Development of an adaptive spine board overlay for interface pressure reduction during long-range aeromedical evacuation: Implication for pressure injury prevention.

Introduction: Prolonged immobilization during long-range aeromedical evacuation (LAE) is vital for stabilizing patients with spinal fractures, spinal cord injuries, and traumatic brain injuries. However, pressure injuries are a significant risk during long periods of immobilization, as continuous high pressure on soft tissues can lead to ulceration. This paper introduces a novel adaptive spine board (ASB) overlay, an air-cell-based support surface, designed to optimize interface pressure redistribution during LAE. Methods: The ASB overlay was developed, tested, and compared with currently available MedEvac Litter and warrior evacuation litter pad (WELP) in terms of immersion and interface pressure. Furthermore, a pressure-maintaining algorithm was tested to ensure that the pressure within the air cells remains constant, regardless of environmental effects due to climate and elevation changes. Results: The American National Standard for Support Surfaces immersion test showed the ASB overlay achieved 10 mm more immersion than the WELP. The interface pressures for all regions of the ASB overlay were lower than those seen in the litter and the WELP, with values remaining below 40 mmHg. Conclusions: These results demonstrated that the ASB overlay can reduce more interface pressure compared to commercial support surfaces while maintaining set air cell pressure under varying pressure and temperature conditions.