First Aid for Spinal Injury
A spinal injury can occur suddenly and may seriously affect a person’s movement, sensation, and overall health. Quick, calm action is essential—especially when there’s a risk of injury to the head, neck, or back—to help prevent further damage and keep the person safe.
These injuries often happen during falls, sports accidents, or car crashes. Taking the right first aid steps in those first critical moments can greatly impact recovery and long-term outcomes.
Understanding Spinal Injury
Spinal injuries can cause serious problems, such as loss of feeling and movement. The type and location of the injury decide its effects on the body.
What Is a Spinal Injury
A spinal injury happens when something damages the spinal cord or the surrounding bones and tissues. The spinal cord is a bundle of nerves that sends signals between the brain and the rest of the body. Most spinal injuries happen because of trauma, such as falls, car accidents, sports injuries, or violence. Less often, infections, tumors, or diseases can also harm the spinal cord.
A spinal injury can affect movement, touch, and basic body functions like breathing, bladder or bowel control, and blood pressure. The effects depend on how badly the spinal cord is hurt.
Types and Severity
Spinal injuries fall into two main types:
- Complete Spinal Injury: The person loses all movement or feeling below the injury. All nerves are affected.
- Incomplete Spinal Injury: The person keeps some movement or feeling below the injury. Only some nerves are affected.
How much function is lost shows how severe the injury is. Injuries higher up on the spine, like in the neck, usually cause more serious problems. These can lead to paralysis of the arms and legs (quadriplegia). Lower injuries, such as in the back, might only affect the legs (paraplegia). Minor injuries might cause numbness without full paralysis.
Spinal Cord Function and Damage
The spinal cord sends signals between the brain and the rest of the body. These signals control muscle movement, touch, pain, and automatic body functions. If the cord is damaged, signals cannot get through. This causes problems such as paralysis and loss of sensation below the injury. The force and location of the injury decide how much damage occurs.
Other effects can include loss of bladder and bowel control, trouble with breathing, and changes in heart rate or blood pressure. Damage to the upper part of the cord can be especially dangerous because it may affect breathing and vital organs.
Recognizing Spinal Injury Symptoms
Spinal injuries often show clear warning signs that should not be ignored. Acting quickly when these symptoms appear can help protect the person from further harm.
Common Signs to Look For
Spinal injuries can cause changes in a person’s ability to move, feel, or stay awake. The most immediate signs often include:
- Sudden loss of movement or trouble moving arms or legs.
- Loss of sensation, especially in the hands, feet, or below the injury site.
- Signs of confusion or unconsciousness if the injury involves the head.
Other important signs are pain or pressure in the neck, back, or head. Visible injuries, like a twisted neck or back, should also raise concern. If a person cannot turn their head or has severe pain when trying to move, treat this as a possible spinal injury. Always keep the person as still as possible and call for emergency help right away.
Tenderness, Numbness, and Tingling
People with spinal injuries might complain of tenderness along the spine, even if they look fine on the outside. Light pressure along the neck or back may cause sharp or unusual pain. Numbness or tingling (“pins and needles”) in the arms, hands, legs, or feet is a warning sign. This means the nerves that pass through the spinal cord may be compressed or damaged.
To check for sensation, gently touch their hands and feet and ask if they can feel it. If the answer is no, or if the feeling is very weak or odd, assume a spinal injury and avoid moving the person.
Breathing Difficulties and Paralysis
Damage to the spinal cord can affect breathing muscles. If someone finds it hard to breathe or take a deep breath, the spinal cord may be involved. Signs to watch for:
- Short, shallow, or weak breaths
- Struggling to talk in full sentences
- Lips or face turning blue
Paralysis is another serious symptom. This might show up as total or partial loss of movement in the arms, legs, or body below the injury. Paralysis often appears soon after the injury and should be treated as an emergency. Keep the person still until professional help arrives.
Immediate First Aid Steps for Spinal Injury
Spinal injuries need quick and careful action to prevent further harm. The main goals are to keep the person safe, reduce movement, and get emergency help right away.
Initial Scene Safety and Assessment
Before helping someone with a possible spinal injury, check if the area is safe. Do not risk your own safety. Look for dangers like falling objects, traffic, or fires. Once you know it is safe, check the injured person without moving them. Signs of spinal injury include neck or back pain, numbness, tingling, or weakness in arms or legs, and trouble moving.
