Trauma

Cervical spine trauma

Before / During / After / Pitfalls

Before

• Clarify manual inline stabilization, collar strategy, and backup plan.
• Optimize position as allowed; ramp torso if needed while maintaining spinal precautions.
• Video laryngoscopy can help reduce head movement but must be paired with good technique.

During

• One person owns C-spine stabilization; operator verbalizes difficulty early.
• Avoid levering; use bougie/tube delivery strategy deliberately.
• If attempt fails, oxygenate and change something.

After

• Secure tube without losing alignment; recheck depth after transfers.
• Maintain spinal precautions and communicate airway difficulty to trauma team.
• Document device, view, attempts, and confirmation.

Pitfalls

• Rigid adherence to collar preventing mouth opening without a plan.
• Poor positioning because “C-spine” was treated as no-positioning.
• No backup oxygenation plan.