The effect of power stretchers on occupational injury rates in an urban emergency medical services system.

BACKGROUND: To examine occupational injury rates in a dual-response emergency medical services (EMS) system before and after implementation of a power-lift stretcher system. METHODS: The seasonally-adjusted occupational injury rate was estimated relative to medical call volume (per 1000 calls) and workers (per 100 FTEs) from 2009 to 2019, and stratified by severity (lost-time, healthcare only), role (EMS, FIRE) and type (patient-handling). Power-lift stretchers were adopted between 2013 and 2015. Preinjury versus postinjury rates were compared using binomial tests. Interrupted time series (ITS) analysis was used to estimate the trend and change in injuries related to patient-handling, with occupational illnesses serving as control. RESULTS: Binomial tests revealed varied results, with reductions in the injury rate per 1000 calls (-14.0%) and increases in the rate per 100 FTEs (+14.1%); rates also differed by EMS role and injury severity. ITS analysis demonstrated substantial reductions in patient-handling injuries following implementation of power-lift stretchers, both in the injury rate per 1000 calls (-50.4%) and per 100 FTEs (-46.6%), specifically among individuals deployed on the ambulance. Injury rates were slightly elevated during the winter months (+0.8 per 100 FTEs) and lower during spring (-0.5 per 100 FTEs). CONCLUSIONS: These results support the implementation of power-lift stretchers for injury prevention in EMS systems and demonstrate advantages of ITS analysis when data span long preintervention and postintervention periods.

Optical nanofiber stretcher.

Piezoelectric stretching of optical fiber is a technique that enables the creation of optical delays of a few picoseconds; this is useful in a variety of applications in interferometry or optical cavities. Most commercial fiber stretchers involve lengths of fiber of a few tens of meters. Using a 120-mm-long optical micro-nanofiber, we can create a compact optical delay line that achieves tunable delays of up to 19 ps at telecommunication wavelengths. The high elasticity of silica and the micron-scale diameter allow this significant optical delay to be achieved with low tensile force while keeping the overall length short. We successfully report both static and dynamic operation of this novel, to the best of our knowledge, device. It could find application in interferometry and laser cavity stabilization, where short optical paths and strong resistance to the environment would be required.

Developmentally interdependent stretcher-compressor relationship between the embryonic brain and the surrounding scalp in the preosteogenic head.

BACKGROUND: How developing brains mechanically interact with the surrounding embryonic scalp layers (ie, epidermal and mesenchymal) in the preosteogenic head remains unknown. Between embryonic day (E) 11 and E13 in mice, before ossification starts in the skull vault, the angle between the pons and the medulla decreases, raising the possibility that when the elastic scalp is directly pushed outward by the growing brain and thus stretched, it recoils inward in response, thereby confining and folding the brain. RESULTS: Stress-release tests showed that the E11-13 scalp recoiled and that the in vivo prestretch prerequisite for this recoil was physically dependent on the brain (pressurization at 77-93 Pa) and on actomyosin and elastin within the scalp. In scalp-removed heads, brainstem folding was reduced, and the spreading of ink from the lateral ventricle to the spinal cord that occurred in scalp-intact embryos (with >5 µL injection) was lost, suggesting roles of the embryonic scalp in brain morphogenesis and cerebrospinal fluid homeostasis. Under nonstretched conditions, scalp cell proliferation declined, while the restretching of the shrunken scalp rescued scalp cell proliferation. CONCLUSIONS: In the embryonic mouse head before ossification, a stretcher-compressor relationship elastically develops between the brain and the scalp, underlying their mechanically interdependent development.

[Design and analysis of shoulder type exoskeleton stretcher for individual soldier].

For the transportation process of rescuing wounded personnel on naval vessels, a new type of shoulder type exoskeleton stretcher for individual soldier was designed in this paper. The three-dimensional model of the shoulder type exoskeleton stretcher for individual soldier was constructed using three dimensional modeling software. Finite element analysis technique was employed to conduct statics simulation, modal analysis, and transient dynamics analysis on the designed exoskeleton stretcher. The results show that the maximum stress of the exoskeleton stretcher for walking on flat ground is 265.55 MPa, which is lower than the allowable strength of the fabrication material. Furthermore, the overall deformation of the structure is small. Modal analysis reveals that the natural frequency range of the exoskeleton stretcher under different gait conditions is 1.96 Hz to 28.70 Hz, which differs significantly from the swing frequency of 1 Hz during walking. This indicates that the designed structure can effectively avoid resonance. The transient dynamics analysis results show that the maximum deformation and stress of exoskeleton stretcher remain within the safety range, which meets the expected performance requirements. In summary, the shoulder type exoskeleton stretcher for individual soldier designed in this study can solve the problem of requiring more than 2 people to carry for the existing stretcher, especially suitable for narrow spaces of naval vessels. The research results of this paper can provide a new solution for the rescue of wounded personnel on naval vessels.

