Pearls and Pitfalls

The elderly are at high risk of cervical spine injury from relatively minor mechanisms of injury (e.g. falling from standing): always consider the possibility of a neck injury in an old patient with a fall and head injury
Missed cervical spine fractures tend to occur in patients with distracting injuries, reduced level of consciousness or under the influence of alcohol or drugs
If the patient is holding their neck in a flexed position, DO NOT try to get into a collar. There are many case reports of paralysis resulting from putting patients with ankylosing spondylitis into a collar.