What is the recommended on-field assessment process for suspected cervical spine injuries?

• A. Stabilize the head/neck, assess ABCs, avoid movement, immobilize with collar if indicated, perform careful log-roll to transport with spinal precautions, reassess neurological status
• B. Move the athlete to a bench for evaluation
• C. Immobilize and transport without assessment
• D. Perform self-administered movement tests before immobilization

Answer: (A)

When a cervical spine injury is suspected, the priority is to prevent any movement of the spine while you address life threats and monitor for changes. Start by stabilizing the head and neck to maintain in-line alignment, using manual support immediately. At the same time, run the primary survey focused on airway, breathing, and circulation to ensure the athlete can be protected and oxygenated. Movement should be avoided until spinal precautions are in place, because even small motions can worsen a neck injury or compress the spinal cord.

If indicated, immobilize the neck with a cervical collar and secure the body to minimize motion during transport. When transfer is needed, perform a careful log-roll with multiple rescuers to move the athlete onto a backboard, keeping the spine aligned throughout and continuing to protect the head and neck. Throughout the process, reassess neurological status to catch any changes as early as possible.

This approach differs from moving the athlete to a bench without spinal precautions, immobilizing and transporting without assessment, or performing self-directed movement tests, all of which increase the risk of further injury.