Which of the following is contraindicated when managing a suspected C-spine injury?

• A. Immobilizing the head with foam head blocks
• B. Exposing the airway immediately
• C. Realigning the spine only when neutral is achieved
• D. Applying traction to C-spine

Answer: (D)

Injury to the cervical spine is managed by preventing any movement of the neck and keeping the spine aligned with minimal disruption. The reason traction is contraindicated is that applying a pulling force along the spine can worsen an unstable injury. If there’s a fracture or dislocation, traction can increase displacement, threaten the spinal cord or nerve roots, and potentially cause new or greater neurological damage. Because the exact injury pattern isn’t known in the field, using traction risks making things worse rather than helping.

Because of this, the focus is on immobilization—keeping the head and neck in a neutral position with a rigid collar and secure support on a backboard or immobilization device to prevent any movement. Airway management, when needed, is performed with careful in-line stabilization to avoid neck movement. Repositioning or realigning the spine is not something to attempt in the field; definitive realignment, if necessary, is done in controlled, equipped settings under appropriate supervision.

So, applying traction to the cervical spine is the action that should be avoided in managing a suspected C-spine injury.