A 30-year-old male involved in a high-speed motor-vehicle collision is found supine on the roadway with complaints of neck pain and tingling in all extremities. Cervical-spine injury is suspected. What is the most appropriate initial intervention to immobilize the patient and prevent secondary spinal cord damage?
Log-roll the patient onto a long backboard before stabilizing the neck.
Immediately apply a rigid cervical collar without manual stabilization.
Place the patient in a semi-Fowler position to reduce neck muscle tension.
Apply manual in-line stabilization of the head and neck.
The first step in immobilizing a patient with a potential cervical-spine injury is manual in-line stabilization (MILS). A rescuer places both hands on the patient's head, holding it in a neutral, in-line position to prevent flexion, extension, or rotation. MILS is maintained continuously while a properly sized rigid cervical collar is applied and the patient is transferred to a spinal immobilization device. Skipping MILS or delaying it until after a collar is available allows uncontrolled neck motion that can exacerbate cord injury, and immediately placing the patient on a board without MILS offers no protection to the cervical spine.
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