For a patient with suspected spinal injuries, which airway maneuver is preferred?

• A. NPA
• B. Endotracheal tube
• C. Head tilt-chin lift
• D. Jaw-thrust maneuver

Answer: (D)

Minimizing neck movement while keeping the airway open is crucial when spinal injury is suspected. The jaw-thrust maneuver accomplishes this by lifting the mandible forward to move the tongue and soft tissues away from the airway without tilting or extending the neck. It allows you to open the airway quickly while maintaining manual in-line stabilization of the cervical spine, which helps protect the injured spine from further injury.

This is safer in trauma than the head tilt-chin lift, which requires extending the neck and can worsen spinal injury. While a definitive airway like an endotracheal tube may ultimately be necessary, it is more invasive and involves greater manipulation and risk, and the question focuses on the initial maneuver to open the airway. Nasopharyngeal airways are sometimes used, but if facial or basal skull injuries are suspected, they can be contraindicated and do not provide the same protection against neck movement as the jaw-thrust.