necessary. If transportation is necessary, keep
the victim lying down.
In any significant head or facial injury, assume
injury to the cervical spine. Immobilization 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 MEDICATIONS. See that
the victim receives a medical officers attention
as soon as possible.
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 that the victim is
properly cared for. Any twisting or bending of the neck
or backwhether due to the original injury or
carelessness from handling lateris 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 victim cannot move the legs, feet, or
toes, the fracture 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.
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.
Emergency 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 transportation 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 possible damage.
DO NOT BEND OR
TWIST THE VICTIMS BODY, DO NOT MOVE
THE HEAD FORWARD, BACKWARD, OR
SIDEWAYS, AND DO NOT UNDER ANY
CIRCUMSTANCES ALLOW THE VICTIM TO
If it is necessary to transport a person who has
suffered a fracture of the spine, follow these general
If the spine is broken at the neck, the victim 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 padding 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 broken (i.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 transporting 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 victim firmly to the
When placing the victim on a spineboard, one of
two acceptable methods may be used. However,
DO NOT ATTEMPT TO LIFT THE
VICTIM UNLESS YOU HAVE ADEQUATE
ASSISTANCE. Remember: Any bending or
twisting of the body is almost sure to cause
serious damage to the spinal cord. Figure 4-42
shows the straddle-slide method. One person
lifts and supports the head while two other
persons each lift at the shoulders and hips,
A fourth person slides the
spineboard under the patient. Figure 4-43 shows
the proper procedure in performing the log-roll
method. The victim is rolled as a single unit
towards the rescuers, the spineboard is
positioned, and the victim is rolled back onto the
spineboard and secured in place. If there are at
least four (preferably six) people present to help
lift the victim, they can accomplish the job
without too much movement of the victims