First aid: Spinal Injury – when to move them

People are often confused and scared about when to move someone and when to keep them still, this is particularly important when there is a serious risk of them having a spinal injury.

Spinal Injuries

You should suspect a spinal injury if:

    They have fallen from more than twice their height, or been pushed with force

    something heavy has fallen onto them,

    they have been involved in a road traffic accident – either within a moving vehicle, or being hit by anything at speed, particularly if it is over 15 mph.

    they have been doing any form of combat or contact sport,

    they have a head injury.

If they are conscious, try and keep them completely still, but do not restrain them if they want to move. Ideally you want to avoid them twisting If they are unresponsive but breathing, you will need to very carefully put them into the recovery position to protect their airway, ideally by log rolling them onto their side. If they are unresponsive and not breathing, you will need to move them onto their back and resuscitate them
Most people don’t have spinal injuries, but it is really important to be cautious. It is possible to have broken your back or neck and not know and it is only when it is X-rayed, that the break is discovered. It is really important to keep the spine in line and not to let them twist.
If they have a damaged spinal column (bones) and they twist, it can damage the spinal cord and result in paralysis.

If someone is on their own with a casualty who may have a spinal injury, but is unresponsive but breathing you still need to put them in the recovery position supporting their head and neck  Shout loudly to them to keep still and tell them you are coming over.

Support their head and neck in-line with the body, whilst you assess their level of consciousness. DO NOT MOVE THEM! Get someone to phone for an ambulance.

Support their head and neck, but don’t cover their ears, as hearing is the last sense to go and the first to come back!

To assess their level of consciousness, first speak to them. Shout loudly and clearly, tell them who you are and as if they are ok. If there is no response, then pinch their ears. You want to give them a sharp, painful stimulus to see if they are alive or not. If you don’t get a response when you pinch one ear, pinch the other, in case they have a weakness down one side. If you get a response, you know they are alive and breathing. If there is no response, but they are breathing, they need to be put into the recovery position quickly and carefully.

To check if they are breathing, put your cheek above their mouth and nose, look down their body and look down the body, listen to their breathing and feel their breath on your cheek. (If they are not breathing you will need to resuscitate them)

Keep supporting their head and neck. Very carefully straighten their limbs and quickly prepare to log roll them into the recovery position. Check the pocket on the side that you are rolling them onto.

The second person, should position themself at the shoulders and be ready to roll the casualty towards them.

The third person should position themselves in the middle of the body and overlap hands to support the casualty’s body really well.

The 4th person supports the leg. They need to gutter the leg supporting underneath, so that when the casualty is rolled over – they remain completely straight. Check everyone is ready.

The person holding the head should take charge. On the count of 3, everyone rolls together keeping the spine in line.

Check the casualty is sufficiently on their side to keep the airway open and to allow the contents of their stomach to drain. 

Keep supporting the head – do not let go until the paramedic takes over. The other people should continue to support the lower part of the body. 

Keep checking that they are breathing.

THE AUTHOR: Tel 0208 675 4036. First Aid for life provides this information for guidance and it is not in any way a substitute for medical advice. First Aid for Life is not responsible or liable for any diagnosis made, or actions taken based on this information. It is strongly advised that you attend a practical First Aid course to understand what to do in a medical emergency.

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