Which airway-management approach is appropriate when cervical spine injury is suspected?

• A. Suspected cervical spine injury with airway compromise should be opened using a jaw-thrust maneuver.
• B. Always use head-tilt chin-lift
• C. Remove helmet for easier access
• D. Use a nasopharyngeal airway without stabilization

Answer: (A)

The essential idea is airway management that protects a potentially injured neck while still keeping the airway open. When cervical spine injury is suspected, the jaw-thrust maneuver is preferred because it opens the airway by moving the lower jaw forward without tilting or extending the neck. This preserves in-line immobilization of the head and neck, minimizing any movement of the spine while you ventilate or prep for advanced airway support.

Head-tilt chin-lift would require extending the neck, which can worsen a cervical spine injury and is therefore avoided in this scenario. Removing a helmet can cause or increase movement, disturbing immobilization. Using a nasopharyngeal airway without stabilization ignores spinal precautions and can still allow unwanted movement or cause complications if there’s a skull fracture or other injury.

So, the safest approach in this context is to open the airway with a jaw-thrust while maintaining manual in-line stabilization of the head and neck. If ventilation remains inadequate, proceed with an advanced airway using techniques that preserve neck stabilization.