In a patient with suspected cervical spine injury, which airway maneuver is preferred to maintain spinal alignment?

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The key is securing the airway without moving the neck. In suspected cervical spine injury, you want a maneuver that opens the airway while keeping the spine in a neutral, stabilized position. The jaw-thrust technique accomplishes this by lifting the mandible forward, which moves the tongue and soft tissues away from the airway, all without requiring any head or neck extension. When performed with inline stabilization—one provider maintaining hands on the back of the head and the neck in a straight line, and another lifting the jaw—the cervical spine is protected from movement during airway management.

This approach is safer for spinal injury because head-tilt-chin-lift involves extending the neck, which can worsen the injury. Relying on an oropharyngeal airway alone may help airway patency momentarily but doesn’t guarantee adequate ventilation or protection from further cervical movement. Endotracheal intubation without stabilization risks significant neck movement during placement, potentially worsening injury.