How should a casualty with suspected spinal injuries be evacuated?

• A. Evacuate without immobilization
• B. Use rigid immobilization; secure on spine board; maintain in-line stabilization during transport
• C. Use soft immobilization only
• D. Place patient prone for transport

Answer: (B)

Protecting the spine during movement is essential when a spinal injury is suspected. The safest approach is rigid immobilization with the person secured on a spine board and kept in a neutral position with the head and neck stabilized throughout transport. This setup limits any movement of the spine, helping prevent a secondary cord injury as the casualty is moved to safety or into care.

To implement this, apply a rigid cervical collar if available, log-roll the casualty onto a long backboard while maintaining in-line alignment, secure the body with straps across the chest, pelvis, and legs, and immobilize the head with blocks or a head immobilizer. Throughout transport, maintain the head and neck in a straight, neutral position to prevent any flexion, extension, or rotation.

Evacuating without immobilization allows movement of the spine and can worsen injury. Soft immobilization is less stable and more easily disrupted. Placing the patient prone is generally not appropriate for suspected spinal injury and can complicate airway management and spinal alignment.