Before removing an unrestrained patient from a car after an automobile crash, what should be done first?

Before removing an unrestrained patient from a car after an automobile crash, the most crucial step is to immobilize the patient with a vest-style device. This approach is vital because the patient may have sustained neck or spinal injuries due to the collision. Proper immobilization helps to prevent any further movement that could exacerbate these injuries during the extraction process.

By utilizing a vest-style device, emergency responders effectively stabilize the patient's spine while preparing for safe removal from the vehicle. This is particularly important in situations involving significant trauma, as premature movement without appropriate immobilization increases the risk of causing paralysis or other severe complications.

The other actions may have their place in certain settings, such as assessing for visible trauma, but they should not take precedence over the immediate measure of immobilization to protect the patient's safety and prevent further injury.