If there is serious bleeding from the wounds,
try to control it by the application of direct
pressure, using caution to avoid further injury to
the skull or brain. Use a donut shaped bandage
to gently surround protruding objects. Never
manipulate those objects.
Be very careful about moving or handling
the victim. Move the victim no more than
is necessary. If transportation is necessary,
keep the victim lying down.
In any significant head or facial injury,
assume injury to the cervical spine. Immo-
bilization of the cervical spine is indicated.
Be sure that the victim is kept comfortably
warm, but not too warm.
Do NOT give the victim anything to drink.
DO NOT GIVE ANY MEDICINES. See
that the victim receives a medical officers
attention as soon as possible.
Fracture of the Spine
If the spine is fractured at any point, the spinal
cord may be crushed, cut, or otherwise damaged
so severely that death or paralysis will result.
However, if the fracture occurs in such a way that
the spinal cord is not seriously damaged, there is
a very good chance of complete recovery
PROVIDED the victim is properly cared for. Any
twisting or bending of the neck or back, whether
due to the original injury or carelessness from
handling later, is likely to cause irreparable
damage to the spinal cord.
The primary symptoms of a fractured spine
are pain, shock, and paralysis. PAIN is likely to
be acute at the point of fracture. It may radiate
to other parts of the body. SHOCK is usually
severe, but (as in all injuries) the symptoms may
be delayed for some time. PARALYSIS occurs
if the spinal cord is seriously damaged. If the vic-
tim cannot move the legs, feet, or toes, the frac-
ture is probably in the back; if the fingers will not
move, the neck is probably broken. Remember
that a spinal fracture does not always injure the
spinal cord, so the victim is not always paralyzed.
Any person who has an acute pain in the back
or the neck following an injury should be treated
as though there is a fractured spine, even if there
are no other symptoms.
First aid treatment for all spinal fractures,
whether of the neck or of the back, has two
primary purposes: (1) to minimize shock and (2) to
prevent further injury to the spinal cord. Keep the
victim comfortably warm. Do not attempt to keep
the victim in the position ordinarily used for the
treatment of shock, because it might cause further
damage to the spinal cord. Just keep the victim
lying flat and do NOT attempt to lower the head.
To avoid further damage to the spinal cord,
DO NOT MOVE THE VICTIM UNLESS IT IS
ABSOLUTELY ESSENTIAL. If the victims life
is threatened in the present location or transpor-
tation is necessary to receive medical attention,
then of course you must move the victim.
However, if movement is necessary, be sure that
you do it in a way that will cause the least possi-
ble damage. DO NOT BEND OR TWIST THE
VICTIMS BODY, DO NOT MOVE THE HEAD
FORWARD, BACKWARD, OR SIDEWAYS,
AND DO NOT UNDER ANY CIRCUM-
STANCES ALLOW THE VICTIM TO SIT UP.
If it is necessary to transport a person who has
suffered a fracture of the spine, follow these
If the spine is broken at the NECK, the vic-
tim must be transported lying on the back,
FACE UP. Place pillows or sandbags
beside the head so that it cannot turn to
either side. Do NOT put pillows or pad-
ding under the neck or head.
If you suspect that the spine is fractured
but do not know the location of the break,
treat the victim as though the neck is
brokeni.e., keep the victim supine. If
both the neck and the back are broken,
keep the victim supine.
No matter where the spine is broken, USE
A FIRM SUPPORT IN TRANSPORT-
ING THE VICTIM. Use a rigid stretcher,
or a door, shutter, wide board, etc. Pad
the support carefully and put blankets both
under and over the victim. Use cravat
bandages or strips of cloth to secure the vic-
tim firmly to the support.
Figure 4-60.Moving spinal cord injury victim onto a