Spinal injury

The spinal cord connects the brain to the rest of the body. Together they make up the central nervous system.

The spine is made up of:

• the spinal cord itself

• the bones that protect the spinal cord (called vertebrae)

• the discs of tissue between the vertebrae

• the surrounding muscles

• and the nerves which branch off it, to carry messages between the brain and the rest of the body in the form of high-speed electric pulses.

The spinal cord connects to individual muscles and tells them to move (called motor function). It also connects to organs like the skin, which communicates feelings like touch, pain and heat (called sensory functions).

The greatest risk if someone has a spinal injury is that their spinal cord will be either temporarily or permanently damaged. If this happens, they’ll become paralysed from the point of injury down.

The most common cause of a spinal injury is extreme force, violent twisting or bending forwards or backwards. You should be aware of the possibility of a spinal injury if someone has:

• fallen from a height, e.g. a ladder

• fallen awkwardly, e.g. while doing gymnastics

• dived into a shallow pool and hit the bottom

• fallen from a moving vehicle, e.g. a motorbike, or a horse

• been in a collapsed rugby scrum

• been in a motor vehicle which suddenly crashes

• been hit by a heavy object falling across their back

• had an injury to the head or face.

Watch our video - spinal injury

What to look for - Spinal injury

If you think someone may have injured their spine, these are the seven key things to look for:

If the vertebrae (bones protecting the spinal cord) are damaged:

  • 1. pain in the neck or back
  • 2. unusual shape or twist in the normal curve of the spine
  • 3. soreness and/or bruising in the skin over the spine

If the spinal cord is damaged:

  • 4. loss of control over limbs – may not be able to move arms or legs
  • 5. loss of sensation, or abnormal sensations, e.g. burning or tingling
  • 6. loss of bladder and/or bowel control
  • 7. breathing difficulties

What you need to do - Spinal injury

If they’re responsive:

• Reassure them and tell them not to move

• Call 999/112 for an ambulance or ask someone else to call one for you

• You need to stop their head or neck from moving to prevent further damage

• To do this, kneel or lie behind their head. Rest your elbows on the ground or on your knees to keep your arms steady. Grip each side of their head, without covering the ears, to support their head in this position so that the head, neck and spine are in a straight line

Jaw thrust technique

• You need to support the head until emergency services can take over, no matter how long it takes for them to come. If there is someone who can help you, ask them to put rolled-up blankets, towels or clothes on either side of the head to help support it.

If they’re unresponsive:

• Open their airway using the jaw-thrust technique. To do this, put your fingertips at the angles of the jaw and gently lift to open the airway, avoiding tilting the neck

• Then check if they’re breathing

• If they’re breathing, continue to support their head and call 999/112 for an ambulance. If you can’t maintain an open airway then carefully follow the instructions of how to put someone with a spinal injury in the recovery position.

If they’re not breathing, you’ll need to start CPR (cardiopulmonary resuscitation)

While waiting for help to arrive, keep checking their breathing, pulse and level of response.

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