First on the scene: spinal injury
Serious neck or back injury is a common occurrence and can be fatal. Fast, competent first-aid administered at the scene of an accident can give an injured person a much greater chance of recovery. What happens in the first hour after a neck or back injury is all-important: it can mean the difference between paralysis and full use of the limbs, or between life and death.
Why? A neck or back injury often causes swelling. If this swelling isn’t relieved quickly, it can cause permanent damage to the spinal cord and nerves – and lead to paralysis. An accident can also result in almost instantaneous, irreparable damage if the spinal column is hurt.
- Keep the person as still as possible if you suspect a neck or back injury. The smallest movement of a damaged spine can cause permanent paralysis and even death.
- Don’t give an injured person anything to eat or drink, even if they ask.
Look for these signs of a neck or spinal injury:
- A stiff neck and back, or neck and back pain
- Unusual neck or back position
- A tingling sensation, numbness or weakness in the hands and feet
- Poor or no bladder control
- Breathing difficulty
- Contusions (bruises or injuries with unbroken skin) on the head, neck, shoulders or back
- Partial consciousness or complete unconsciousness
After a diving accident in a swimming pool, shallow water, dam, river or the sea:
- If you suspect someone has hurt her neck after diving into a sandbank or shallow water, don't try to pull her out of the water (unless she is not breathing, or is in a life-threatening situation in dangerous water).
- If she's face-up in the water, keep her as still as possible until help arrives. Without bending or snapping the neck, make sure her nose and mouth are above water, and keep the head as still as you can. Make sure she's not swallowing water and can breathe. The water will support the injured back and keep it stable.
- If she's lying face-down, turn her over without bending or snapping the neck. Get two other people to help you. One helper must support the head while the other two turn the injured person on her back in a single, controlled motion. Never turn the head sideways without also turning the rest of the body. All three lifesavers should work together, on the count of three.
- Once the injured person is face-up, it's best to keep her as still as possible. Wait for paramedics to arrive so they can stabilise the spine with the correct equipment before the victim is removed from the water.
- Remove the injured person from the water only if she can't breathe or if you can't detect a pulse in the neck. In that case, drag her from the water while keeping the head and spine aligned as far as possible, without bending or snapping the neck. Place her flat on the ground and apply CPR.
After a neck or back injury on the sports field:
- Check to see if the injured person’s airways are clear and whether he's breathing by holding your ear close to his nose while looking to see if his chest is moving up and down.
- If he's breathing, check if he can speak. If he can, ask if he has any back or neck pain or numbness or weakness in the limbs.
- If he can't breathe or speak, don't touch him – leave him in the same position until an ambulance arrives.
- However, if he's not breathing and you can't detect a pulse you must apply CPR. To do this, you'll need two or three people to help you turn the injured person onto his back. One person should hold the head in such a way that the head and body can be turned in one controlled movement without the neck bending in any way. Then apply CPR without removing any protective headgear the person may be wearing.
- Stabilise the head and neck while waiting for paramedics to arrive.
After a road accident:
- If you suspect an injured pedestrian, cyclist or passenger has a neck or back injury, follow the same steps as for a sports injury (above).
- Move the injured person only if he or she is in life-threatening danger. If you're alone and have to act fast, pull the person to safety by the shoulders, at the same time using your forearms to prevent the neck from bending.
How to roll an injured person onto a stretcher without hurting his neck:
- Get two or three people to help you. While one of you supports the injured person's neck the others can help turn him or her. Use a neck brace if you have one.
- Move the injured person's head, neck and shoulders as a unit. Work together on the count of three.
- With a single movement, turn the person on his/her side and move the stretcher close to his/her back.
- Roll the person back onto the stretcher. Secure the victim and make sure the neck is in a stable position.
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