I'm a member of the National Ski Patrol, and this year at the OEC refresher we were told (repeatedly) that EMTs no longer use backboards as immobilization devices, so we shouldn't be surprised if paramedics ask us to take a patient off of one for transfer to a stretcher. We were also told to put a blanket under the patient when possible to make transport easier, and that NSP would likely be switching soon.

We weren't, however, told why this change is happening.

Why aren't EMTs using long spine boards as immobilization devices anymore? NSP is apparently planning to change, so it's clearly not limited to ambulances.

Also, I couldn't tell if it was an EMT standard of training change or local protocol, so apologies if it's the latter. If it's local, it's going to be local to New York State, in the USA.

I'm not sure if emergency care is on-topic here, but I saw nothing indicating it wasn't. Also, just joined this community, so I have no idea what the tags are. Apologies.


1 Answer 1


I took a quick look at the National Registry site, and their practice tests still show protocols and usage questions for backboard application, so if it is a new national EMS policy, then it isn't showing on the tests.

However, I was able to find a couple of articles on EMSWorld and on JEMS (Journal of Emergency Medical Services) citing current research that shows:

  • Increase pain/pressure with backboards
  • Increased constriction of breathing with backboards (Due to the straps)
  • Increased airway compromise with collars and backboards (Exacerbated in patients with COPD and other breathing compromises)
  • Increased inability for patients to protect their own airway

The American Heart Association has noted from a 2010 study, that in drowning victims

Routine c-spine immobilization is a Class III (potentially harmful) unless clear trauma is evident in the history or exam, because it may unnecessarily delay or impede ventilations. Writeup

And as of March 2014, at least some of the EMS groups in Kansas were moving away from using backboards in the field.

TL; DR: I can't find it as an official policy, so I would suspect that much like Kansas, it is a local EMS policy decision based on some of the most current research on the subject.

  • EMS protocols are almost always local policy decisions, although quite often "local" means at the state level. There are no national EMS protocols in the US. That said, the death of the backboard is long overdue and has been in the discussion phase since the 1990s. There is no evidence showing they are helpful and significant evidence showing they are harmful.
    – Carey Gregory
    Commented Mar 22, 2016 at 19:38

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