Feb 1, 2018
Different Approaches?
Aimee Brunelle

When working with emergency medical services (EMS), athletic trainers might be surprised to encounter differences in trauma protocols, such as spine boarding. In certain cases, EMS will no longer immobilize those with suspected cervical spine injury to a backboard. Instead, they may place the patient directly on a stretcher and transport them with only a cervical collar.

These protocols were changed for EMS in 2015 and were based on NEXUS (National Emergency X-Radiography Utilization Study) criteria. The reasoning for the shift is because full immobilization to a backboard is uncomfortable, even painful. It also increases the amount of time needed to transport the patient, puts them in a vulnerable position, and increases their risk of aspiration. Some studies have even shown that spine boarding is often unnecessary — according to the New York State Department of Health, 97 percent of 800,000 patients surveyed who were backboarded had negative cervical X-rays.

Now, the concept of “spinal motion restriction” versus “immobilization” in EMS protocols allows for various methods to be used. In New York, for example, a sports injury with spinal trauma needing spinal motion restriction would involve the use of a properly fitted cervical collar. Although a spine board could be used to transfer the athlete to the stretcher, the stretcher alone would provide adequate spinal motion restriction.

Image by Ron Cogswell

Aimee Brunelle, MS, ATC, EMT, is the Athletic Trainer and District Wellness Coordinator at Colonie High School in Albany, N.Y. She is a Past President of the New York State Athletic Trainers' Association (NYSATA) and the current Newsletter Editor for NATA District 2. In June, she received the NYSATA's 2017 Kent Scriber Recognition Award.

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