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Spinal Injuries

Updated: Jun 22

Spinal injuries can be extremely dangerous, and need to be managed carefully. The greatest risk is that the spinal cord* is permanently damaged, which could cause paralysis.


Stretch!

Damage to the spinal cord is usually irreversible because nerve cells in the central nervous system cannot regenerate easily.


Possible causes of a spinal injury:

  • Falling from a height

  • Falling awkwardly

  • An injury to the head or face

  • Sudden deceleration* in a vehicle

  • Something heavy falling across the back


What you might see:

  • Twist in the normal shape/curve of the spine

  • Weak/absent movement of limbs

  • Pain in the neck or spine

  • Breathing difficulties

  • Bruising over the site of injury

  • Loss of bladder and/or bowel control


What to do:

The most important thing to remember is not to move the casualty*, except in very specific cases (such as to put them in the recovery position). They are extremely fragile right now, and should only be moved by medical professionals.


For a responsive casualty

  1. Reassure the casualty.

  2. Do not move them, and ask them not to move. Call emergency services immediately.

  3. Steady their head so that their head, neck and spine are in one line to minimise further damage. To do this, kneel behind their head while resting your elbows on the ground to stay steady. Hold each side of their head, making sure you do not cover their ears, and support their head in this position.

  4. Ask those around you to put rolled up blankets, towels or clothing on either side of the casualty's neck or head to maintain this neutral position.

  5. Support their head and neck - do not stop until emergency services arrive.

  6. Keep monitoring their breathing and level of response.


For an unresponsive casualty

  1. Do not move the casualty. Call emergency services as soon as possible.

  2. Steady their head so that their head, neck and spine are in one line to minimise further damage. To do this, kneel behind their head while resting your elbows on the ground to stay steady. Hold each side of their head, making sure you do not cover their ears, and support their head in this position.

  3. Ask those around you to put rolled up blankets, towels or clothing on either side of the casualty's neck or head to maintain this neutral position.

  4. Open their airways using the jaw thrust technique, where you place your fingers at the sides of the jaw and lift it to open the airway. Avoid tilting their neck.

  5. Check the casualty’s breathing. Place your ear above their mouth, looking down their body. See if you can hear, see or feel them breathing.

    • If they are breathing, continue to support their head and monitor them carefully.

    • If they are unresponsive and not breathing, make sure emergency services has been called, and start CPR immediately. Send someone to get a defibrillator* if possible.


Spinal injury recovery position

If you think someone has a spinal injury, but they cannot keep their airway open, you should put them in the recovery position.

If you are alone, try to roll them into the recovery position normally while maintaining a straight line with their head, neck and spine.

If someone is with you, ask them to steady the head or neck while you roll the casualty into the recovery position.


This is the spinal injury recovery position known as HAINES (High Arm In eNdangered Spine.)
This is the spinal injury recovery position known as HAINES (High Arm In eNdangered Spine.)

Summary:

Spinal injuries are very serious and can lead to permanent damage, so it's important not to move the casualty unless you have to. If the person is responsive, keep their head, neck, and spine in a straight line and support their head until help arrives. If they’re unresponsive, call for help, use the jaw thrust to open their airway (not head tilt), and only move them into the recovery position if they can’t breathe properly.


Glossary:


Spinal cord: A really important nerve that connects our brain to the rest of our body. If its damaged, the casualty may be paralysed. This means they can't move.


Deceleration: Slowing down.


Casualty: The person that's hurt in a first aid scenario.


Defibrillator: A device that uses electricity to restart someone's heart.


For Older Learners

Use these questions to challenge yourself!

  1. Why is the jaw thrust used instead of the head-tilt/chin-lift in suspected spinal injuries?

  2. Why might someone with a spinal injury lose bladder and/or bowel control?

  3. In what situations would it be more dangerous to leave a casualty with a spinal injury in place than to move them?


 
 
 

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