You have a patient with a suspected spinal injury after they were ‘dumped’ in shallow water by a large, powerful wave at your local surf beach. Compare Queensland Ambulance Service (QAS) current spinal injury management with two other Ambulance service guidelines and discuss the current evidence surrounding the recent change in Australian Resuscitation Council Guideline 9.1.6 – Management of a suspected spinal injury in relation to the use of hard collars and backboards for immobilisation, extrication and transport.