Benchmark Clinical Judgment Exam (CJE) Practice Exam

In suspected spinal injury, the first priority is protecting the spine by immobilizing the patient to prevent any movement that could worsen a fracture or injure the spinal cord. This means securing the neck with a cervical collar and immobilizing the entire spine to a rigid backboard or stretcher, maintaining inline stabilization during any assessment, repositioning, or transport. Imaging is performed after the patient is stabilized so that the spine remains as still as possible during evaluation.

Antibiotics aren’t given as an initial step for a spinal injury unless there’s a specific indication like an open fracture or contaminated wound. Elevating the legs or placing the patient in Trendelenburg aren’t protective measures for spinal injuries and can cause unnecessary complications or hinder airway and circulation. Immobilization directly protects the spine and buys time for safe assessment and imaging.