During extrication, who should guide the movement of a patient being removed from a vehicle?

• A. The patient
• B. The driver
• C. The most senior firefighter on scene
• D. The person holding c-spine

Answer: (D)

In vehicle extrication, keeping the spine, especially the neck, in a stable position is the top priority. The movement of the patient should be guided by the person who is maintaining cervical spine immobilization because any rotation, flexion, or abrupt movement can worsen a spinal injury. This responder holds the head and neck in a neutral alignment and directs the team with clear commands as to when and how to lift, slide, or transfer the patient, ensuring the body moves as a single unit. Movements are slow and coordinated, minimizing any bending or twisting of the spine. Other team members support under that guidance, but the immobilizer leads to protect the neck and spine.