Wilderness Medical Society practice guidelines for spine immobilization in the austere environment: 2014 update

Wilderness Environ Med. 2014 Dec;25(4 Suppl):S105-17. doi: 10.1016/j.wem.2014.05.004.


In an effort to produce best practice guidelines for spine immobilization in the austere environment, the Wilderness Medical Society convened an expert panel charged with the development of evidence-based guidelines for management of the injured or potentially injured spine in an austere (dangerous or compromised) environment. Recommendations are made regarding several parameters related to spinal immobilization. These recommendations are graded on the basis of the quality of supporting evidence and balance between the benefits and risks or burdens for each parameter according to the methodology stipulated by the American College of Chest Physicians. A treatment algorithm based on the guidelines is presented. This is an updated version of original WMS Practice Guidelines for Spine Immobilization in the Austere Environment published in Wilderness & Environmental Medicine 2013;24(3):241-252.

Keywords: cervical spine clearance; cervical spine immobilization; cervical spine injury; spinal immobilization; spinal injury; spinal trauma.

Publication types

  • Practice Guideline

MeSH terms

  • Algorithms
  • Humans
  • Immobilization / instrumentation
  • Immobilization / methods*
  • Practice Patterns, Physicians'*
  • Societies, Medical
  • Spinal Cord Injuries / therapy*
  • Spinal Injuries / therapy*
  • Wilderness Medicine* / methods
  • Wilderness Medicine* / standards