Children restrained in a car seat (with a high back) may be immobilized and extricated in the car seat; however, once removed from the vehicle, the child should be placed in:

• A. spinal immobilization
• B. backboard immobilization only
• C. no immobilization is needed
• D. a neck brace only

Answer: (A)

When there’s potential spinal injury after a crash, you keep the spine immobilized during and after extrication. A child may be safely removed from a car seat, but movement can still worsen an undetected spine injury. Therefore, once outside the vehicle, place the child in spinal immobilization with a cervical collar and secure them to a rigid backboard or immobilization device to keep the head, neck, and spine aligned during transport. A neck brace alone doesn’t control motion of the rest of the spine, and backboard alone without neck stabilization is insufficient. No immobilization is not appropriate given the injury risk.