Which technique is recommended for helmet removal in a patient with suspected cervical spine injury to maintain c-spine during airway access?

• A. One-person technique with stabilization only
• B. Two-person technique maintaining c-spine
• C. Helmet removal is contraindicated in the field
• D. Remove helmet and neck brace together

Answer: (B)

In a patient with suspected cervical spine injury, keeping the head and neck in their neutral, immobilized position during airway access is essential to prevent any movement that could worsen a spinal injury. The best approach to achieve this is a two-person technique: one rescuer maintains inline stabilization of the head and neck, while the second rescuer carefully removes the helmet. This setup allows immediate airway access without losing control of the spine, reducing the risk of secondary injury.

Having only one person attempt stabilization while removing the helmet increases the chance of movement and compromise. Saying that helmet removal is contraindicated in the field isn’t accurate when airway access is needed and it can be done safely with proper two-person technique. Removing the helmet and neck brace together is not advised because it can disrupt the maintained spine alignment during the removal process.