Always initiate manual cervical immobilization before application of the XCollar. If patient is found in the supine position special care and consideration must be taken to minimize unnecessary manipulation of the cervical spine. The Back Support should be placed behind the patient's neck and between the shoulder blades as close to the body as possible (Pic 24).

Hold the Back Support firmly from the top center when sliding it in place using an angular motion to utilize the natural gap between the shoulder blades (Pic 25). This will facilitate the downward movement of the XCollar while avoiding unnecessary cervical manipulation. To continue application of the XCollar follow the Neutral Position or Position of Comfort application steps.