You are assisting a 22-year-old patient who overdosed; the safest way to bring her downstairs is?

• A. secured to a stair chair with the strongest provider at the head end.
• B. secured to a fracture board with the strongest provider at the foot end.
• C. secured to a fracture board with the strongest provider at the head end.
• D. secured to a stair chair with the strongest provider at the head end.

Answer: (C)

Stabilizing the spine and controlling the head during transfer is essential when there’s potential spinal injury or a decreased level of consciousness from overdose. A rigid fracture board provides consistent immobilization of the spine along its entire length, which helps prevent any movement that could worsen an injury as you move the patient down the stairs.

Having the strongest provider at the head end is crucial because the head and neck must be held in a neutral, aligned position to minimize cervical movement. This person also manages the airway and watches for vomiting or other airway threats during the descent, coordinating with teammates to keep the patient safe.

A stair chair offers less protection against spinal movement, and placing the strongest provider at the foot end would reduce control of the head and neck, increasing the risk of misalignment during the transfer. So, securing the patient to a fracture board with the head-end provider in control best minimizes movement and protects the airway throughout the downstairs move.