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Cervical spine immobilisation — DIPIMC MCQ

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ModeratePre-Hospital TraumaCervical spine immobilisationDIPIMCDipIMC

An elderly patient has fallen down stairs and reports neck pain with tingling in both hands. They are alert and cooperative. Your service has moved away from routine application of rigid collars. What is the most appropriate approach to protecting the cervical spine?

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

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Correct answer: E — Use manual in-line stabilisation and minimal handling, encouraging the patient to keep still

Current practice favours minimal handling with manual in-line stabilisation and a clear instruction to keep still, rather than routine rigid collars, which can raise intracranial pressure and cause discomfort without proven benefit. Long-board immobilisation is reserved for specific situations and is not a transport device. Assessing instability by active movement risks harm. Pearl: a calm, cooperative patient kept still with gentle reminders is often better protected than one fighting a rigid collar.

Reference: NICE NG41 (Spinal Injury); JRCALC Clinical Guidelines