Wilderness Medical Society Clinical Practice Guidelines for Spinal Cord Protection

Seth C. Hawkins, Jason Williams, Brad L. Bennett, Arthur Islas, Dietrich Whitfield Kayser, Robert Quinn

Research output: Contribution to journalReview articlepeer-review

10 Scopus citations


The Wilderness Medical Society reconvened an expert panel to update best practice guidelines for spinal cord protection during trauma management. This panel, with membership updated in 2018, was charged with the development of evidence-based guidelines for management of the injured or potentially injured spine in wilderness environments. Recommendations are made regarding several parameters related to spinal cord protection. These recommendations are graded based on the quality of supporting evidence and balance the benefits and risks/burdens for each parameter according to the methodology stipulated by the American College of Chest Physicians. Key recommendations include the concept that interventions should be goal oriented (spinal cord/column protection in the context of overall patient and provider safety) rather than technique oriented (immobilization). This evidence-based, goal-oriented approach does not support the immobilization of suspected spinal injuries via rigid collars or backboards.

Original languageEnglish (US)
Pages (from-to)S87-S99
JournalWilderness and Environmental Medicine
Issue number4
StatePublished - Dec 2019


  • cervical spine immobilization
  • cervical spine injury
  • spinal immobilization
  • spinal injury
  • spinal motion restriction

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Emergency Medicine


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