To immobilize or not immobilize: that is the question

For those practicing selective immobilization, the strongest protection from liability is to avoid aggravating or causing injury by withholding c-spine immobilization from a patient who needs it. That means applying c-spine decision tools as objectively and carefully as possible. Prehospital providers in areas that use those tools should be trained to adequately assess the cervical spine and receive regular continuing education to maintain adequate performance. Applied correctly, selective spinal immobilization can be a great tool for decreasing patient discomfort, encouraging reluctant patients to seek medical care and reducing patient-provider conflicts. Any system that chooses to selectively apply cervical spine immobilization to trauma patients must regularly review cases in which spinal immobilization is withheld to determine effectiveness of, and ensure adherence to, decision criteria. Patients deserve the best care we can give them, with or without immobilization.