This topic is discussed here often. Try the search feature to find them.
A lot of services now use selective spinal protocols using the Canadian c spine rules, nexus, or something similar.
Every service I know of up here in Canada uses the Canadian c spine rules or a variation of it. Maine uses something very close to nexus. There are also a growing number of services who are using long boards for what they were intended... An extrication and carrying device . NH eliminated pts being transported on boards in their last state wide protocol update.
We (UK) have been using CCSR and/or Nexus for a few years and using the lard as an extrication tool only for the past 10 years. We are expecting a national guideline allowing us to allow the patient self mobilise from an RTC even if they have mid-line tenderness under certain circumstances. This should be in by Christmas.
There are going to be a fair few paramedics who will ignore the advise based upon 30 years of historical practice. I'm hoping there will be a middle ground of common sense in it's application. http://prehospitalmed.com/2013/12/0...mmobilisation-an-initial-consensus-statement/
Here in MA the selective c spine protocol has completely removed longboards. We only carry one for extrication and we also have a modified scoop. But if a spinal injury is suspected only a collar is applied, minimal movement from the pt, "secure/immobilize" the pt on the stretcher. There's a whole Algorhythm to follow to be able to not even use a collar
Hopefully all of them... I'm fighting an uphill battle trying to get my providers to stop using them because "that's the way it's always been done". That is the worst reason in the world to do something, but it appears that EBM doesn't mean anything to the majority because they cling to what they learned in EMT class 20+ years ago. Our protocol, however, does call for selective immobilisation, though what actually happens is often totally different. Keep in mind, we're a department-based protocol that differs from the state and region, so I'm not sure of the specifics of other areas.