Reducing intraoperative time with laryngeal mask airway and stretcher in pediatric adenotonsillectomy.

OBJECTIVES: Adenotonsillectomy (T&A) is one of the most common surgical procedures performed in the United States. Several studies have defined the safety of laryngeal mask airway (LMA) during this surgery, and conflicting evidence exists describing the role it plays in reducing intraoperative times. Our objective is to describe the role LMA and operating on a stretcher have on reducing intraoperative time during pediatric T&A. METHODS: This is a retrospective review between October 2017 and January 2020. We included patients between the ages of 4-18 years old undergoing T&A. We excluded medically complex patients with chromosomal, craniofacial, and metabolic abnormalities, patients with cerebral palsy, and those who were tracheostomy dependent. Patient demographics included surgical indication, age, sex, obesity, use of preoperative midazolam, type of airway used, use of traditional operating room (OR) bed versus transport stretcher, surgeon type, and intraoperative times. Data was analyzed with univariate t-test and multivariate linear regression. RESULTS: One hundred seventy-nine patients were included with an average age of 7.2 years. LMA and stretcher were used on 46.4% and 40.2% of patients, respectively. On multivariate linear regression LMA reduced emergence time by 4.4 min (p ≤ 0.001, 95% CI -6.7 to -2.1) and transport stretcher reduced induction time by 2.5 min (p = 0.04, 95% CI -4.9 to -0.1). Use of LMA and stretcher did not have a statistically significant difference on actual procedure time. CONCLUSION: Our study further supports the role LMA has in reducing intraoperative times in addition to describing a novel method of reducing intraoperative time by operating on a transport stretcher for healthy children undergoing T&A. LEVEL OF EVIDENCE: 3.

Effect of Ambulance Stretcher Bed Height Adjustment on CPR Quality and Rescuer Fatigue in a Laboratory Environment.

Background: The quality of cardiopulmonary resuscitation (CPR) is closely related to the survival rate of a patient, and it is crucial to maintain the quality of CPR during the ambulance journey to the receiving hospital. The purpose of this study was to investigate the effects of different stretcher bed heights on operator CPR quality. Methods: In this randomized crossover trial, 16 male emergency medical technicians-paramedics (EMT-Ps) performed continuous chest compressions on a hemimorphic mannequin for 5 minutes, alternating between the current height of the stretcher bed on the ambulance (38 ± 1 cm) (S-38) and the height of the participant's midpoint of the patella (S-knee), where the stretcher bed surface is. Results: According to the analysis of the quality of CPR exercises with two different stretcher bed heights at 5 minutes of continuous chest compression, the mean chest compression depth (CCD) of the S-38 position (53.81 ± 1.91 cm) was significantly lower than that of the S-knee (55.12 ± 2.03 cm; p < 0.001). The mean chest compression rate (CCR) of the S-38 position (111.44 ± 3.44 beats/min) was significantly higher than that of the S-knee (109.63 ± 4.46 beats/min; p = 0.027). The mean of total chest compressions (TCC) of the S-38 position (557.44 ± 16.81 times) was significantly higher than that of the S-knee (548.24 ± 19.40 times; p = 0.029). The rating of perceived exertion (RPE) of the S-38 position was significantly higher than that of the S-knee (12.75 ± 1.91 %; p = 0.015). Only the chest compression rebound rate (CCRR) (S-38: 97.56 ± 4.63 % vs. S-knee: 98.31 ± 1.89 %, p = 0.401) and the chest compression fraction (CCF) (S-38: 98.44 ± 0.81 % vs. S-knee: 98.44 ± 0.96 %, p = 1.000) did not reach a significant difference. Conclusion: When a resuscitator is performing chest compressions in a standing position in an ambulance, the excessive downward leaning of the resuscitator's upper body affects CPR quality and increases fatigue. This study has verified that setting the stretcher bed of the ambulance at the knee height of the EMTs provides better CPR quality and lower fatigue.

