SPINAL INJURY
Injuries to the spine can involve one or more parts of the back and/or neck: the
bones (vertebrae), the disks of tissue that separate the vertebrae, the
surrounding muscles, and ligaments, or the spinal cord and the nerves that
branch off from it.
The most serious risk associated with spinal injury is damage to the spinal cord.
Such damage can cause loss of power and/or sensation below the injured area.
The spinal cord or nerve roots can suffer temporary damage if they are pinched
by displaced or dislocated disks, or by fragments of broken bone. If the cord is
partly or completely severed, damage may be permanent.
The most important indicator is the mechanism of the injury. Suspect spinal injury
if abnormal forces have been exerted on the back or neck, and particularly if a
casualty complains of any changes in sensation or difficulties with movement. If
the incident involved violent forward or backward bending, or twisting of the
spine, you must assume that the casualty has a spinal injury. You must take
particular care to avoid unnecessary movement of the head, neck, and spine at all
times.
Although spinal cord injury may occur without any damage to the vertebrae,
spinal fracture greatly increases the risk. The areas that are most vulnerable are
the bones in the neck and those in the lower back.
Any of the following incidents should alert you to a possible spinal injury:
■ Falling from a height, such as a ladder
■ Falling awkwardly, for instance, while doing gymnastics or bouncing on a
trampoline
■ Diving into a shallow pool and hitting the bottom
■ Falling from a horse or motorcycle
■ Football tackle or misplaced hit
■ Sudden deceleration in a motor vehicle
■ A heavy object falling across the back
■ Injury to the head or the face
SPINAL CORD PROTECTION :
The spinal cord is protected by the bony vertebral (spinal) column. Nerves
branching from the cord emerge between adjacent vertebrae.
RECOGNITION :
When the vertebrae are damaged, there may be:
■ Pain in the neck or back at the injury site. This may be masked by other, more
painful, injuries.
■ Irregularity or twisting in the normal curve of the spine
■ Tenderness and/or bruising in the skin over the spine
When the spinal cord is damaged, there may be:
■ Loss of control over limbs movement may be weak or absent
■ Loss of sensation, or abnormal sensations such as burning or tingling; a casualty
may tell you that his limbs feel stiff, heavy, or clumsy
■ Loss of bladder and/or bowel control
■ Breathing difficulties
CONSCIOUS CASUALTY
CAUTION :
■ Do not move the casualty from the position in which you found her unless she is
in immediate danger.
■ If the casualty has to be moved, use the log-roll technique (opposite).
FIRST AID FOR A CONSCIOUS CASUALTY:
1. Reassure the casualty and advise him not to move. Call RESCUE 1122 for
emergency help, or ask a helper to do this.
2. Kneel or lie behind the casualty’s head. Rest your elbows on the ground or
on your knees to keep your arms steady. Grasp the sides of the casualty’s
head. Spread your fingers so that you do not cover his ears, so he can hear
you. Steady and support his head in this neutral position, in which the head,
neck, and spine are aligned.
3. Ask a helper to place rolled- up blankets, towels, or items of clothing on
either side of the casualty’s head and neck, while you keep his head in the
neutral position. Continue to support the casualty’s head until emergency
services take over, no matter how long this may be.
4. Get your helper to monitor and record vital signs—level of response,
breathing, and pulse—while waiting for help to arrive.
YOUR AIMS :
■ To prevent further injury
■ To arrange urgent removal to the hospital
UNCONSCIOUS CASUALTY (FIRST AID)
CAUTION:
■ If the casualty has to be moved and you have help, use the log- roll technique
(below).
■ If you are alone and you need to leave the casualty to call for emergency help,
and if the casualty is unable to maintain an open airway, you should place her in
the recovery position before you leave her.
FIRST AID FOR AN UNCONSCIOUS CASUALTY:
1. Kneel or lie behind the casualty’s head. Rest your elbows on the ground or
on your knees to keep your arms steady. Grasp the sides of her head.
Support her head so that her head, trunk, and legs are in a straight line.
2. Open the casualty’s airway using the jaw-thrust technique. Place your
fingertips at the angles of her jaw. Gently lift the jaw to open the airway.
Take care not to tilt the casualty’s neck.
3. Check the casualty’s breathing. If she is breathing, continue to support her
head. Call RESCUE 1122 for emergency help or ask a helper to do this.
4. If the casualty is not breathing , begin CPR. If you need to turn the casualty,
use the LOG-ROLL-TECHNIQUE.