Which order is correct for immobilization under spinal motion restriction?

• A. Secure torso before head
• B. Secure head before torso
• C. Secure pelvis before torso
• D. Secure extremities first

Answer: (A)

In spinal motion restriction, stabilizing the spine begins with securing the central trunk so the entire spine stays aligned as you complete immobilization. Securing the torso first creates a solid anchor to the backboard, which minimizes the amount of movement the spine can undergo as you apply additional restraints.

You typically maintain manual in-line stabilization of the head while this is done, then place and secure a cervical collar to keep the neck in neutral alignment. Once the torso is strapped to the backboard and stabilized, you finish by immobilizing the head to the device. This order limits leverage and prevents the head from moving independently while the trunk is being secured.

If the head were secured before the torso, tightening straps around the body could translate into unwanted movement of the neck, increasing the risk of spinal misalignment. Securing the pelvis or extremities first does not provide the same central stabilization, and focusing on extremities first can allow the spine to move as limbs are strapped.