The primary assessment should be conducted while maintaining spinal in-line stabilization with patients who may have a cervical spine injury. Conditions where a spinal injury should be suspected include patients with altered level of consciousness; high suspicion of mechanism of injury such as ejection from a motor vehicle, fall from height or pedestrian struck; signs of head or neck trauma; or neurologic abnormalities (e.g., weakness, numbness).

Spinal stabilization with motion restriction should be maintained throughout the assessment by maintaining the head in a neutral position.