In suspected spinal injury during air transport, what is the recommended approach?

• A. Immobilize neck/spine with a cervical collar; maintain inline stabilization; avoid unnecessary movement; secure firmly to minimize motion.
• B. Administer rapid IV fluids and reposition the patient to assess response.
• C. Remove protective equipment to improve airway access.
• D. Delay stabilization until after landing to avoid in-flight complications.

Answer: (A)

In a suspected spinal injury during air transport, the priority is to prevent any movement of the head, neck, and spine to avoid worsening a potential spinal cord injury. The recommended approach is to immobilize the neck with a cervical collar, maintain inline stabilization of the spine, avoid unnecessary movement, and secure the patient firmly to minimize motion during flight. This keeps the spine in a stable, neutral position until definitive care can be provided and reduces the risk of secondary injury from turbulence or aircraft maneuvers.

Moving the patient or attempting rapid fluid administration without maintaining immobilization can cause further injury. Removing protective equipment can compromise airway protection and spinal protection, and delaying stabilization until after landing increases the chance of movement and damage during in-flight transport.