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Spinal Injury & Motion Restriction — NREMT Cheat Sheet

Restrict motion, not every patient
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👤 By the CinnaEMS Content Team 🕐 Updated 2026-09-27 🏷️ Patient Treatment & Transport 🔖 Free to read, print, and share

Also known as: SMR · spinal immobilization · c-collar · cervical spine · backboard · neurogenic shock · spinal cord injury

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Use this quick-reference guide to recognise, treat and hand over Spinal Injury & Motion Restriction on the NREMT and on the call. Keep it handy during review and on exam day!

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📒 The 1-minute cheat sheet

📌 Who

  • Altered or intoxicated
  • Midline pain or tenderness
  • Deficit · distracting injury

✅ How

  • Manual first, then collar
  • PMS before and after
  • Board = extrication only

🩺 Watch

  • Airway beats the collar
  • Low BP + slow pulse → neurogenic

📚 Spinal Injury & Motion Restriction — full study notes

The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what changes the plan, and what to hand over.

Spinal care has moved from routine backboarding to selective spinal motion restriction. The exam asks who needs it, how to keep the spine aligned and why neurologic checks come before and after.
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Key points

Understand these first
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Treatment priorities

What to do, in order
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Red flags — report now

Escalate immediately
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Patient teaching

What patients must know

❓ Spinal Injury & Motion Restriction: NREMT FAQs

What are the priority actions for Spinal Injury & Motion Restriction in the field?

Airway beats the collar: use a jaw thrust and reposition if the airway is compromised. Keep the head, neck and torso in line during every move. Pad elderly and small patients to keep neutral alignment.

What findings in Spinal Injury & Motion Restriction change your plan or your transport decision?

Low blood pressure with a slow pulse and warm skin (neurogenic shock). New numbness or weakness. Loss of bowel or bladder control.

What do I need to know about Spinal Injury & Motion Restriction for the NREMT?

Indications: altered, intoxicated, midline spinal pain or tenderness, focal deficit, distracting injury. Manual stabilization first, then a sized cervical collar and a firm surface or scoop. Check pulse, motor and sensation in all four extremities before and after immobilizing. Long backboards are for extrication, not for lying on during transport.

What should the crew communicate or document for Spinal Injury & Motion Restriction?

Remove a helmet only when it blocks airway care or does not fit snugly.

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Quick Tip

Indications: altered, intoxicated, midline spinal pain or tenderness, focal deficit, distracting injury.

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