At the scene of a motor vehicle crash, a semiconscious patient with a forehead laceration; best action is?

• A. apply a cervical collar and quickly remove the patient with a clothes drag.
• B. direct your partner to apply manual in-line support of the patient's head.
• C. slide a long backboard under his buttocks and lay him sideways on the board.
• D. apply a vest-style extrication device before attempting to move the patient.

Answer: (B)

When there’s potential cervical spine injury in a crash victim who is semiconscious, the priority is to prevent any movement of the head and neck while you assess and prepare for transport. Directing your partner to apply manual in-line stabilization of the head achieves this immediately, keeping the head in line with the spine and minimizing further injury as you manage the airway and prepare for extrication.

This approach is better than dragging the patient, which can cause neck movement and worsen spinal injury; or moving him onto a backboard with side-lying without maintaining head stability, which risks spinal misalignment and airway concerns; and it’s preferred over applying a vest-style immobilizer before stabilization, since immediate manual stabilization preserves alignment while you set up definitive immobilization.