The use of the spinal immobilization in prehospital settings is still the most effective device for the patient’s safety? A narrative review of the literature

Introduction: in out-of-hospital treatment, immobilization of the spine with the spinal board and cervical collar has been considered the best method to ensure patient safety for many years. In recent years, many doubts have arisen about the actual effectiveness of this practice. The aim of this paper is to find out if this garment is still the best for the patient and to find possible alternatives to its use.

Materials and Methods: a literature search was conducted by consulting Medline databases via PubMed, GoogleScholar, Web of science and Scopus. The search was conducted in the month of January 2023. Articles in Italian and English dealing with the use of the spinal board and other immobilization aids published within the last 5 years were included.

Results: 33 articles were identified in the various databases and 10 articles were subsequently included in the review.

Discussion: the use of the spinal board in the out-of-hospital setting is no longer the most effective method of ensuring patient safety and can only be used in certain cases. The use of spinal motion restriction takes the field as an alternative technique.

Conclusions: it is necessary that standard immobilization with a cervical collar and spinal board be performed only incases where it is considered truly necessary. Operators should use tools that help them identify such high-risk individuals.