Selective Spinal Motion Restriction
Modern protocols focus on patients with a mechanism or findings suggesting spinal injury. Indications include midline spinal tenderness, neurologic deficit, altered mental status, intoxication, and distracting injuries. Clinical decision rules help identify patients who can safely skip restriction.
Equipment
A cervical collar with a stretcher mattress or vacuum mattress is now preferred in many systems. The long board is primarily an extrication and transfer device rather than a prolonged transport surface. Prolonged board use causes pressure injuries and pain.
Practical Considerations
Always maintain manual stabilization during assessment and movement. Monitor the airway, since collars can restrict mouth opening and impair ventilation. Document neurologic findings before and after movement.