When applying a vest-style immobilization device to a patient with traumatic neck pain, which step is performed first?

• A. Immobilize the head prior to securing the torso straps.
• B. Gently flex the head forward as you position the device.
• C. Ask the patient to fully exhale as you secure the torso.
• D. Secure the torso section prior to immobilizing the head.

Answer: (D)

The first step is to secure the torso before immobilizing the head. Stabilizing the trunk locks the body in place and helps prevent any movement of the cervical spine as you complete the immobilization. Keeping manual in-line stabilization on the head while you snug the torso straps minimizes the risk of neck motion, which is crucial when neck pain or injury is suspected. Securing the head first can allow movement of the spine when you later tighten the torso, and the other options describe movements or steps that don’t support maintaining spinal alignment during application.