If midline spinal tenderness is present during exam after trauma, what is the appropriate immediate action?

• A. Expose the chest for DCAP-BTLS only
• B. Administer analgesics and continue
• C. Immobilize the spine
• D. Move the patient to assess other injuries

Answer: (C)

Midline spinal tenderness after trauma signals a possible spinal injury, so the priority is to prevent any movement that could worsen damage to the spinal cord. Immobilizing the spine—maintaining in-line stabilization, keeping the patient flat, applying a cervical collar if available, and securing them to a backboard—protects neurological function during assessment and transport. Movement or relocation before immobilization can displace fractures or compress the spinal cord, leading to paralysis or other serious outcomes. Once immobilization is in place, you can proceed with a careful, systematic assessment and planned transport. Exposing the chest, giving analgesics and continuing, or moving the patient to assess other injuries would risk further injury and do not address the immediate need to protect the spine.