A camp in the bush, an afternoon hike, a Pathfinder falls and can't put weight on their foot. The ambulance will take a while. Someone is already shouting "grab him and carry him!" — and that is exactly where most mistakes happen.
Transporting a casualty is one of the skills the First Aid specialty requires, and it is not brute force: it is decision-making. The right question is not how to carry, but whether to carry at all, and by which technique. The answer changes with the severity of the victim. Supporting someone who sprained an ankle has nothing to do with moving someone who may have broken their spine.
This guide brings together the three things that usually come apart: when to move (and when not), which technique to choose by severity, and how to improvise a stretcher with what the field offers — branches and a blanket. It serves the specialty and it serves life. Content verified on 07/22/2026 against the official and technical sources listed at the end.
When should you move a casualty — and when should you not?
Start with the part nobody likes to hear: most of the time, the right call is not to move.
Moving a seriously injured victim the wrong way can turn an injury that would have healed into a permanent disability — especially when a spinal fracture is suspected. That is why the guidance in any serious first aid course is the same: only remove the casualty from the spot if staying there is a greater risk than moving them. Fire, risk of explosion, traffic, rising water, risk of collapse. Outside those extreme situations, you stabilize the victim where they are and wait for help to arrive.
Before thinking about transport, three steps come first, always in this order:
- Ensure your safety and the safety of the site. A rescuer who becomes a second victim helps no one.
- Call for help. In Brazil, SAMU at 192 and the Fire Brigade at 193. Say where you are with as many landmarks as possible — in the bush, that is the hardest and most important piece of information.
- Stabilize. Check breathing, control bleeding, immobilize whatever needs it. A fracture should only be transported after it is immobilized.
Keep the phrase that sums it all up: immobilizing comes before transporting, and transporting is the last step. The field changes the math — sometimes the rescue team really won't reach you, and then moving becomes necessary. But that decision is deliberate, not the reflex of someone who panics and starts carrying.
How do you choose the transport technique by severity?
Decided you need to move? Then the next choice is the technique — and it comes straight from the severity of the victim and the number of rescuers you have. There is no "best" technique: there is the right one for each case.
The First Aid specialty at the intermediate level asks precisely that you know the various ways to transport a victim, from the simplest to the stretcher. This table organizes the main ones by situation:
| Victim's situation | Recommended technique | Rescuers |
|---|---|---|
| Conscious, can walk with support, minor injury (sprain, faintness) | Support transport | 1 |
| Conscious, cannot walk, no suspected serious fracture | Seat carry (seat made with hands) | 2 |
| Unconscious or heavy, no suspected spinal injury, short distance | Carry by two or three people | 2 to 3 |
| Needs to leave a dangerous place in seconds, alone, smooth floor | Drag by the shoulders or on a blanket | 1 |
| Suspected fracture of the spine, neck or pelvis | Log-roll + rigid surface | 3 to 4 |
| Long route in the field, victim stabilized | Improvised or conventional stretcher | 2 to 4 |
Notice the thread that stitches the table together: the greater the suspicion of serious injury, the more people and the more rigidity you need, and the less the victim can be bent or twisted. A sprained ankle leaves supported on your shoulder. A possible spinal fracture demands four hands aligning the body like a board. Confusing the two is the classic mistake.
One safety rule applies to every technique: when in doubt between a minor and a serious injury, treat it as serious. It costs more effort and is almost always harmless. The opposite — treating a serious injury as minor — is what leaves a mark.
Conscious, cooperative victim: support and seat carry
These are the everyday techniques of the club, and the easiest to train at a meeting. They apply to anyone who is conscious, oriented and with no suspected fracture in the spine or legs.
The support transport is the simplest: the victim passes an arm behind your neck, you hold their wrist with one hand and pass the other around their waist. They walk; you are the crutch. It works for dizziness, a minor sprain, faintness — cases where the person walks, they just can't walk alone. If they can't put weight on one foot, two rescuers provide the support, one on each side.
The seat carry comes in when the victim can't walk but is still conscious and has no injury that would prevent sitting. Two rescuers stand one on each side and interlock their hands to form a seat — the firmest way is for each to grip their own forearm and the other's forearm, forming a square. The victim sits on the hands and holds the shoulders of both. Agree on who gives the command to lift and walk together: a wrong step brings everyone down.
Two precautions instructors insist on that prevent scares:
- Lift with your legs, not your back. Bend your knees, keep your spine straight. A rescuer who strains their own lower back becomes the next incident.
- Never use support or the seat carry if there is any suspicion of a spinal fracture. Sitting and walking bend the spine — exactly what must not happen in that case.
Suspected spinal fracture: the log-roll
This is the most delicate technique and the most important to understand properly. It is for when you suspect an injury to the spine, neck or pelvis — a fall from height, a dive into shallow water, a hard impact, or a victim who complains of tingling, numbness or can't move their arms and legs.
The idea is a single one: move the head, neck, trunk and legs as if they were one single piece, without twisting or bending at any point. That is why it is called a log-roll. An injured spine that bends can compress the spinal cord — and that is where the risk of paralysis lies.
How it works, in broad terms:
- It needs people: ideally three to four rescuers, plus one who takes on the head alone.
- One person commands — usually the one holding the head, keeping it aligned with the trunk the whole time, without pulling or turning.
- Everyone rolls or lifts at the same instant, on command, keeping the body straight as a board, in order to slide a rigid surface underneath.
- The surface has to be hard: a door, a wide board, a backboard. A soft blanket won't do for a suspected spine, because it gives way and lets the body bend.