Comparison of Chest Compression Quality between Transfer Sheet and Stretcher Use for Transporting out-of-Hospital Cardiac Arrest Patients in a High-Rise Building - A Randomized and Open-Label Cross-over Design.

OBJECTIVES: Stretchers are commonly used for transporting cardiac arrest patients, but their use may be limited in confined spaces, like elevators. Use of transfer sheet as an alternative has not been explored. We aimed to compare manual chest compression quality between these two methods. Methods: In this prospective, open-label, randomized cross-over manikin study, the subjects included emergency medical technicians who were assigned to 12 three-person crews. Scenarios included transport of a cardiac arrest in a high-rise building and elevator using transfer sheet (TS) and stretchers adjusted to 45° (S45) and 90° (S90). Chest compression quality was measured using a recording manikin and that before (on-scene phase) and after (transport phase) the manikin moved via transfer sheet or stretcher were compared. Results: The final analysis included 72 simulation runs. Chest compression quality did not differ among the groups in the on-scene phase. In the transport phase, the transfer sheet group provided greater mean compression depth (54.4 ± 4.2 vs 39.6 ± 7.2 mm, p < 0.01 and 54.4 ± 4.2 vs 40.6 ± 8.3 mm, p < 0.01, respectively) than stretchers of S45 and S90, and higher percentage of deep-enough compression (TS: 51.0 [23.8-74.8]% vs S45: 19.5 [5.8-29.5]%, p < 0.01) than the S45 group. Transfer sheet use showed a trend of lower percentages of full recoil (TS: 40.0 [12.8-64.5]% vs S45: 70.5 [47.0-79.8]% vs S90: 52.5 [25.3-76.0]%, p = 0.09). Chest compression fraction, compressions with correct hand position, and mean compression rates did not differ between groups in the transport phase. The TS group showed shorter time intervals of simulation start-to-first-compression (TS: 13.9 [12.4-15.1] sec vs S90: 15.9 [13.3-16.4] sec, p = 0.04) and total run time (TS: 145.7 [135.1-151.4] sec vs S90: 160.0 [151.9-175.4] sec, p < 0.01) than the S90 group. Conclusion: In this simulation, using transfer sheet outperform using stretcher for transporting cardiac arrest patients from high-rise buildings. Rescuers need to be aware of full chest recoil.

[Application of vacuum stretcher combined with feeding in cranial magnetic resonance imaging examination for neonates: a prospective randomized controlled study].

OBJECTIVE: To study the effect and safety of vacuum stretcher combined with feeding in cranial magnetic resonance imaging (MRI) examination for neonates. METHODS: A prospective study was performed for the neonates with hyperbilirubinemia, with a gestational age of >34 weeks and stable vital signs, who needed cranial MRI examination and did not need oxygen inhalation hospitalized in the Department of Neonatology, Children's Hospital of Zhejiang University School of Medicine, from September to November, 2019. The neonates were randomly divided into a vacuum stretcher combined with feeding group and a conventional sedation group. Vital signs were monitored before, during, and after MRI examination. The success rate of MRI procedure was recorded. RESULTS: A total of 80 neonates were enrolled in the study, with 40 neonates in the vacuum stretcher combined with feeding group and 40 in the conventional sedation group. The vacuum stretcher combined with feeding group had a significantly higher success rate of MRI procedure than the conventional sedation group (P<0.05). As for the neonates who underwent successful MRI examination, the fastest heart rate after examination in the vacuum stretcher combined with feeding group was significantly lower than that in the conventional sedation group (P<0.05), while there were no significant differences between the two groups in transcutaneous oxygen saturation, respiratory rate, and body temperature before and after MRI examination (P>0.05). No complications, such as apnea, acute allergic reactions, and malignant fever, were observed. CONCLUSIONS: Vacuum stretcher combined with feeding can improve the success rate of MRI procedure and reduce the use of sedatives, and meanwhile, it does not increase related risks.

To what extent do paramedics apply safe handling principles when transferring patients from stair chairs to stretchers?

The efficiency of training programmes in handling designed to prevent injuries has rarely been demonstrated by studies in the workplace. This study aimed to identify factors that may favour or inhibit the application of safe handling principles by paramedics performing full-body transfers of patients from a stair chair to a stretcher. In an observational field study, handling methods used in 45 patient transfers from a stair chair to stretcher were characterised. Principles concerning the physical environment seem to be applied frequently, but those applicable during the transfer are neglected. Principles taught during training may not be applied due to the physical constraints of the workplace and the underestimation of risk exposure. The results suggest that training should be enhanced, not by focussing on handling techniques but by focussing on compromise and the capacity to adapt work techniques based on the working context and the team-mate.

