Rapid extrication from a vehicle should be performed by which approach?

• A. Applying a cervical collar and removing the patient from the car using the direct carry method.
• B. Maintaining support of the head, grasping the patient by the clothing, and rapidly removing the patient from the car.
• C. Applying a vest-style extrication device and sliding the patient out of the car onto a long spine board for full immobilization.
• D. Applying a cervical collar, sliding a long spine board under the patient's buttocks, and removing the patient from the car.

Answer: (D)

In rapid extrication with possible spinal injury, the goal is to move the patient quickly while keeping the spine aligned. The best approach combines cervical spine protection with immediate immobilization by a long spine board placed under the patient as you move them out. By applying a cervical collar and sliding the board under the patient so they can be removed onto the board, you minimize head, neck, and torso movement during extraction and provide continuous immobilization for transport.

This method is preferred because it preserves spinal alignment during the exit and sets up full immobilization right away. Other options either risk movement of the spine (removing by direct carry without a board or grabbing the patient by clothing) or add extra steps that can slow the process (vest-style devices with subsequent transfer onto a board).