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Head injury with agitation — DIPIMC MCQ

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HardPre-Hospital TraumaHead injury with agitationDIPIMCDipIMC

A head-injured patient is agitated and repeatedly removes a cervical collar; forced strapping provokes violent struggling. Airway and ventilation remain adequate and rapid transport is available. What is the safest spinal strategy?

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Correct answer: C — Use tolerated manual support or self-positioning and expedite assessment

The best answer is “Use tolerated manual support or self-positioning and expedite assessment”. Spinal precautions must not create greater immediate harm. Violent forced restraint can worsen agitation, compromise airway care and injure patient or staff. Use the least restrictive stabilisation the patient tolerates, discourage unnecessary movement, continue neurological and head-injury assessment and expedite definitive care. Sedation is reserved for a clinical indication with appropriate expertise and monitoring, not merely to enforce a collar.

Reference: NICE NG41, Spinal injury: https://www.nice.org.uk/guidance/ng41/chapter/recommendations