Blast or explosion injury is a positive indication for spinal motion restriction.

• A. No injury
• B. Minor bruising
• C. Hypotension
• D. Blast or explosion injury

Answer: (D)

Spinal motion restriction is guided by mechanisms that suggest a potential spinal injury, because movement could worsen damage or prevent a reliable exam. A blast or explosion injury is a high-energy mechanism that can cause spinal injuries and often leaves the patient unable to provide a trustworthy history or exam due to unconsciousness, confusion, or other injuries. In such cases immobilizing the spine helps prevent secondary injury while you assess and manage the patient. By comparison, having no injury or only minor bruising doesn’t indicate a risk of spinal injury, and hypotension points to shock management rather than a direct sign of spinal damage, so they don’t by themselves mandate spinal immobilization.