It really depends on who someone is employed by as to how aggressive they are about C-Spine protocols. I happen to work a lot of "event medicine" (Baseball games, triathlons, wrestling matches, volleyball games, etc). If I C-Spine'd everyone who had a minor hit to the neck or head, we'd be too busy using boards to provide care to others. Each company or agency sets up their own protocols, which have to be observed by those working for them, or they risk losing their jobs. Litigation does drive a lot of this, unfortunately. Now, that said, there may be changes occurring in the industry. I actually see less C-Spine at accidents nowadays than, say, 5 years ago. Considering there has been no appreciable difference in outcomes from patients placed in C-Spine vs not (I come from when we didn't routinely do this... back in the late 70's and early 80's), it seems this may switch back to major injuries only. Which is better for us, and more importantly, better for our patients. If you have ever been strapped to a board for more than an hour (I have), you know how bad your back feels just from the board. I can't remember where I heard about it, but there is a study from (I think) Australia that shows outcomes were no different.