Skill sheet · About 10 minutes
Spinal Motion Restriction
Modern EMS restricts spinal motion rather than rigidly immobilizing everyone. The station tests whether you assess neurologic function before and after, size the collar correctly, and move the patient as a unit.
Step-by-step order
- BSI and scene safety; direct manual in-line stabilization immediately.
- Assess and document distal pulses, motor function, and sensation in all four extremities.
- Size and apply a rigid cervical collar without moving the head.
- Position the device — long board, scoop, or vest-type for seated extrication — per protocol.
- Move the patient as a unit with a coordinated count; the person at the head calls it.
- Secure the torso first, then the pelvis and legs, then the head last.
- Pad voids to keep the spine in neutral alignment.
- Reassess pulses, motor, and sensation in all four extremities.
- Verbalize continued monitoring and transport.
Critical fail criteria
- Failed to immediately direct or take manual in-line stabilization.
- Failed to assess motor, sensory, and circulatory function before and after.
- Moved the patient excessively, compromising spinal integrity.
- Secured the head before the torso.
- Applied a collar that allows excessive movement or is the wrong size.
- Failed to keep the head in a neutral in-line position.
Say-it-out-loud script
Examiners score what they hear. Narrate the station: "Taking manual in-line stabilization now. Pulses, motor, and sensation present in all four extremities. Sizing and applying the collar. On my count, we move as a unit — one, two, three. Torso straps first, then pelvis, then the head. Rechecking PMS in all four extremities."
FAQ
Which patients need spinal motion restriction?
Those with midline spinal tenderness, neurologic deficit, altered mental status, intoxication, or a distracting injury with a concerning mechanism. Reliable patients with none of these do not require it.
Why is the head secured last?
Strapping the head first turns the neck into a lever if the torso shifts. Torso, then pelvis and legs, then head.
Is the long backboard still used?
Mostly as an extrication device rather than a transport surface. Many systems transport on the cot with a collar. Follow local protocol and verbalize your reasoning.
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