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When dealing with a patient who may have a spinal injury, it is vital to follow some basic rules. The Spine contains the Spinal Cord, which is where the messages from the brain are sent to control the entire Body.

If damaged, the Spinal Cord cannot be repaired. The area where the spinal cord is damaged will affect the level of paralysis that occurs. Damaging the spinal cord in the lower lumbar region in the back, can result in the loss of use of the legs. Damage higher up can result in loss of control to vital life support systems, such as respiration.

The simple rule of spinal injury management are:

If there is someone who has hurt their back, do not move them.
If you think someone may have hurt their back or if there is the possibility that they have, do not move them.

When dealing with a patient with a suspected spinal injury, as a first aider your responsibilities are to support the person’s head and neck, explain to them not to move and to look straight ahead. Leave their body in the exact position you found it in. In many cases there won’t be a spinal injury, but we always treat as if they have damaged their back.

The only exceptions to the rule about not moving someone with a suspected spinal injury would be:

If the patient is in imminent danger, for example in a burning car.

If the patient is not breathing and you need to perform CPR, which would mean turning them onto their back.

The patient is vomiting and may choke if the vomit cannot "drain away"

If you do have to move a patient with a suspected spinal injury to perform CPR for example, you would use the “log roll”, this moves the patient in one single motion. If they are vomiting, they will choke if they remain on their back, so this would be a situation where they would need to move, again you would use the “log roll” to move them onto their side so that the vomit can come out.

Remember the Mnemonic SPINAL

S- Safety – Make sure you and the patient are safe

P - Patient – Tell the patient not to move
I  - Immobilise – Protect and maintain the airway and hold their head still
N -Neutral – Keep the head in a neutral position
A -Assess – for other injuries, but only if safe to do so
L - Leave them where they are or use the Log Roll if you absolutely have to move them.

As a first aider remember don’t move someone if you suspect there may be a spinal injury, unless it is absolutely necessary, leave the patient in the position you found them, support their head and neck, make sure that the emergency services are on their way, reassure the patient and keep them as calm as possible.