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Trauma RSI with cervical spine injury — FRCA Final MCQ

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HardTrauma and Emergency AnaesthesiaTrauma RSI with cervical spine injuryFRCA Final

A 30-year-old man with suspected cervical spine injury requires emergency laparotomy for abdominal bleeding. He is confused, vomiting and hypotensive. Manual in-line stabilisation is applied and videolaryngoscopy is available. What is the most appropriate anaesthetic technique?

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Correct answer: A — Rapid sequence induction with manual in-line stabilisation and videolaryngoscopy

The patient needs urgent haemorrhage control and has aspiration risk, confusion and shock, making awake intubation impractical. Rapid sequence induction with manual in-line stabilisation, experienced help and videolaryngoscopy balances airway, aspiration and cervical spine concerns. Facemask anaesthesia is unsafe for laparotomy and aspiration. Imaging should not delay life-saving surgery in an unstable patient.

Reference: DAS/Association of Anaesthetists cervical spine airway guideline 2024; NICE NG39 major trauma