In a staged extrication using a roof lift, what is the correct sequence?

• A. Create entry, assess entrapment, stabilize, plan access, and carefully extract with in-line stabilization and patient monitoring.
• B. Plan access, stabilize, assess entrapment, create entry, extract.
• C. Assess entrapment, plan access, stabilize, create entry, and carefully extract with in-line stabilization and patient monitoring.
• D. Stabilize, plan access, assess entrapment, extract, create entry.

Answer: (C)

In a staged roof-lift extrication, the safest and most effective approach starts with understanding what you’re dealing with before you move anyone. First, assess entrapment to determine exactly what parts of the vehicle and what body areas are involved, and to identify any hazards that could affect movement or spinal safety. Once you know the specifics of entrapment, you plan access so you choose the safest route to reach the patient with minimal disturbance to the spine or surrounding structures. Then you stabilize the scene, the patient, and any immobilization devices to prevent unwanted movement during lifting and manipulation. After stabilization is in place, you create the entry path—the opening or access point you will use to reach the patient—while maintaining controlled conditions. Finally, you extract the patient with inline stabilization and continuous monitoring to protect the spine, monitor vital signs, and detect any changes as you lift and remove them.

This order matters because rushing to lift or extract without fully understanding entrapment or without stabilization can lead to further injury. Stabilization and planning should follow assessment to ensure the chosen access and extraction method maintains spinal alignment and patient safety throughout the maneuver.