Evolution of the Spineboard

I’ve watched the backboard evolve a lot over recent years. For the first two thousand years of human history, backboards evolved very little. Early man used slabs of wood with straps of sinew and leather to secure the injured victim.  By 1979 we advanced to slabs of wood with straps of nylon webbing. These boards were often constructed of inexpensive plywood, hastily finished and poorly sealed. They wore badly and being porous, absorbed fluids. But there were notable exceptions of high quality wooden back boards.

The Parr Backboard was finely finished Baltic Birch, with  many layers of sealant over a baby-smooth sanding job. It had reinforcing runners and many handholds and strap-pin locations available, and was largely a custom-made product. The HenleyBoard from Maryland is a regional favorite in the Mid-Atlantic, sporting a still innovative and durable head immobilizer mechanism.

With HIV came increased sensitivity to infection control issues. Plastic backboards quickly became the favorite backboard material. The first synthetic backboard I remember using was the Ferno folding aluminum backboard. It was all we could really carry in the Cadillac ambulances, and they worked great.

The earliest plastic boards were two-piece plastic and some were one-piece acrylic with runners. Some used ABS plastic, which proved somewhat brittle and heavy. But the breakthrough technology for plastic spine boards came with rotational molding.

These two-part boards initially used high-density polyethylene plastic shells, filled with polyurethane foam. This two-part structure delivered a lightweight board that was strong, and could really take the abuse of EMS. Another version of two-part composite uses rigid fiberglass rods inside a hollow plastic board.

Then along came the first three-part composite boards. They employed an innovative and still favored method of construction. They use rotationally molded hollow polyethylene plastic filled with polyurethane foam reinforced with carbon plastic rods. These rods help make the structure much stronger, but over time the hard rods inside the foam would displace the foam and the boards could
become more flexible.

The latest evolution is placing the rods inside molded plastic channels directly, so the rods make contact with plastic itself and then the board is foamed. This creates a solid contact of rod to plastic, for a firm bonding and improved wear. This unique method is employed by a handful of the finest boards on the market.

Another favorite design feature is contoured boards. Instead of being flat, the surface is concave, providing improved lateral stability and comfort. You can get most with pins for speed clip straps. Some come with their own proven backboard strap systems. Most offer the ability to secure Pediatric patients by having vertical slots down the center to run the straps.

Some good examples are the latest models from Rapid Deployment Pro But there are other great products out there some with unique features. The TomCatICID Backboard from R&B Fabrications, Inc. is a plastic backboard with a built-in head immobilizer. The CID is also plastic, easily clean and replaced. But another solution is the plastic scoop stretcher.

The new Hartwell Combicarrier II™ is a different way to skin the same cat. It’s a durable, functional and versatile piece of patient handling equipment. It combines the features of an aluminum scoop stretcher and plastic spine board in one very innovative product.

We have seen more evolution in long spine immobilization during the last twenty years than in the preceding two thousand. Today we have a wide range of options, some offering real enhancements to patient care.  Understanding how back boards are constructed should help better inform your selection of this piece of essential EMS equipment.


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About Dan White

I'm a retired Paramedic and EMS Instructor with 35 years EMS and emergency medical product experience. I love canoes, cars and EMS. I write about EMS Technology on the Paramedic Blog, the Insights on Innovation column for EMS1.com, on AmbulanceWorld.com and Multibriefs.com. I work for Intersurgical, Inc. managing EMS sales and distribution. I can be reached directly at 573-240-0002. Follow me @Paradan on Twitter
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3 Responses to Evolution of the Spineboard

  1. Jason "JT" Thompson says:

    I will be great if you can do a detailed history of the integration of mortuarial products into emergency medicine, namely Ferno’s Scoop Stretcher. Thank you.

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