Spinal Injury
Spinal Injury
The spine protects the spinal cord, the central nerve that connects the brain to all the other nerves in the body, controlling breathing and movement. Correct treatment is therefore vital.
A spinal injury could be caused by a blow to the head, neck or back (including, for example, a collapsed rugby scrum), a fall from height, a dive into shallow water or an accident involving speed.
Signs & Symptoms
Check if the patient has been involved in any of the incidents described above that could have caused injury.
- Pain or tenderness in the back or neck.
- Loss of sensation or tingling of the extremities.
- Loss of bladder or bowel control.
- Paralysis (sometimes this is temporary as the muscles go into spasm).
Treatment
- Reassure the casualty and tell them not to move – keep them in the position you found them in.
- Support their head with your hands to keep the head and neck in line with the spine. Do not force a casualty into a position that they were not in prior to your involvement.
- Call 999/112.
If the casualty is unconscious, ensure they are immobilised:
- Use your arms to support either side of the head. You can use a trapezius squeeze technique to support the head if trained to do so, or simply provide support either side. Do not cover the ears when holding the head.
- Open the airway using a Jaw Thrust technique (if trained to do this). See below image.
- Assess breathing and perform CPR if indicated.
- Call 999/112.
- Keep the casualty warm and in the position you found them, unless they are in danger.
- If you must leave the casualty or if they vomit and you need to clear the airway, put them into the recovery position. Keep the head and neck in line with the spine while placing in the recovery position – but keeping the airway clear is your priority.
- Continue to monitor airway and breathing and be prepared to start CPR if necessary.
A jaw thrust allows the airway to be opened with minimal movement of the spine. Use a jaw thrust if you suspect a spinal injury.
- Position yourself at the casualties head looking towards their feet
- Place your thumbs on the casualty’s cheeks and your fingers ‘hooked’ under the lower jaw bone.
- Gently lift the jaw upwards with your fingers. An indicator when you have lifted enough is the lower teeth are further forwards than the upper teeth.
- Maintain this position to maintain the airway.
