Changes to an important lifesaving technique

11 May 2016

For more than 20 years, the aquatic industry has been practicing the fine art of measuring key dimensions, collar applications and securing patients to spine boards with a vast webbing of Spider Straps. But after many years of reviewing the outcomes of spinal injuries by the medical profession, ANZCOR (Australian and New Zealand Committee on Resuscitation) has now released changes to spinal management procedures in the latest release of Australian Resuscitation Council (ARC) Guidelines.

In a pleasant surprise, the process just got simpler instead of harder! So what has changed?

The ARC Guidelines, released in January 2016 state that pre-hospital spinal immobilisation has never been shown to affect outcome for the patients, and the the use of semi rigid (SR) cervical collars by first aid providers is no longer recommended.

The current recommendations are as follows; “ANZCOR recommends all rescuers in the pre-hospital environment review their approach to the management of suspected spinal injury with regards to SR cervical collars. Consistent with the first aid principle of preventing further harm, the potential benefits of applying a cervical collar do not outweigh harms such as increased intracranial pressure, pressure injuries or pain and unnecessary movement that can occur with the fitting and application of a collar. In suspected cervical spine injury, ANZCOR recommends that the initial management should be manual support of the head in a natural, neutral position, limiting angular movement (expert consensus opinion). In healthy adults, padding under the head (approximately 2cm) may optimise the neutral position.”

ANZCOR also recommends that victims should not be left on rigid spinal boards; "Healthy subjects left on spine boards develop pain in the neck, back of the head, shoulder blades and lower back... Conscious victims may attempt to move around in an effort to improve comfort, potentially worsening their injury.”

What does all this mean and what will change in participant's training with the Royal Life Saving Society WA?

Royal Life Saving trainers across Australia have been developing new techniques to conform to the new guideline changes, which simplifies the spinal management process. This in turn has lead to a quicker extraction of the patient from the water.

Not using a collar for extraction from the pool will alleviate the need to measure for key dimensions and attaching a collar. In WA we are also implementing new straps to our training that simply go around the board to secure the patient for removal. With only 2-3 buckle clip straps to apply, extraction from the pool will now be reduced to approx 5 mins from time lifeguard enters the water to getting the patient off the board on pool deck. This will please many trainees, who dread the time when they have to play patient during a Pool Lifeguard Requalification, lying on the spineboard outside in the middle of winter!

You can download a copy of the updated Royal Life Saving Aquatics Spinal Management Flow Chart below.

When does this start?

Royal Life Saving National Office has released a statement to industry that is effective immediately. The new procedure will be included in all New Pool Lifeguard Courses and Requals, with updates to resources and online content happening soon. New Spinal Straps have been purchased by LIWA Aquatics and together with Royal Life Saving we will begin the distribution of the new straps to industry during the off season, ready for next summer.

If you have any enquiries relating to these new changes contact Royal Life Saving Society WA.