Here is the honest and most important part of this guide: a correct log-roll is done by trained people, with proper equipment (cervical collar, backboard). If there is a serious suspicion of a spinal injury and the rescue team can reach you, the best first aid is often not moving — just keeping the victim still, warm and talking with you until SAMU or the Fire Brigade take over. Improvising spinal transport without real need is a risk that rarely pays off.
Read alsoFirst aid for venomous-animal bites and stingsHow do you build an improvised stretcher with branches and a blanket?
We reach the classic of the specialty and of camping: when the route is long, the victim is stabilized and you need to carry them firmly, you build a stretcher with what the field gives.
The best-known version uses two straight, sturdy branches and a blanket. The step by step is this:
- Choose two branches (or two broomsticks, pipes, poles) longer than the victim, thick enough not to bend under an adult's weight.
- Spread the blanket open on the ground. Place one branch at about a third of the width and fold the first flap of the blanket over it.
- Put the second branch on top of that folded flap, roughly a third from the other end, and fold the remaining flap over, back toward the first branch.
- Done: the victim's own weight, lying in the center, holds the layers of the blanket and locks everything in place. It is the same principle as "enveloping" the fabric between the poles.
No blanket? The stretcher also comes from two or three buttoned jackets or shirts: close the buttons or the zipper, pass a branch through each sleeve, on both sides, and the garments become the canvas of the stretcher. The same works for sleeping bags, tarps, thick sheets and hammocks.
And the precaution that separates a good stretcher from one that collapses in the middle of the trail: test it first. Before laying the victim down, an adult rescuer lies or leans with weight on the improvised stretcher and it is lifted a few centimeters. If a branch bends too much, a knot loosens or the fabric tears, you find out now — not with the injured person on top. Materials that work for improvising are many: branches, poles, boards, doors, ropes, vines, sheets, tarps. What doesn't change is the test.
And when there's only a blanket, no branches?
You don't always find two good poles on the spot. The blanket alone still solves it, in two ways.
To drag in an emergency — to quickly remove someone from a dangerous place, on a relatively smooth floor —, lay the victim on the blanket, hold the edge near the head and pull along the length of the body, never sideways. That keeps the body more aligned and spares your spine. It is an escape maneuver, for short distances, not long-route transport.
To carry with the blanket without poles, several rescuers are needed: each side of the blanket is rolled tightly inward, creating fabric "handles," and the team lifts on the same command, spread along the body. It works best with four or six people, because the blanket is not rigid and the weight concentrates in the hands.
An alternative that is worth gold at camp is the rigid-surface stretcher already ready by nature or by the structure: a door that can be taken off, a wide board, the backrest of a wooden bench. For a victim with a suspected spine, that rigidity is exactly what you want — as long as the transfer onto the surface is done with a log-roll, as in the previous section.
A note of transparency: the exact assembly of each stretcher varies from manual to manual and from instructor to instructor. The principles, however, don't change — enough rigidity, aligned body, test before use and a single command when lifting. Master the principles and you adapt to whatever material you have at hand.
How this becomes a specialty — and what the instructor usually requires
Casualty transport falls within the First Aid specialty at the intermediate level, which in turn has the basic level as a prerequisite. In other words: you don't study transport before you already know how to assess the victim, control bleeding and immobilize. It makes sense — transporting is the final step.
The requirement asks you to know the various forms of transport, and the ones that appear on the list are exactly those of this guide: dragging by the shoulders, use of a blanket, carrying by two people, log-roll, improvised stretcher, carrying by three people and conventional stretcher. The key word is know — in practice, the instructor wants to see you doing it, not reciting.
To earn this part without stumbling, three pieces of advice from someone who has already assessed many people:
- Train in pairs and in threes for real. The seat carry and the log-roll depend on synchrony. Reading the step by step doesn't teach the "on my command, lift" — only repetition teaches it.
- Build the stretcher with an eye on the clock and then test it. A stretcher that takes fifteen minutes and gives way in the test earns no grade and saves no one. Practice with a branch and with a blanket until it comes out in a few minutes.
- Know how to explain the "when not to move." The best Pathfinder is not the one who carries fastest; it is the one who recognizes the suspicion of a spinal fracture and holds the team back. An experienced instructor values that brake.
The most common mistake in the assessment is memorizing the list of techniques and not knowing how to choose between them. If the instructor describes a situation and asks "which technique?", they are testing your judgment, not your memory. Go back to the severity table: that is where the answer comes from.
To round out the set, it is worth reviewing the fundamentals in first aid for Pathfinders and checking what to carry in the first aid kit — because cloth triangles, bandages and a thermal blanket help both to immobilize and to improvise transport.
Before carrying anyone: did you call for help?
Close the guide with the step that adrenaline makes you forget. No transport technique replaces professional care — it only buys time or takes the victim out of danger until help takes over.
In Brazil, the numbers are 192 for SAMU (Mobile Emergency Care Service) and 193 for the Fire Brigade. Both calls are free and work from any phone. When you call, have on the tip of your tongue: where you are (with landmarks, because in the field the address doesn't exist), what happened, how many victims and their condition (conscious? breathing? bleeding?).
At camp, sort this out before you need it: who has a cell signal, where the nearest exit for a vehicle is, what landmark an ambulance can find. A club leadership that agrees on this on arrival turns the worst moment into something manageable.
And the principle that stitches it all together, from the support to the branch stretcher: transport serves the victim, not your haste. Moving calmly, with the right technique, calling the right help, is what separates the Pathfinder who helps from the one who, without meaning to, makes it worse. That serenity — more than strength — is what the specialty, deep down, is forming in you.