Introduction. Cervical spine injury has the highest frequency in poly-trauma patients due to its high mobility and flexibility. Material and methods. In this study, enrolled 125 patients in the year of 2022 who went to emergency department (ED) of Institute of Emergency Medicine (IEM) with poly-trauma, from which 95 patients were diagnosed with cervical spine injury, and approximately 20% had airway management. Results. The 20% patients who had difficulty breathing, with a necessity of airway management, intubated at sight in the emergency department, when there was a suspecting of fracture between C3-C5 spinal cord following Nexus Guidelines for cervical fractures and Tintinaly’s guidelines for Cervical trauma. The diagnosis was pre confirmed with the help of neurosurgeons and spinal surgeons, and confirmed by cervical CT. Patients suffered cervical pain, cervical stiffness, paresthesia, dysesthesias. Conclusion. The insurance of Airway management in poly-trauma patients is very vital, especially if the patient has a C-spin injury between C3-C5. which at any moment can lead to respiratory insufficiency due to the innervation of the nerves for the diaphragm.