With dealing with a spinal injury, this can occur if you don’t follow some basic rules. The spine itself contains the spinal cord which is where all the messages from the brain are sent to control the entire body. When damaged, the spinal cord cannot be repaired. The area where it’s damaged will affect the level of paralysis that occurs. So, damaging the spinal cord in the lower lumbar region in the back can result in the loss of use of legs. Damage is in the higher part can result in loss of control to vital life support systems like respiration. The simple rules of spinal injury management are that if there’s someone who’s hurt their back, do not move them. If you think someone has hurt their back or there’s a possibility of it, do not move them. So, we’re making sure that we’re not going to because of any injury to that person. Take extreme care if you’re in a car accident because you may well be supporting the person’s head and if you’re doing it from the front, there’s always an issue that the airbag could activate which will because of you and the patient injury. So, in this case, we support person from behind.
There are some exceptions to rule about not moving people, and that’s when there could be an imminent danger. Something like a burning car. Our responsibilities of first aid are to support the person’s head and neck, explain to them not to move, to look straight ahead. Leave their body exactly as you find it. The spinal cord cannot be repaired, so what we don’t want to do is anything that’s going to because of any injury to that or further damage. It may be that the person, although you suspect it, hasn’t actually done any serious damage to their back, but what we do is we always treat as if they would have done something to their back. Because the only way we’re going to find out if the back has been damaged will be in an X-ray in a hospital. So as first-aiders, we are immobilising the person and not moving them, the paramedics will do the same until they get them to the hospital.
One exception to this moving the patient will be if they’re not breathing, and then we’d need to do CPR. For this, we need to turn them onto their back to perform CPR. So, we do this using the log roll. Just turning them over in one motion. Now with this person who’s not breathing, the CPR must take priority. One easy way of remembering what to actually do when your approaching someone with a spinal injury, will be a mnemonic “SPINAL”. The “S” means “safety”. Ensure that the scene is safe and there are no dangers to you or to the patient. “P” equals “patient”. Tell them not to move, introduce yourself to them. “I” is “immobilize”. Protect and maintain the airway and hold their head still. “N” is “neutral”. Keep the head in a neutral position. So, you might need to just move the head into that neutral position. “A” is “assess” the body. This will be for further injuries. But you only assess if it’s safe to do so. “L”, “log roll”. You’d log roll somebody onto their side if they’re vomiting or they’re feeling sick so that the sick can come out. If not, “L” would mean “leave alone”. A person with a spinal injury, we’re going to try and leave them where they are. If you do need to leave somebody because you’re on your own, what we don’t want to do is leave them on their back if there’s a possibility they’re going to vomit. So, in this instance, we would move them onto their side.
We got a separate video showing you how to do that using the recovery position. There are lots of ways people can hurt themselves and lots of different people can be affected. So, start with, if maybe your children, they’re climbing a tree, they fall out of the tree and then they’re lying on the floor. What we need to do in this instance is to keep them still and call the emergency services. In a remote location like that, we can’t physically move the person, we need to get help there. So, immobilize them in the position we found them. Maybe at workplace and someone has fallen down the stairs. When they’ve landed on the stairs, they maybe unconscious. Now if someone’s unconscious, the whole time you’re dealing with this person who’s unconscious, talk to them. So, we’re talking to them, telling what’s going on. Because it maybe they can still hear you. What we need to do is hold their head, so you’re protecting their head. But don’t cover their ears up, you’re taking away another sensation. Just cradle their head to the side, talk to them the whole time, obviously make sure help is on its way.
Another example could be where somebody’s fallen off a ladder. Now if somebody’s fallen off a ladder it may be that when you approach them, they’re actually conscious. Someone who’s conscious like that may want to get up. So, what we need to do with the person is to talk to them and tell them to keep still. Approach around the head, hands either side of the head, don’t get them turning to you. So, the whole time, you need to talk to them and maybe even put your hand over their face so they’re watching your hand. Or tell them just to look straight up. When you’ve actually got the head, you’re in a lot more control at that point. So, remember, with spinal injuries, we need to make sure that we don’t do any further harm. So, we leave them in the position we found them, making sure the emergency services are on their way, and just keep talking to them and keep reassuring them the best we can. The only time we move them, CPR, or they’re in imminent danger, or we thinking they’re going to vomit.