During the primary survey for a suspected spinal injury, what is the recommended airway management approach?

• A. Tilt the Head Back to Open the Airway and Use a Chin-Lift Maneuver
• B. Stabilize the Head and Neck in Line and Perform a Jaw-Thrust; Avoid Head Tilt; Suction as Needed; Consider an Oropharyngeal Airway if Unconscious and Gag Reflex Absent
• C. Remove Cervical Spine Precautions and Use a Bag-Valve Mask Without Stabilization
• D. Wait for EMS to Manage the Airway Without Intervention

Answer: (B)

In a suspected spinal injury, securing the airway must be done without moving the spine. The jaw-thrust maneuver opens the airway while keeping the head and neck in line with the spine, which minimizes the risk of worsening a cervical injury. Tilting the head back or performing a chin-lift would disrupt spinal alignment and is avoided in this scenario. The head and neck should be stabilized in a neutral position throughout airway management.

Suction helps keep the airway clear of secretions or vomitus, which is essential for maintaining patency in a trauma patient. An oropharyngeal airway can be used if the patient is unconscious and does not have a gag reflex, because it helps maintain airway patency without requiring head movement. If the patient is conscious or has a gag reflex, an OPA is not appropriate. If bag-valve mask ventilation is needed, continue to maintain cervical spine stabilization while delivering breaths.