Question: Although not employed by a service under the SWORBHP, I have been closely following this site and your LINKS newsletter. Thank you for both of these invaluable resources. After reading the most recent question regarding spinal immobilization, I had to share a resource with you that can located here This is a lecture by Dr. Ryan Jacobson, a former paramedic who is now medical director of Johnson County EMS in Kansas and Assistant Professor of Emergency Medicine at University of Missouri-Kansas City School of Medicine. If you have already seen it, you are familiar with its informative value. If not, I’m confident that you will find it of value. This link is unplublished and cannot be found via YouTube search.

Something that I have been wondering after viewing the lecture and statistical evidence is as follows. Hypothetically, if the current practice of securing patients to backboards increases morbidity and mortality (particularly penetrating trauma) and that there is greater spinal movement than if secured directly to the stretcher, and that no negative effects have been observed by not securing to a backboard, is it reasonable to consider foregoing the backboard as care superior to the minimum requirement as written in the BLS? Similarly to a “letter of the law” vs. “spirit of the law” question. LBBs have been contraindicated for transport in Queensland, Australia for the past five years among numerous other jurisdictions. I’ve inquired with my employer but was given the old “We have standards” response.

Thank you for your time and consideration on this topic. I look forward to your reply.