What is the recommended approach to evacuating a casualty with a suspected spinal injury?

• A. Evacuate only after full immobilization and spinal stabilization during transport
• B. Evacuate immediately without immobilization
• C. Evacuate with no spine board
• D. Evacuate after decontamination first

Answer: (A)

When spinal injury is suspected, any movement can worsen the injury by shifting vertebrae and compressing the spinal cord. The correct approach is to immobilize the casualty first—use manual stabilization, apply a rigid cervical collar, and secure the person to a spine board or rigid stretcher to keep the spine in neutral alignment during transport—and then evacuate. This keeps the spine protected throughout movement and reduces the risk of secondary neurologic damage. Evacuating without immobilization or without a spine board would leave the spine unstable and vulnerable, and decontamination, while important for other reasons, does not address spinal protection and would delay transport.