What is the correct approach to suspected cervical spine injuries in the ED?

• A. Remove the collar during transport to imaging
• B. Stabilize with collar, move as needed to imaging without immobilization
• C. No immobilization is used and transport is rapid
• D. Stabilize with cervical collar; minimize movement; maintain immobilization during transport; use log-roll technique

Answer: (D)

When cervical spine injury is suspected, the priority is to prevent any movement of the spine to avoid secondary spinal cord damage. The patient should be kept immobilized with a cervical collar in place, and movement should be minimized throughout assessment and transfer. Move the patient as a single unit using the log-roll technique with inline stabilization so the head, neck, and torso stay aligned during repositioning. Maintain this immobilization during transport to imaging until imaging or clinical assessment proves stability. Removing the collar or moving without immobilization or rushing transport without stabilization increases the risk of worsening injury. If airway management is needed, maintain manual inline stabilization during intubation to protect the spine.