After a patient with head trauma has a confirmed patent airway, what should the nurse's first priority in management be?

• A. Establish IV access with a large-bore catheter
• B. Monitor for changes in neurologic status
• C. Maintain cervical spine precautions
• D. Determine the presence of increased ICP

Answer: (C)

Protecting the cervical spine is the first priority once the airway is secured because head trauma often accompanies a spinal injury. Movement of the neck can worsen a spinal cord injury, so immobilizing the cervical spine (keep the neck in a neutral position, apply a collar, and use careful log-rolling techniques during any transfer or assessment) is essential before pursuing other actions. After spine protection is in place, ongoing neurologic checks and other steps—such as establishing IV access or monitoring for signs of increased intracranial pressure—can proceed, but only after the spine is stabilized to prevent secondary injury.