The Importance of Airway vs. Cervical Spine
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Immobilisation of the cervical spine is frequently carried out on patients who are at risk of spinal cord injury
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This is often based on the history and mechanism of injury rather than obvious signs and symptoms
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As clearly put in the book 'Trauma Rules'....
"The cervical spine is therefore usually immobilised because of potential injury,
not absolute injury. However, airway obstruction is an absolute problem:
if untreated the patient will certainly die" (1)
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The cervical spine should always be protected and immobilised whilst opening the airway in patients at risk of spinal cord injury
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The one exception is when there is impending death from a compromised airway - in this situation protection of the cervical spine may be overlooked (2)
Airway must take priority...
It is those patients without neurological signs & symptoms who benefit most from cervical spine immobilisation... (3)
References
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Hodgetts T, Deane S, Gunning K. Trauma Rules. BMJ Publishing Group 1997 p15
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Lewis FR, Trunkey DD. Emergency department care. In: Trunkey DD, Lewis FR, eds. Current therapy of trauma 1984-85. Philadelphia: BC Decker, 1984.
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Hodgetts T, Deane S, Gunning K. Trauma Rules. BMJ Publishing Group 1997 p15
Dr. N. Sparrow - 26 January 2006
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