Cervical stabilization is indicated in any patient who meets the indications (A-E) below:

This procedure may be performed on any patient with potential for spinal injury based upon the following (NEXUS) criteria:
A.  Midline cervical spinal tenderness
B.  Focal neurologic deficit
C.  Altered mental status
D.  Evidence of drug and/or alcohol intoxication
E.  Any painful, distracting injury

Cervical stabilization is NOT performed in the following conditions:
A.  Penetrating trauma to the head and/or neck and no evidence of spinal injury
B.  Injuries where placement of the collar might compromise patient assessment, airway management, ventilation and/or hemorrhage control
C.  Patients in cardiac arrest

Key procedural considerations:
A.  If (A-E) above are ALL NEGATIVE, cervical stabilization is not required.
B.  If required, cervical stabilization is the placement of an approved, properly- sized cervical collar before the patient is moved.
C.  Backboards are only indicated for extrication and patient movement. Patients are not to be transported on backboards (unless movement off the backboard would delay immediate transport of patients with life-threatening injuries or acute spinal injuries).
D.  Tape, head straps, wedges, and head and/or neck support devices are not recommended.
E.  Patients found in motor vehicles should be asked if they are able to exit the motor vehicle on their own. If so, they should be assisted to a soft stretcher and secured for transport. Patients unable to exit the vehicle on their own accord should be removed by the appropriate extrication method.
F.  Once on the stretcher, the patient may be moved to a semi-Fowler’s or high-Fowler’s position for comfort.
G.  If a backboard is used for extrication or movement, the patient should be immediately moved to a soft mattress, if possible.
H.  In special situations, alternate stabilization devices lpar;e.g. vacuum mattress, KED, etc. may be used as indicated).
I.  Pediatric patients may be stabilized in an approved car seat or with a commercial pediatric stabilization device.