For me, using the Maine spinal protocols is a must. In the backcountry of Maine's north woods, extraction of an injured crew member can take up to 12 or more hours just to get to a suitable take out for a traditional transport to an ER. The amount of discomfort would just be too great, as well as the risks associated with putting a strapped in patient in a canoe on a big lake with rolling swells, or a river with white water. Strapping a patient to a board here requires careful consideration of many subjective, and objective risk factors, some of which, there are no control over.....