In a high-speed motor vehicle accident scenario involving a 9-month-old in a rear-facing car seat, how should spinal motion restriction (SMR) be performed?

In the context of a high-speed motor vehicle accident involving an infant in a rear-facing car seat, spinal motion restriction (SMR) should be performed while the child remains securely in the car seat. This approach is important because removing the child from the car seat can pose significant risks.

The rear-facing car seat is designed to provide optimal support and restraint for infants, helping to minimize movement and potential injury during transport. By keeping the child in the car seat, it helps maintain spinal alignment and prevent further injury during the critical period of assessment and stabilization.

Additionally, the infant's size means they are vulnerable to spinal injuries, and the car seat inherently supports their head and neck, reducing the risk of exacerbating any potential spinal or cervical injuries. When SMR is maintained in this way, emergency responders can then strategically and safely transport the child for further medical evaluation without compromising their safety.

Overall, the preference for performing SMR while the child is still in the car seat emphasizes both the safety of the infant and the importance of preserving spinal alignment during the early stages of trauma care.