How should you handle a patient with suspected spinal injury who requires extrication from a vehicle?

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The key idea is protecting the spine during any movement. In a vehicle extrication with suspected spinal injury, you keep the head, neck, and spine in alignment the whole time—using inline stabilization—and you move the patient only as a coordinated team to minimize motion. A coordinated roll with responders lets everyone work together to transfer the patient onto a backboard or immobilization device without twisting or bending the spine. This approach reduces the risk of secondary injury during the extrication.

Moving the head first would disrupt spinal alignment and risk worsening injury. Removing the cervical collar before extrication removes a critical stabilizing measure during a vulnerable moment. Asking the patient to crawl out unaided invites unpredictable movement and potential harm to the spine and airway.