What are the key steps in on-field management of a suspected cervical spine injury?

• A. Evaluate motor and sensory function to determine severity on scene
• B. Remove from field immediately and begin aggressive manual manipulation
• C. Scene safety, manual stabilization with the neck in neutral, avoid movement, immobilize with cervical collar if indicated, reassess airway/breathing, prepare for transport with spinal precautions
• D. Let athlete move to determine pain location and never immobilize

Answer: (C)

On-field management of a suspected cervical spine injury hinges on preventing further injury by keeping the head and neck in a neutral position, minimizing movement, and preparing for safe transport with spinal precautions, all while ensuring the airway remains protected. The first step is scene safety, then manually stabilize the head and neck in a neutral alignment and avoid any movement of the spine. If indicated, immobilize the cervical spine with a collar and continue immobilization during transport, using a spine board as appropriate. Reassess airway and breathing after stabilization and maintain spinal precautions throughout transfer.

Evaluating motor and sensory function is important for prognosis and later medical assessment, but it does not replace the need for immobilization and spinal precautions on scene. Movement or aggressive manipulation should not occur, and the athlete should not be allowed to move to locate pain or determine severity, as such movement can worsen spinal injuries.