In an emergency with head, neck, or spinal injuries suspected, what is the first priority?

• A. Clear the area
• B. Ensure the student has an airway to breathe
• C. Move the head to align spine
• D. Check blood pressure

Answer: (B)

The top priority is ensuring an airway to breathe. In a head, neck, or spinal injury, you must open and protect the airway without moving the neck, because life can be at immediate risk if breathing is blocked. Use a jaw-thrust maneuver to lift the tongue and open the airway while keeping the neck in line with manual in-line stabilization. Once the airway is open, assess breathing and provide rescue breaths if needed, all while continuing to stabilize the spine. Moving the head to align the spine is unsafe and can worsen an injury, so maintain immobilization. Clearing the area is important for safety, but it doesn’t address breathing and spinal protection as the first step, and checking blood pressure comes after you have ensured a patent airway and breathing.