The RLS Lifeguarding Manual (5th Edition, 2018 reprint) gives the below instruction on spinal injury management and immobilisation.
'Lifeguards must use their judgement based on the particular circumstances when making decisions about when and how to place a patient on a spinal board, when to use immobilisation devices such as head blocks and straps (and how many straps), and when to remove the patient from the water. Remember, the priority is always airway management over immobilisation, but in circumstances where airway management has been achieved the use of spinal boards, straps and head blocks to assist in immobilisation is encouraged.
The GSPO recommends that aquatic facilities purchase spinal boards with straps, however the number of straps is not prescribed and use of straps - and how many straps – should be decided based on the particular circumstance. It is recommended that as part of their initial and ongoing training, Lifeguards practice using all the straps that come with a particular spinal board.'
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