What should be done immediately if a patient on a backboard vomits?

If a patient on a backboard vomits, the immediate priority is to ensure that their airway remains clear to prevent aspiration, which can lead to serious respiratory complications. Therefore, suctioning the airway and repositioning the patient is the appropriate action to take.

Suctioning helps to remove any vomit or secretions from the airway, which is critical in preventing obstruction and ensuring that the patient can continue to breathe effectively. Furthermore, repositioning the patient is important as it can assist in drainage and allow for better access to the airway.

Leaving the patient as they are would not be safe, as it risks aspiration of the vomit into the lungs. Performing abdominal thrusts is not appropriate in this context, especially since the patient is already immobilized on a backboard, which could lead to further injury. Inserting an advanced airway is generally a more advanced and later step in management that may not be immediately feasible in a vomit scenario, particularly without first ensuring that the airway is clear and providing suction as needed. Thus, the correct choice is the one that directly addresses the immediate need to secure the airway and prevent further complications.