The Stabilization Protocol: A Mini Review on Evidence-based Traumatic Stabilization

Standard spinal immobilization traditionally involving a spinal board and cervical collar, has long been the prehospital standard of care for trauma patients. However, recent studies highlight potential adverse effects, including pain and respiratory impairment. A narrative mini-review was conducted using Medline, Web of Science, Scopus, and Google Scholar. Nine articles published in the last five years were selected, comprising observational studies, literature reviews, and expert consensus documents. The S.T.A.B.I.L.E. protocol emerged as a structured, evidence-based decision-making model for prehospital spinal management. Integrated within the Airway, Breathing, Circulation, Disability, Exposure framework, it supports emergency medical services personnel in assessing whether to apply and, if so, how to apply spinal motion restriction, considering clinical and logistical variables. Compared to traditional protocols such as NEXUS and the Canadian C-Spine Rule, S.T.A.B.I.L.E. emphasizes a broader clinical context-such as respiratory status, hemodynamic stability, and environmental conditions-providing a more pragmatic and patient-centered approach. The protocol may enhance patient safety, reduce unnecessary immobilization, and support clinical decision-making. While the S.T.A.B.I.L.E. protocol represents a promising alternative to traditional immobilization practices, further clinical validation is needed to confirm its efficacy and facilitate its adoption in prehospital trauma care. Keywords: Trauma, emergency medical services, spinal cord, immobilization, spinal motion restriction