The correct answer is B. Place padding under the torso only.
Key Pediatric Anatomical Difference:
Children (especially under ~8 years old) have a larger occiput (back of the head) relative to their body. When lying flat on a backboard:
The head is naturally pushed forward (flexed position)
This can compromise the airway and spinal alignment
Correct Technique:
To achieve a neutral airway and spinal alignment:
Padding is placed under the torso (shoulders/back)
This raises the body and allows the head to fall into a neutral position
NREMT-aligned guidance states:
“Due to a larger occiput, pediatric patients may require padding under the torso to maintain a neutral airway.”
“Avoid placing padding under the head alone, as this worsens flexion.”
Why the other options are incorrect:
A. Padding under the head only→ Worsens neck flexion, potentially compromising airway
C. Padding under both head and torso→ Unnecessary and may misalign the spine
D. No padding→ Leaves the head in a flexed, non-neutral position
Exact Extracts (NREMT-aligned EMT educational references):
“Children have a proportionally larger head, causing flexion when supine.”
“Padding under the torso helps achieve neutral alignment.”
“Maintain neutral in-line stabilization during immobilization.”
Clinical Priority Summary:
Because pediatric patients naturally fall into neck flexion on a backboard, placing padding under the torso restores neutral alignment, making B the correct answer.
[References:, NREMT EMT Education Standards – Trauma (Spinal Immobilization – Pediatrics) , NREMT National Continued Competency Program (NCCP) , AAOS Emergency Care and Transportation of the Sick and Injured (NREMT-aligned) , ============================================, , , , , ]
