Related Experiment Video
Updated: Mar 10, 2026
Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
Published on: November 8, 2024
EMS Providers' Beliefs Regarding Spinal Precautions for Pediatric Trauma Transport
Insights
Emergency Medical Services (EMS) providers believe rigid cervical collars and soft backboards are best for pediatric spinal precautions. However, there was no consensus on specific precautions for different pediatric ages or injury risks.
Area of Science:
- Emergency Medicine
- Pediatric Trauma Care
- Prehospital Care
Background:
- Spinal precautions are critical in pediatric trauma.
- Current guidelines for pediatric spinal immobilization lack consensus.
- Understanding Emergency Medical Services (EMS) provider beliefs is essential for improving care.
Purpose of the Study:
- To describe prehospital EMS providers' beliefs about spinal precautions for pediatric trauma transport.
- To assess EMS provider preferences for specific spinal precautions based on child's age and injury risk factors.
Main Methods:
- Nationally certified EMS providers were surveyed.
- Beliefs about specific precautions and preferred interventions were assessed.
- Data were analyzed based on provider demographics, experience, and call volume.
Main Results:
- A majority of EMS providers believed rigid cervical collars and long backboards with soft surfaces maintain optimal pediatric spinal position.
- Less than half believed rigid long backboards were useful for pediatric spine protection.
- No consensus was reached on specific precautions for different pediatric age groups or injury risk factors.
Conclusions:
- EMS providers favor rigid cervical collars and soft-surfaced long backboards for pediatric spinal precautions.
- Lack of consensus exists regarding the application of specific spinal precautions based on pediatric age and injury risk.
- Further research and standardized protocols are needed to optimize pediatric trauma spinal care.
Objective:
Describe prehospital Emergency Medical Services (EMS) providers' beliefs regarding spinal precautions for pediatric trauma transport.
Methods:
We randomly surveyed nationally certified EMS providers. We assessed providers' beliefs about specific precautions, and preferred precautions given a child's age (0-4 or 5-18 years) and presence of specific cervical spine injury (CSI) risk factors.
Results:
We received 5,400 responses (17%). Most were Paramedics (36%) or EMTs (22%) and worked at fire-based services (42%). A total of 47% endorsed responding to pediatric calls more than once per month. Consensus beliefs (>66% agreement) were that rigid cervical collars (68%) and long backboards with soft conforming surfaces (79%) maintain an injured pediatric spine in optimal position. Only 39% believed in the utility of the rigid long backboard to protect the pediatric spine. For most risk factors in both age categories, a rigid cervical collar with a long backboard with a soft conforming surface was the most common response (28-40% depending on age group and risk factor); however, there were no consensus beliefs. Provider-level experience, working as a patient care provider, less education, and parent status were associated with endorsing the rigid cervical collar. Factors associated with endorsing the rigid long backboard included provider level, working as a patient care provider, low pediatric call volume, and less education.
Conclusions:
EMS providers believe that rigid cervical collars and long backboards with soft conforming surfaces provide optimal spinal precautions. There were no consensus beliefs, however, for use of particular precautions based on age and risk factors.
