In trauma cases, what is the recommended immobilization approach for suspected spinal injury during flight?

• A. Remove cervical collar to facilitate airway management
• B. Place patient in semi-supine position
• C. Maintain cervical immobilization with collar, secure to backboard, minimize movement and logroll per protocol
• D. No immobilization is required

Answer: (C)

In air medical trauma care, protecting the spine during transport hinges on strict spinal immobilization. The best approach is to keep the cervical collar in place, secure the patient to a backboard, and minimize movement, performing logrolls only per protocol to maintain neutral alignment. This approach reduces the risk of worsening a spinal injury from any jostling, turbulence, or repositioning during flight, which can translate into a devastating secondary injury.

Removing the cervical collar to facilitate airway management can allow dangerous neck movement, and attempting airway management without maintaining immobilization risks shifting the spine even during procedures. Placing the patient in a semi-supine position can compromise both spinal alignment and airway access. Not immobilizing at all leaves the neck unprotected in a high-risk environment.