/wp\/v2\/tags?post=86527"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}