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Cervical spine injury — DIPIMC MCQ

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ModeratePre-Hospital TraumaCervical spine injuryDIPIMCDipIMC

A pedestrian is struck by a car at low speed. He is walking at the scene, alert with a GCS of 15, not intoxicated, has no distracting injury and no limb weakness, but reports midline tenderness over the cervical spine on examination.

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Apply manual in-line stabilisation, immobilise the cervical spine and transport for assessment

Explanation lettering: E = shown as C · C = shown as D · D = shown as E

Midline cervical tenderness is a clinical red flag that mandates immobilisation and imaging regardless of whether the patient is walking, because significant injury can occur without neurological deficit. Concluding that ambulation excludes injury (E) or discharging at scene (B) risks missing an unstable fracture. The presence of any single high-risk feature overrides the reassurance of a normal examination elsewhere.

Reference: NICE NG41; JRCALC Clinical Guidelines