b'Spinal Immobilisation Techniques and DevicesChapterThe clinical importance of immobilising spinal injuries prior to hospitalisation remains uncertain / unproven. There have been no random / controlled medical experiments / studies on immobilisation techniques or devices for trauma patients with suspected spinal cord injury.Fitting / applying a semi rigid cervical collar can result in many potential adverse effects including:unnecessary movement of the head and neck with the sizing and fitting of the collardiscomfort and painrestricted mouth opening and difficulty swallowingairway compromise should the patient vomitpressure on neck veins raising pressure within the brain (harmful to head injured patients)hiding other potential life-threatening conditionsA first aid principle is to prevent further harm / injury.Therefore, the use of semi rigid cervical collars by first aiders is not recommended.In the event of a suspected cervical spine injury, it is recommended that the initial management should be to provide gentle support of the head in a natural, neutral position, limiting angular movement in healthy adults. Padding under the head (approximately 2cm) may assist the neutral position.Spinal Boards Rigid backboards placed gently under the patient can be used should it be necessary to move the patient. The benefits of stabilizing the head will be limited unless the motion of the trunk is also controlled effectively during lifting / transport.Patients should not be left on rigid spinal boards as pain can develop in the neck, back of the head, shoulder blades and lower back. The same areas are also at risk of pressure necrosis (death of living tissue).A conscious patient may attempt to move around in an effort to improve comfort, potentially worsening the injury. A paralysed or unconscious patient is at higher risk of development of pressure necrosis due to the lack of pain sensation. Strapping has been shown to restrict breathing and should be loosened if causing further injury or discomfort.A patient may be more comfortable on a padded spine board, air mattress or bead filled vacuum mattress (devices used by ambulance service).The Log Roll The log roll is a manoeuvre generally performed by a trained team, to gently roll a patient from their back onto their side, and then flat again, so as to examine the back and/or to place or to remove a spine board. It is also a technique used to gently roll a person onto their side (recovery position) eg. sport.98 Head, Neck and Spinal Injury'