Which maneuver should be avoided when a cervical spine injury is suspected?

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Airway management in a suspected cervical spine injury aims to keep the spine in a neutral, stabilized position while opening and maintaining the airway. The head-tilt chin-lift moves the head back and the chin upward, which extends and flexes the neck and can misalign or injure the cervical spine. Because of that risk, it should be avoided. The jaw-thrust maneuver, on the other hand, opens the airway without significantly moving the cervical spine when done with manual inline stabilization, making it the preferred method in this scenario. Suctioning is appropriate as needed and can be performed with the spine kept in a neutral alignment, since it doesn’t require tilting the head. Inserting an oropharyngeal airway can also be done while maintaining inline stabilization to help keep the airway patent without neck movement.