A backboard immobilization device includes a first section having a plurality of interconnected panels and a second section having a like plurality of interconnected panels. A coupling assembly releasably couples the first section to the second section. The coupling assembly comprises a male insert having a plurality of ratchet teeth. The male insert is coupled to the first section. A female coupler has a pawl for releasable engagement with the plurality of ratchet teeth. The female coupler is coupled to the second section. An assembly including the backboard immobilization device and an inflatable air bladder assembly is also disclosed.