1032026 ART V6

Safety training

G WO Advanced Rescue Training Standard / V6 02032026

2. The Danish evidence -based guideline on spinal stabilisation of adult trauma patients (Maschmann et al., 2019) reaches similar conclusions: ⁴

e.

Evidence that rigid collars improve outcome is weak.

f. There is concern for harm (including increased mortality in some subgroups,

↑ ICP, airway issues and

pressure sores).

g. Routine prehospital rigid -collar use is not recommended. Instead, the guideline emphasises:

g.i spinal motion restriction using manual support and patient cooperation;

g.ii vacuum mattress or similar whole -body support when required;

g.iii self- or minimally assisted extrication where safe.

2.3 Extrication and movement research

⁵ ⁶

Extrication and biomechanical studies (including the EXIT project) show that:

• Self-extrication or minimally assisted extrication with verbal instructions often causes equal or less spinal movement than device -based extrication with collar and long spinal board.

Long spinal boards are best regarded as short

-term extrication devices, not transport devices;

prolonged use is associated with discomfort and potential harm.

• National inquiries and safety alerts have highlighted the risk of worsening thoracic, abdominal or pelvic injuries when patients are suspended or vertically lifted on a board, particularly if it is attached to a harness.

3.

Non-Routine use of a cervical collar during rescue

Within ART, the cervical collar is considered a non -routine, last -resort option for head support.

Wherever possible, rescuers shall prioritise:

1. Self-control by the injured person (conscious casualty instructed to minimise head movement).

2. Manual support of the head and neck by a rescuer, with careful movement and clear communication.

3. Device -based support from the primary packaging system (e.g. head blocks, straps, padding on a stretcher or vacuum mattress) configured in accordance with the manufacturer’s instructions.

A cervical collar may be considered only when all of the following are true:

The injured person is unconscious or cannot reliably follow instructions.

Mechanism or findings suggest a possible spinal injury.

Global Wind Organisation ©2026 / www.globalwindsafety.org

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