Perceived exertion using two different EMS stretcher systems, report from a Swedish study.

BACKGROUND: Emergency medical services (EMS) facilitate out of hospital care in a wide variety of settings on a daily basis. Stretcher-related adverse events and long term musculoskeletal injuries are commonly reported. Novel stretcher mechanisms may facilitate enhanced movement of patients and reduce workload for EMS personnel. AIM: To describe EMS personnel's perceived exertion using two different stretcher systems. METHODS: The methodology of this explorative simulation study included enrolling twenty (n=20) registered nurses and paramedics who worked in ten pairs (n=10) to transport a conscious, 165lb. (75kg) patient using two different EMS stretcher systems: the Pensi stretcher labeled A and the ALLFA stretcher labeled B. The ten pairs (n=10) were randomized to use either an A stretcher or a B stretcher with subsequent crossover. The pairs performed six identical tasks with each stretcher, including conveying stretchers from an ambulance up to the first floor of a building via a staircase, loading a patient on to the stretcher, and using the stretcher to transport the patient back to the ambulance. The subjective Rating of Perceived Exertion (RPE) survey (Borg scale) was used to measure perceived exertion at predefined intervals during transport. RESULTS: No significant differences in workload were seen between stretcher groups A and B regarding unloading the stretcher (7.4 vs 8.2 p=0.3), transporting up a stairway (13.7 vs 12.5 p=0.06), lateral lift (12.1 vs 11.2 p=0.5), or flat ground transportation (10.4 vs 11.1 p=0.13). Pairs using stretcher A showed significantly less workload with regards to transporting down a stairway (11.0 vs 14.5 p<0.001) and loading into ambulance (11.1 vs 13.0 p<0.001). CONCLUSION: A structured methodology may be used for testing the exertion levels experienced while using different stretcher systems. The use of supporting stretcher system mechanisms may reduce perceived exertion in EMS personnel mainly during transports down stairs and during loading into ambulance vehicles.

Comparing the Efficacy of Methods for Immobilizing the Thoracic-Lumbar Spine.

OBJECTIVE: The purpose of this study was to compare the relative efficacy of immobilization systems in limiting thoracic-lumbar movements. METHODS: A dynamic simulation system was used to reproduce transport-related shocks and vibration, and involuntary movements of the thoracic-lumbar region were measured using 3 immobilization configurations. RESULTS: The vacuum mattress and the long spine board were generally more effective than the cot alone in reducing thoracic-lumbar rotation and flexion/extension. However, the vacuum mattress reduced these thoracic-lumbar movements to a greater extent than the long spine board. In addition, the vacuum mattress significantly decreased thoracic-lumbar lateral movement relative to the cot alone under all simulated transport conditions. In contrast, the long spine board allowed greater lateral movement than the cot alone in a number of the simulated transport rides. CONCLUSION: Under the study conditions, the vacuum mattress was more effective for limiting involuntary movements of the thoracic-lumbar region than the long spine board. Moreover, the increased lateral bend observed with the long spine board under some conditions suggests it may be inadequate for immobilizing this anatomic region as presently designed. Should emergency medical service providers choose to immobilize patients with suspected injuries of the thoracic-lumbar spine, study results support the use of the vacuum mattress.

Chest Compression Fraction between Mechanical Compressions on a Reducible Stretcher and Manual Compressions on a Standard Stretcher during Transport in Out-of-Hospital Cardiac Arrests: The Ambulance Stretcher Innovation of Asian Cardiopulmonary Resuscitation (ASIA-CPR) Pilot Trial.

