You have been called for an 87-year-old male who fell in his kitchen while making breakfast. The patient states that he hit his forehead but managed to catch himself on the way down and did not hit the ground 'too hard.' Your assessment reveals him to have kyphosis of the thoracic and cervical spine, but no neurologic deficits. His legs, however, 'feel weaker.' Which action is appropriate given these assessment findings?

Emergency medical services (EMS) first aid for spinal trauma includes: Keeping the head in line with the neck Preventing twisting the head Maintaining an open airway Applying a cervical collar Securing the stretcher Minimizing movement Spinal motion restriction (SMR) is a technique used by Emergency Medical Services (EMS) to limit the movement of a patient's spine, especially when the patient may have sustained a spine injury. SMR involves stabilizing the head, neck, torso, and pelvis to protect the spinal cord from movement of potentially fractured or unstable bone elements. This... Show more

Emergency medical services (EMS) first aid for spinal trauma includes:
Keeping the head in line with the neck
Preventing twisting the head
Maintaining an open airway
Applying a cervical collar
Securing the stretcher
Minimizing movement

Spinal motion restriction (SMR) is a technique used by Emergency Medical Services (EMS) to limit the movement of a patient's spine, especially when the patient may have sustained a spine injury. SMR involves stabilizing the head, neck, torso, and pelvis to protect the spinal cord from movement of potentially fractured or unstable bone elements. This technique includes using cervical collars, gurneys, and other commercial devices to limit the movement of patients with potential spine injuries. 

SMR is used in cases of trauma when certain criteria are met, such as when the patient's GCS is less than 15. EMTs should apply or direct application of SMR when the extent of injury is in question or the patient's history is unreliable. 
The goal of SMR is to limit the spine's lateral movement, rotation, and flexion. The procedure includes:
Limiting flexion, extension, rotation, and distraction of spine
Providing manual stabilization restricting gross motion
Reducing gross movement of patient 
When using SMR, you should avoid methods that provoke increased spinal movement and/or combativeness. 
Improper movement and handling of patients in such situations can lead to permanent disability or even death. 

Other devices currently in use for spinal immobilization include: hard collar with blocks and tape, backboard, scoop stretcher, and vacuum splint.

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