A 35-year-old man falls from a ladder, and is complaining of neck pain with midline tenderness. What is the correct initial management?
Answer and explanation
Correct answer: A. Manual in-line stabilisation of the cervical spine with imaging as indicated
- Step 1: Midline tenderness is a concerning feature.
- Step 2: Spinal precautions and imaging by CT per the NICE trauma guidance reduce the risk of cord injury.
Answer
Manual in-line stabilisation of the cervical spine with imaging as indicated.
Why not the others: Apply a heavy sandbag and remove it for transport: Sandbags are not an adequate or recommended immobilisation method. Leave the neck unsupported and discharge with analgesia: Discharging without assessment ignores a possible unstable fracture. Ask him to flex and extend his neck to test pain: Active movement risks cord injury.
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