The NIEJ is primarily an interim device for use on sitting patients to take the patient from the sitting position to a lying position on a Long Spine Board or Vacuum Mattress.

The NIEJ is indicated for use as a cervical splinting device when the patient is found in a confined or restricted space, and where:

1. Signs & symptoms of potential or actual spinal cord / column injury exist

                                           OR

2. Mechanism of Injury exists without signs & symptoms of  spinal cord / column injury, but the patient has:      

• Altered Conscious State

• Alcohol Consumption

• Distracting Injury

The NIEJ has a number of limitations that should be considered when deciding on whether to use as a cervical splint:

1. Can be time consuming to apply varying upwards from 4 minutes.
   
   

2. Whilst providing excellent cervical spine immobilisation, the NIEJ provides only moderate thoracic / lumber support.
   
   

3. May be difficult  to insert when:

• Access to torso is limited 
  
  
  

• Patient is sitting, but inclined on side at an angle greater than 30°
  
  
  

• Patient is sitting, but inclined backwards at an angle greater than 30°  
  
  

When applying the NIEJ,  the following precautions should be considered:

1. Chest straps too tight can interfere with respiratory effort.
   
   

2. Groin straps not placed within the gluteal fold, or not sufficiently secure may result in the NIEJ sliding up during the extrication potentially causing  neck stretch.
   
   

3. Incorrect head padding can lead to cervical spine hyperextension or hyperflexion.
   
   

4. Immobilising the head to the NIEJ without properly securing the torso section may cause c-spine movement.

The NIEJ is contraindicated for use as a cervical splint when:

• The patient is actual time critical,  

                                     AND

• The application of the NIEJ will directly delay transport to a trauma centre or appropriate hospital.