Once in hospital the board serves no purpose above that of a firm bed and should be removed as soon as practical during they early phase of assessment. Controlled transfers in hospital can be carried out with sliding boards or scoop systems, provided there are enough trained individuals to perform the manoeuvers. Consider the relationship if the axial skeleton to the backboard. In adults, the head is relatively smaller in an AP direction than the body and the cervical spine may be in extension without some form of occipital padding. The converse is true in children, who have relatively larger heads and will have a cervical spine in flexion.
Some backboards have recessed pits for child heads.