The Tactical Combat Casualty Care (TCCC) Guidelines highlight that cervical spine stabilization is not necessary for casualties who have sustained only penetrating trauma.

The Joint Trauma System (JTS) clinical practice guideline on spinal injuries points out that approximately 5.5% of evacuated battle casualties experience a spinal injury, which can occur through a variety of battle-related and nonbattle-related mechanisms. Explosions, motor vehicle accidents, and falls comprise the majority of the mechanisms of injury.

Those same guidelines advise that on the battlefield, preservation of the life of the casualty and medic are of paramount importance, and in those circumstances, evacuation to a more secure area takes precedence over spine immobilization.

That said, if you suspect that the casualty has suffered a neck or spinal injury, use the jaw-thrust method to open an airway, if needed. If a casualty cannot maintain an open airway once opened, a second responder may be needed to assist in maintaining an open airway when using the jaw-thrust method.