What should always be done prior to pulling a patient out of an access hole?

While spinal immobilization is important in many situations involving potential spinal injuries, particularly in vehicle extrication scenarios, assessing the vehicle's stability is a critical initial step before any action is taken. Prioritizing the stabilization of the vehicle ensures that the extrication process does not put both the rescuers and the patient at further risk in an unstable environment.

Assessing the vehicle's stability helps to prevent secondary accidents or injuries caused by the vehicle shifting during extrication. If the vehicle is not stable, it can lead to additional risks for everyone involved. Once it is established that the vehicle is secure and stable, appropriate measures such as spinal immobilization can be effectively and safely carried out before the patient is pulled from the access hole.

Ensuring safety during the extrication is paramount, as it allows for a more controlled and less hazardous rescue environment.