Sometimes, the person may be unconscious after an accident or a fall. Car crashes, sports injuries, or falls from heights are especially risky. If you have first aid training, check the person’s breathing and if they are awake. Avoid twisting or bending the neck and back. Do not move the person unless there is immediate danger (like fire or an unsafe location).
Stabilizing the Head and Spine
Keep the head and spine stable. Do not try to reposition or move the person unless there is no other option for safety. If possible, ask the person not to move. If you are trained, hold their head and neck in line with the spine by placing your hands on both sides of the head. If you are alone, use rolled towels, blankets, or clothing on each side of the head and neck to prevent movement.
Make sure the entire body, especially the head and neck, stays still. Moving the person the wrong way can make the injury worse. If the person is not breathing and you must do CPR, try to keep their neck straight, tilting the jaw carefully without bending the neck if you have first aid training.
Calling for Emergency Help
Call emergency services (911) as soon as you suspect a spinal injury. Give clear information: location, type of injury, and person’s condition. Tell them that you suspect a spinal injury so responders bring the right equipment. While you wait for help, stay with the person and keep them calm. Do not let them eat, drink, or move.
Watch for signs of shock, like pale skin, sweating, or fast breathing, and be ready to give first aid if needed. Follow instructions from dispatchers and stay on the line until told to hang up.
Managing Different Casualty States
First aid for spinal injuries depends on whether the person is conscious or unconscious. Each situation needs a specific approach to avoid further harm and to protect breathing and spinal alignment.
Unconscious Casualty Response
If the person is unconscious, first check their airway, breathing, and pulse. Keep the spine in a straight, neutral position. Do not move the person unless there is immediate danger, such as fire or flooding.
If the person is not breathing, start CPR right away and try to keep the head and neck as still as possible. Use a gentle chin lift or jaw thrust to open the airway if needed, supporting the head at all times. If the person is breathing, keep them still and watch their breathing closely.
If they start to vomit or have breathing problems, you may need to roll them onto their side. Use more than one person to move the person as a single unit and keep the spine straight. Any twisting could cause more injury.
Conscious Casualty Care
A conscious person with a suspected spinal injury should stay calm and still. Tell them not to move their head, neck, or back. Support their head in the position you find it, using rolled towels or clothing on each side if possible.
Watch for signs of shock, such as pale skin, sweating, or confusion. Pay attention to breathing problems or loss of feeling in the arms or legs. If the person reports numbness, tingling, or trouble moving limbs, treat this seriously.
Do not give them food or drink, as surgery might be needed later. Reassure them and encourage slow, steady breathing. Call for emergency help and stay with the person until help arrives, letting them know what is happening to keep them calm.
Preventing Further Harm During First Aid
Spinal injuries can become much more serious if the wrong actions are taken. The right steps can reduce the risk of permanent problems, such as paralysis or long-term nerve damage.
Mistakes to Avoid
Mistakes during first aid for spinal injury can lead to permanent harm. Never move a person with a suspected spinal injury unless there is immediate danger, such as fire. Moving the person unnecessarily can increase damage to the spinal cord and may cause paralysis. Do not try to straighten their back, neck, or head.
Avoid trying to remove helmets or protective gear, except to ensure breathing if absolutely necessary. Do not lift, twist, or bend the person. Stay calm and call emergency services. Reassure the injured person and ask them to stay still. Let trained responders handle most care, unless you must act to prevent death.
Handling Airway and Breathing
Keeping the airway open and making sure the person can breathe is always a priority. If the person is not breathing, use the jaw-thrust maneuver instead of tilting their head back. This limits movement of the neck and spine.
- Jaw-Thrust Maneuver Steps:
- Kneel at the head of the person.
- Place your hands on each side of the jaw.
- Gently push the jaw forward without moving the neck.
If the person starts vomiting, carefully roll the whole body, keeping the head and neck in line with the spine. Use at least one other helper if possible to keep the spine straight during this movement. Do not use force.
Movement Precautions
Moving a person with a spinal injury can cause permanent nerve damage and paralysis. Move the person only when no safer option exists. If you must move them, support the head, neck, and back so they stay in a straight line at all times. Key practices:
- Use a backboard or a firm stretcher if you have one.
- Have several people coordinate movements, with one person giving directions.
- Do not twist or bend at the waist.
- If you are alone, stabilize the head and neck as best as you can during the move.
Keep the spine straight and supported during transport. Wait for emergency services to arrive.
