- Assess the scene and adjust board buoyancy by inserting or removing rods based on water depth and patient position.
- While a primary rescuer maintains manual in-line cervical stabilization, submerge and position the spineboard directly beneath the patient.
- Secure the patient to the board with straps in the following sequence: chest, hips, then legs.
- Apply the universal head immobilizer base, position padded blocks on both sides of the head, and secure with head and chin straps.
- Execute a coordinated, multi-rescuer lift to extricate the patient from the water.
- Once on a stable surface, re-assess patient status and prepare for transfer to EMS personnel.
