For years, first aiders were taught one rule above all others: “Don’t move them!” 

Back then, “immobilise the spine” meant collars, backboards, and keeping casualties perfectly still at all costs. 

 

But modern research — and new guidance from both the Wilderness Medical Society (WMS, 2024) and the UK Faculty of Pre-Hospital Care (RCSEd, 2025) — has changed the way professionals and rescuers think about spinal care. 

 

Today, the goal is Spinal Cord Protection (SCP) — not rigid immobilisation. 

A broken femur (thigh bone) is one of the most serious injuries you can face outdoors. It’s not just a painful fracture – it’s a life-threatening emergency that can cause massive internal bleeding and shock. It can kill you, the casualty needs to be in hospital ASAP, with safe, expedient evacuation. Not an orange survival bag, six rocks, a broom handle and a wish and a prayer. 

 

So what should a first aider actually do? Do you call 999 and wait, or do you try and splint the leg with sticks and bandages? 

 

I can remember early in my career, outdoor courses making improvised traction splints, it was a laugh and we thought it was cool. Three decades down the line and having attended serious fractures of the pelvis and femur, it is not a laughing matter. 

 

It is not as easy in real life as it is in a classroom, it is incredible painful and the risks are high if you cock it up. Add to that, we will have to take everything off to put proper splints in place. More movement, more pain, more time wasted. 

 

Let’s break it down.