Pressure sores and patient comfort in spinal immobilisation : the vacuum mattress and the spinal board

Abstract

Overview of the topic: Spinal immobilisation in patients with spinal cord injuries reduce further risks of spinal injuries during pre-hospital care and transportation, however, the risk of developing pressure sores and patient discomfort are increased when using the equipment. Different equipment is available for spinal immobilisation, including the vacuum mattress and the spinal board. Research Question: Does the use of a vacuum mattress in patients with suspected spinal cord injury result in less pressure sores and increased patient comfort than the spinal board? PICO elements: Population - adults over the age of 18 years with spinal trauma. Intervention - Vacuum mattress. Comparison - Spinal board and outcome- reduction in pressure sores and increase in patient's comfort. Inclusion Criteria: Adult patients with back trauma, requiring spinal immobilisation during pre-hospital care. Exclusion Criteria: Patients under the age of 18 years and studies in which the language of publication is not in English. Outcome of the search: 13 articles were retrieved, but only 9 were relevant. These articles consisted of 2 systematic reviews, 2 randomised controlled trial, and 5 observational studies. Methods of appraisal used: CASP tools Main Results: A vacuum mattress results in less pressure sores than the spinal board, and also increases patient's comfort. Conclusion, implications and recommendations: Since the vacuum mattress has been found to decrease pressure sores and increase patient's comfort, it should be introduced to the ED nurses by hands on practice, and supported with guidelines and protocols. However, further research is needed to reduce the risks of pressure sores. The vacuum mattress is faster to apply than the spinal board. Moreover, the vacuum mattress was superior at immobilization of the torso, whereas the backboard provided better immobilization of the head.