The aim was to evaluate seven evacuation support surfaces. These included the conventional spinal board, two designs of vacuum stretcher, a prototype support surface which was a combination of both principles, and three conventional stretchers. Interface pressures were evaluated in four healthy volunteers. The sacral and thoracic interface pressures were measured. Mean sacral readings were: spinal board 233.5 mm Hg, old vacuum stretcher 139 mm Hg, new design 94.8 mm Hg, prototype board 119.5 mm Hg, York Two stretcher 46 mm Hg, Army stretcher 61 mm Hg, and the PVC and aluminium stretcher 66 mm Hg. Thoracic pressure readings were: spinal board 82.9 mm Hg, old design vacuum stretcher 58 mm Hg, new design 37.8 mm Hg, prototype board 53.7 mm Hg, York two 21 mm Hg, army stretcher 35.4 mm Hg, and PVC stretcher 38.5 mm Hg. Analysis of variance showed both distributions to be highly significant (P < 0.001). The spinal board has several deficiencies, including lack of support for the lumbar lordosis. It should not be the preferred surface for the transfer of patients with spinal injuries.