BACKGROUND: Cardiopulmonary resuscitation (CPR) with the use of mechanical devices is recommended during ambulance transport. However, the CPR quality en route and while in transfer to the emergency department (ED) for out-of-hospital cardiac arrests (OHCAs) remains uncertain. We developed a mechanical CPR device outfitted on a reducible stretcher (M-CPR) and compared with standard manual CPR on a standard stretcher (S-CPR) to evaluate CPR quality. METHODS: Adult OHCAs transported by five ambulances in a metropolitan area with a population of 3.5 million (many of whom lived in high-rise buildings) from September to October (before-phase) and November to December (after-phase) in 2015 were collected. The reducible stretcher was developed for use in a small elevator during the transfer from scene to ambulance, and the AutoPulse® (ZOLL Medical, Chelmsford, MA, USA) was used for M-CPR. Chest compression fraction (CCF) was measured by transthoracic impedance data using an X-series® cardiac monitor (ZOLL Medical) during time from attachment to patient to arrival to the ED. A comparison of CCF using a Wilcoxon signed-rank test evaluated the difference between the before- and after-phases. RESULTS: Of the eligible 49 OHCAs, 31 (21 in the before-phase and 10 in the after-phase) were analyzed, excluding patients for whom CCF was not measured, for whom M-CPR was not used, who had a return of spontaneous circulation in the field before transport, or who collapsed during transport. There were no differences in demographic data. Median total CCF (median, q1-q3) was significantly higher in the after-phase M-CPR group (85.2, 83.4-86.3) than in the before-phase S-CPR group (80.1, 68.0-85.2) (p = 0.03). CONCLUSION: Mechanical CPR on the reducible stretcher during the transport of OHCAs to the ED showed a much higher chest compression fraction than standard manual CPR.

Effect of bed width on the quality of compressions in simulated resuscitation: a randomized crossover manikin study.

OBJECTIVES: To investigate the effects of bed width on the quality of chest compressions during simulated in-hospital resuscitation. METHODS: Each candidate performed two 2-minute cycles of compression-only cardiopulmonary resuscitation on an adult manikin placed on either an emergency stretcher (narrow bed) or a standard hospital bed (wide bed) in random order at 1 day intervals. We conducted subjective assessments of cardiopulmonary resuscitation quality and rescuer fatigue at the end of each session, using surveys. RESULTS: There were no significant differences between narrow and wide bed sessions in either mean depth or the percentage of compressions with adequate depth (P=.56 and .58, respectively). The mean rate of compressions and the percentage of compressions with adequate rate were also similar between sessions (P=.24 and .27, respectively). However, the percentage of correct hand position and complete chest recoil was significantly higher in the narrow bed session than in the wide bed session (P=.02 and .02, respectively). In addition, survey results showed that rescuers felt more comfortable and less exhausted in the narrow bed session compared with the wide bed session (P<.001 and < .001). CONCLUSIONS: When rescuers performed chest compressions on an emergency stretcher, chest compression quality increased, and the fatigue of rescuers decreased compared with a standard hospital bed. Therefore, we propose a narrow bed for critically ill inpatients with high risk of cardiac arrest.

Quality between mechanical compression on reducible stretcher versus manual compression on standard stretcher in small elevator.

OBJECTIVES: Manual cardiopulmonary resuscitation (CPR) during vertical transport in small elevators using standard stretcher for out-of-hospital cardiac arrest can raise concerns with diminishing quality. Mechanical CPR on a reducible stretcher (RS-CPR) that can be shortened in the length was tested to compare the CPR quality with manual CPR on a standard stretcher (SS-CPR). METHODS: A randomized crossover manikin simulation was designed. Three teams of emergency medical technicians were recruited to perform serial CPR simulations using two different protocols (RS-CPR and SS-CPR) according to a randomization; the first 6 minutes of manual CPR at the scene was identical for both scenarios and two different protocols during vertical transport in a small elevator followed on a basis of cross-over assignment. The LUCAS-2 Chest Compression System (Zolife AB, Lund, Sweden) was used for RS-CPR. CPR quality was measured using a resuscitation manikin (Resusci Anne QCPR, Laerdal Medical, Stavanger, Norway) in terms of no flow fraction, compression depth, and rate (median and IQR). RESULTS: A total of 42 simulations were analyzed. CPR quality did not differ significantly at the scene. No flow fraction (%) was significantly lower when the stretcher was moving in RS-CPR then SS-CPR (36.0 (33.8-38.7) vs 44.0 (36.8-54.4), P< .01). RS-CPR showed significantly better quality than SS-CPR; 93.2 (50.6-95.6) vs 14.8 (0-20.8) for adequate depth (P< 0.01), and 97.5 (96.6-98.2) vs 68.9(43.4-78.5) for adequate rate (P< .01). CONCLUSION: Mechanical CPR on a reducible stretcher during vertical transport showed significant improvement in CPR quality in terms of no-flow fraction, compression depth, and rate compared with manual CPR on a standard stretcher.

Predictive discomfort of supine humans in whole-body vibration and shock environments.

