• The spine should be immobilised until a senior surgical/orthopaedic opinion has confirmed that no unstable fracture is present, both radiologically and clinically.

• Place a hard cervical collar if a neck fracture is possible. This does not stabilise the spine; either skull traction or operative stabilisation will be needed for an unstable fracture.

• Move the patient by 'log-rolling' or straight-lifting, using at least four staff members. Exercise care with neck manipulation; intubation should be performed by an experienced operator.

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