New York State Basic Emergency Medical Technician (EMT-B) Practice Exam

Upon assessing a conscious driver with a head injury, what is your first management step?

1. Perform a neurological assessment

2. Apply an extrication collar and immobilize the entire spinal column

3. Check for internal bleeding

4. Administer pain relief

The correct answer is: Apply an extrication collar and immobilize the entire spinal column

The first management step when assessing a conscious driver with a head injury is to apply an extrication collar and immobilize the entire spinal column. This is essential because head injuries often occur in conjunction with cervical spine injuries, and securing the spine prevents any potential movement that could exacerbate an injury. By using an extrication collar, you stabilize the patient's neck and prevent flexion, extension, or rotation that could impact the spinal cord. Immobilizing the entire spinal column is crucial, as it keeps the head and neck in alignment, reducing the risk of further injury during transport or assessment. The safety and stability of the patient are paramount, especially in head injury cases where the full extent of injury may not be immediately evident. Performing a neurological assessment, checking for internal bleeding, or administering pain relief, while important steps in patient care, are secondary to ensuring spinal stability in the context of a head injury. Without proper immobilization, any subsequent assessments could pose a risk to the patient's well-being.