This work presents a predictive model to evaluate discomfort associated with supine humans during transportation, where whole-body vibration and repeated shock are predominant. The proposed model consists of two parts: (i) static discomfort resulting from body posture, joint limits and ambient discomfort; and (ii) dynamic discomfort resulting from the relative motion between the body segments as a result of transmitted vibration. Twelve supine subjects were exposed to single and 3D random vibrations and 3D shocks mixed with vibrations. The subjects' reported discomfort and biodynamic response were analysed under different support conditions, including a rigid surface, a stretcher and a stretcher with a spinal backboard. The results demonstrated good correlations between the predictive discomfort and the reported discomfort for the different conditions under consideration, with R(2) = 0.69-0.94 for individual subjects and R(2) = 0.94 for the group mean. The results also indicated a strong relationship between the head-neck and trunk angular velocities and discomfort during supine transportation. Practitioner Summary: The quantification of discomfort of supine humans under vibration and shocks by using a predictive model is an important contribution to this field, whereby the efficacy of different transport systems can be compared. The predictive discomfort model can be used as design criteria for ergonomic enhancement in supine transportation of humans.

Jerry can carriage is an effective predictor of stretcher carry performance.

Carrying a casualty on a stretcher is a critical task conducted in a range of occupations. To ensure that personnel have the requisite physical capacity to conduct this task, two bilateral jerry can carries were used to predict individual performance in a four-person stretcher carry. Results demonstrated a bilateral 22-kg jerry can carry (R(2) = 0.59) had superior predictive ability of stretcher carry performance than a bilateral 15-kg jerry can carry (R(2) = 0.46). Pre- to post-carry changes in grip endurance (p > 0.05), back-leg isometric strength (p > 0.05) and leg power (p > 0.05) were not significantly different between carry tasks. There was no significant difference in heart rate (p > 0.05) and oxygen consumption (p > 0.05) between the stretcher carry and either jerry can carry. Thus, on the basis of performance correlations and physiological measures, the 22-kg jerry can carry is an appropriate predictive assessment of four-person stretcher carriage. Practitioner Summary: This study investigated the ability of a jerry can carry to predict individual performance on a four-person stretcher carry. Performance correlations were substantiated with physiological measures to demonstrate similar physical requirements between task and test. These results can be used to set physical employment standards to assess stretcher carriage.

A biomechanical and subjective comparison of two powered ambulance cots.

This study investigated biomechanical effects of different leg folding/unfolding mechanisms used for loading/unloading two powered cots (Cots A and B) into and from a simulated ambulance. Sixteen experienced emergency medical service (EMS) workers loaded and unloaded cots with weights of 45, 68 and 91 kg placed on the cots to simulate patients. Peak back and shoulder/arm muscle activity was reduced 52-87% when using Cot A in comparison to Cot B. Peak ground reaction force (PGRF) was reduced by 74% with Cot A. Adding weight resulted in increased muscle activity and PGRF when using Cot B, but had little effect when using Cot A. Task time was longer with Cot A, though was not perceived unfavourably by participants. This study confirmed that it is possible to substantially reduce physical stress imposed on EMS workers when loading and unloading a cot to and from an ambulance through improvements in cot design. PRACTITIONER SUMMARY: This study compared two powered ambulance cots, one that lifts/lowers the front and rear wheels independently and one that lifts/lowers the four wheels simultaneously during ambulance loading and unloading. Measured muscle activity, ground reaction forces and operator perceptions support using cot designs that lift/lower the front and rear wheels independently.

The Effect of a Liner on the Dispersion of Sacral Interface Pressures During Spinal Immobilization.

Sacral pressure ulcers are a significant problem following spinal cord injury and are felt to be in part due to the high interface-pressures generated while strapped to the spine board. The objective of this study was to determine sacral interface-pressure and sensing area in healthy volunteers on a spine board and the effects of a gel pressure dispersion liner. Thirty-seven volunteers were placed on a pressure-sensing mat between the subject and the spine board. Measurements were carried out with and without a gel liner. Pressures and sensing area were recorded every minute for 40 minutes. The highest pressure was generated at the sacral prominence of each subject. Mean interface-pressures were higher on the spine board alone than with the gel liner (p < .0001). Overall, mean sensing area was lower on the spine board than with the gel liner (p < .0001). Standard spinal immobilization causes high sacral interface-pressures. The addition of a gel liner on the spine board decreased overall mean sacral pressures and increased mean sensing area. Generation of sacral pressure ulcers may be related to the initial interface-pressures generated while the patient is strapped to the spine board. The addition of a gel liner may reduce the incidence of sacral pressure ulcers.