In drowning or near-drowning, what is a key concern during transport?

• A. Spinal injury assessment and protection
• B. Immediate intubation at the scene
• C. Administer diuretics
• D. Defibrillate immediately

Answer: (A)

Protecting the spine during transport is the primary concern after a drowning or near-drowning event. Movement can convert a potential spinal injury into a catastrophic one, so the patient should remain immobilized with the head and neck aligned with the spine, immobilized on a backboard, and moved with minimal rotation or flexion (often using a log-roll technique). Airway and breathing support remain important, but maintaining spinal alignment takes priority in the transport phase to prevent secondary injury. The other options aren’t universally applicable: intubation at the scene depends on airway status and resources, diuretics aren’t part of acute drowning care, and defibrillation is only used if a shockable rhythm is present, not as a routine transport concern.