A 15-year-old female was struck by a small car while riding her bicycle. She was wearing a helmet and was thrown to the ground, striking her head. In addition to managing problems associated with airway, breathing, and circulation, it is MOST important for you to:

• A. Leave her bicycle helmet on.
• B. Stabilize her entire spine.
• C. Inspect the helmet for cracks.
• D. Obtain baseline vital signs.

Answer: (B)

The main concept being tested is the need to prevent secondary spinal cord injury by immobilizing the cervical spine in any trauma patient with potential spinal injury. After addressing airway, breathing, and circulation, the immediate priority is to keep the head and neck aligned and prevent movement of the spine. A high-energy head injury from a vehicle strike raises strong concern for cervical spine injury, and even with a helmet, moving the neck can worsen neurologic damage. Stabilizing the spine—manual stabilization of the head and neck, and applying immobilization with a collar and backboard as appropriate—directly reduces the risk of extending a spinal injury during transport.

The other options don’t address this critical risk as effectively: while a helmet offers head protection, it does not negate the need to immobilize the spine and can even complicate movement if the neck isn’t stabilized; inspecting the helmet for cracks or obtaining baseline vital signs are useful tasks, but they do not prevent potential spinal cord injury as the top priority in this scenario.