Casualty lifting is the first step of casualty movement, an early aspect of emergency medical care. It is the procedure used to put the casualty (the patient) on a stretcher. Developed emergency services use lifting devices, such as scoop stretchers, that allow secured lifting with minimal personnel. Other methods (explained below) can be used when such devices are not available. Since only stabilised casualties are moved (except in unusual circumstances), the lifting is usually never performed in emergency; emergency movements are sometimes performed to respect the Golden Hour. This depends on the organisation of the medical services and on the specific circumstances. Maximum care must be taken to avoid to worsen an unstable trauma. The head-neck-chest axis must be kept straight to protect the spine, and the first responders must keep the patient's body stable (no movement of the feet) during the lift. The first responders have to carry a heavy load (probably more than 20 kg for an adult casualty) in an uncomfortable position. There is thus a risk of injury to the carrier, especially of the lumbar back. To avoid an injury, they must push with their legs (quadriceps), trying to keep their back straight. Preparation of the stretcher The stretcher must be unfolded, and the hinges secured and tested: a first responder presses the cloth with their knee at several points. When a vacuum mattress is used, it must be put on the stretcher, and the balls must be evenly distributed. A blanket is often used since hypothermia is a major risk for a casualty. The blanket must be wrapped around the casualty to avoid the heat leak from below (this is not necessary when the stretcher has a mattress, e.g. a vacuum mattress, or in case of an ambulance stretcher). For this purpose, the blanket is put before the lifting, and folded in a specific way: the blanket is laid so the diagonal is along the axis of the stretcher; the corners are put on the centre of the stretcher; the folded part are then rolled towards the stretcher; the rolls are then put under the blanket, so they will not unroll spontaneously; the corners are sticking out so they can be pulled. Scoop stretcher The use of a scoop stretcher allows a secure lifting with only two team members even in case of a spinal trauma. The use of this device is thus recommended for