Management of trauma patients practice

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Acute Careniche
A 24-year-old man comes off a trail bike at speed and arrives in a semi-rigid cervical collar and head blocks applied at the scene. He opens his eyes to voice, is combative, and repeatedly pulls at the collar; he has vomited once on the trolley. Oxygen saturation is 97 per cent on 6 L/min, blood pressure 138/82 mmHg and pulse 98/min. He has a scalp laceration and grazes over both shoulders, and he moves all four limbs. Which one of the following should be done first?