Selective Spinal Immobilization

Revision of 08/2026 Removed the routine use of Cervical Collars when ALL Omission criteria are met.

1. Purpose:  To determine which patients may have spinal immobilization safely omitted.

2. Patients for whom immobilization on a backboard is NOT necessary include those with all of the following:

a. Normal level of consciousness

b. No spine tenderness or anatomic abnormality

c. No neurologic findings or complaints

d. No distracting injuries

e. No intoxication

3. Immobilization on a rigid backboard is NOT REQUIRED in the following situations unless spinal injury suspected:

a. Penetrating injuries of head, neck, or trunk

b. Isolated fall from standing position

c. Ambulatory MVA patient

4. ALL TRAUMA PATIENTS SHOULD HAVE A CERVICAL COLLAR APPLIED REGARDLESS OF THE ABSENCE OF NECK PAIN including nursing home falls.

5. Trauma patients with back pain should be transported in a SUPINE position.   The head of the EMS stretcher may be inclined 10 - 20 degrees - if any of the following are present:

a. Head injury

b. Respiratory compromise

c. Morbid obesity

6. Whether or not a patient is secured on a backboard, spinal PRECAUTIONS should always be observed i.e. limited movement and securing to the EMS stretcher.