Which of the following is an indication for C-spine immobilization?

Cervical spine immobilization is crucial in the management of potential spinal injuries, especially following trauma. Among the options, drug or alcohol intoxication serves as a valid indication for C-spine immobilization. This is because intoxication can impair a patient’s level of consciousness and coordination, making them more vulnerable to falls or accidents that could result in cervical spine injury. Additionally, these patients may not reliably report their symptoms or history, necessitating cautious immobilization to protect against unrecognized spinal injuries.

In contrast to this, penetrating trauma to the head or neck generally requires evaluation of existing injuries rather than blanket immobilization. While airway concerns can be critical, the situation where a cervical collar might impede the airway necessitates addressing those airway risks first. Finally, for patients in cardiac arrest, the immediate concern is resuscitation rather than spinal immobilization unless there is a clear mechanism of injury that suggests spinal involvement. Thus, drug or alcohol intoxication clearly aligns with the reasoning for immobilizing the cervical spine.