Prior to your arrival at the scene, a young female was submerged. You should manage her airway appropriately while considering the possibility of:

• A. Spinal injury.
• B. Airway obstruction.
• C. Internal bleeding.
• D. Hyperthermia.

Answer: (A)

Cervical spine protection during airway management after submersion. When someone has been submerged, there’s a real chance of neck or spinal trauma even if there are no obvious signs at first. Moving the head or neck during airway maneuvers can convert a potential spinal injury into a real one, so treat the head and neck as a suspected injury and keep the spine in a neutral position at all times.

This means applying manual inline stabilization and a rigid collar, maintaining neutral alignment while you clear the airway, suction as needed, and ventilate. If you need to ventilate with a bag-valve mask, do it with the spine held in place and the head in line with the body. If intubation becomes necessary, perform it with inline stabilization and careful technique to avoid flexion, extension, or rotation of the neck. Oxygenation is essential, and while airway obstruction from water or secretions is a concern, the priority here is preventing further spinal injury during airway management and transport. Hyperthermia and internal bleeding are important considerations later in the assessment, but they don’t drive the immediate airway approach in this submerged patient.