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EMS field skills

How to restrict spinal motion (collar and backboard)

Other platforms explain it with text and video. In Making Synapses you practice it on the patient.

EMS (NREMT)
Practice it in VR with Blocky

Modern EMS protocols limit spinal movement in patients at risk instead of boarding everyone. The checks before and after matter as much as the equipment.

Step by step

  1. Decide who needs it

    Altered consciousness, intoxication, neck or back pain or tenderness, new weakness or numbness, or a painful injury that distracts the patient. [1]

  2. Manual stabilization

    One rescuer holds the head in line with the body and does not let go until it is secured. [2]

  3. Check movement and feeling

    Pulse, movement and sensation in all four limbs. [2]

  4. Size and apply the collar

    Measure with your fingers from the shoulder to the jaw and match the collar. Apply it while the head is held. [2]

  5. Move as one unit

    Log roll or use a scoop stretcher, with the person at the head giving the count. [2]

  6. Secure

    Torso first, then legs, then the head. Pad gaps. [2]

  7. Recheck

    Pulse, movement and sensation in all four limbs again. [2]

Common errors

Practice it in Making Synapses

In Making Synapses you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.

Making Synapses cases that train this skill

18 Making Synapses cases train this skill: open the case library

Sources

  1. NASEMSO National Model EMS Clinical Guidelines
  2. NREMT psychomotor skill sheets (EMT and Paramedic)

Facts and steps follow NREMT psychomotor skill sheets (EMT and Paramedic); NASEMSO National Model EMS Clinical Guidelines. Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.