A client comes into the ER after hitting his head in an MVA. He’s alert and oriented. Which of the following nursing interventions should be done first?
All clients with a head injury are treated as if a cervical spine injury is present until x-rays confirm their absence. The airway doesn’t need to be opened since the client appears alert and not in respiratory distress.

Option A: ROM would be contraindicated at this time.
Option B: There is no indication that the client needs a chest x-ray.
Option D: In addition, the head-tilt-chin-lift manoeuvre wouldn’t be used until the cervical spine injury is ruled out.
Assess full ROM to determine extent of injuries
Call for an immediate chest x-ray
Immobilize the client’s head and neck
Open the airway with the head-tilt-chin-lift maneuver