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Again, every situation is different, I recommend that you not spare the backboard straps. Going from side to side and criss-crossing the patient minimizes lateral and up and down movement.Putting the patient on the backboard facilitates a quick head to toe and allows constant monitoring of his condition. If the patient continues to fight, consider sedation in accordance with local protocols. Remember the differential diagnosis of altered mental states, and treat as necessary. Monitor circulation to the extremities. With few exceptions (such as hypoglycemia), the restraints should stay in place until removed by hospital staff.

Fire Engineering Sep 2008: Tactics for Combative Patients, Author: Michael W. Weaver