• Recognize that head wounds can come from many types of injuries, and you will not always see blood or an open wound when someone has hit their head. Diving into shallow water, for instance, may be an unsuspected source of spinal injury.

2. Do NOT move the victim

Any movement of the injured person can cause worse damage to their spinal cord. The only time you should ever move a potential spinal injury victim is if they are in immediate danger, such as in a burning house or car. If you are both in a safe environment, leave them exactly where they are and allow medical professionals to move them.

• If the victim was wearing a helmet at the time of injury, such as during sports or in a motorcycle accident, do not remove the helmet. This should be done by professionals.

3. Call for emergency services

Medical professionals will be better able to assess and manage potential spinal injuries, and will have backboards and special equipment for moving people with these injuries. Contacting emergency medical personnel should be done immediately, assuming you and the victim are in no immediate danger.

• When calling for medical aid, inform staff that you are dealing with a victim of a spinal injury. They will be able to give you more advice on how to take care of the victim.

4. Give CPR if necessary

Observe whether the victim is breathing on their own, as spinal injury can sometimes affect ability to breathe spontaneously. Look to see if their chest is rising with breath, or feel under their nose for air. The only time you should move the victim's head - short of being in immediate peril - is if you have to provide the rescue breathing or chest compressions of CPR. This can be a life-saving measure until emergency medical care arrives.

• If the victim's heart is beating but they are not breathing, provide rescue breaths; if they have no pulse, focus on high-quality chest compressions.
• To give rescue breaths, do NOT lift the victim's chin to open an airway if you can avoid it. Instead perform what is called the Jaw Thrust maneuver: Kneel at the top of the victim?s head, use both hands one on each side to hold the angles of their lower jaw, and lift upward with both hands. This technique may be slightly safer for spinal injury victims. Unfortunately, this requires a second person present to perform the rescue breathing while you hold the jaw upward.
• If they do not need CPR, you can then - without moving the victim - look them over to see if they have any other obvious severe injuries. Apply pressure to wounds that are heavily bleeding.

5. Note the cause of the injury

The most common cause of spinal injury in persons under age 65 is vehicular accidents. Other common causes are falls, gunshot and knife wounds, playing sports without appropriate safety equipment (especially American football), and injury sustained while under the influence of alcohol. Be on high alert for potential spinal damage with any of these injuries, and treat the victim accordingly. It may also help medical staff if you can tell them what caused the injury.

6. Recognize symptoms of spinal injury

If no healthcare professional is on site, you can evaluate the victim for signs and symptoms of spinal injury. First observe the victim - if they are unconscious or only somewhat conscious, their neck or back is at a strange angle, or they have lost control of their bladder or bowels and soiled themselves, assume spinal injury. Also treat them as if they have spinal injury if they won't or can't move their neck, seem to have trouble breathing, or they tell you they have intense pain in their neck, back or head. Another tell-tale sign of spinal injury is change in strength or sensation in their limbs.

• If injury occurs in the water, keep the victim afloat until someone can obtain a rigid board to slide under their head and torso as far down as their buttocks. If you can?t get a board, get help from other people to get the victim out of the water by moving them as one unit. Support their head and body, as if on a stiff board, and don?t let their neck bend or rotate.

4. Use at least two people if you must roll the victim over

If you must roll a spinal injury victim over to prevent choking on blood or vomit, get a second person to help you. Coordinate your timing so that you roll the victim over in such a way that the neck, back, and torso move as one unit. Do not allow the body to twist.

• Changes in sensory perception, like numbness and paralysis, which may worsen gradually.
• Gradual inability to control bladder or bowel, such as ?leaking? urine or becoming incontinent.
• New onset of erectile dysfunction or changes in genital sensitivity.
• Increased or new difficulty with walking, balance or coordination.

2. Obtain diagnostic imaging

If you or a loved one are at risk of spinal injury after an accident, go to the emergency room or at least see your doctor for testing. Your family doctor can perform sensorineural testing, manually testing muscle strength and ability to feel light touch. More definitive tests are CT scans, X-rays, and MRIs.

3. Participate in ongoing rehabilitation

The injury victim of spinal trauma will initially be stabilized in the hospital. After the hospital stay, however, long-term rehabilitation will begin. The rehabilitation team can involve physical therapists, occupational therapists, psychologists, psychiatrists, nurses, nutritionists, and social workers. This can be a physically and emotionally challenging time for the victim.

• Provide emotional support and help however you can, whether that's making frequent visits to play cards, walk the victim's dog, preparing meals, or just being available to talk about their struggles.

_______________________________________________________________________________________________________________________

Are you a healthcare practitioner who enjoys patient education, interaction and communication?

If so, we invite you to criticise, contribute to or help improve our content. We find that many practicing doctors who regularly communicate with patients develop novel and often highly effective ways to convey complex medical information in a simplified, accurate and compassionate manner.

MedSquirrel is a shared knowledge, collective intelligence digital platform developed to share medical expertise between doctors and patients. We support collaboration, as opposed to competition, between all members of the healthcare profession and are striving towards the provision of peer reviewed, accurate and simplified medical information to patients. Please share your unique communication style, experience and insights with a wider audience of patients, as well as your colleagues, by contributing to our digital platform.

Your contribution will be credited to you and your name, practice and field of interest will be made visible to the world. (Contact us via the orange feed-back button on the right).