The spinal cord is a mass of nerve fibres that enables signals to travel between the brain and the rest of the body. It runs down through the neck and is protected by the spinal column that consists of 33 vertebrae bones that have a spongy disc between each vertebra. The lower spinal bones are fused together. In an accident the vertebrae may be fractured or dislocated, causing injury to the spinal cord.

Symptoms

• Evidence of trauma

• Nausea, headache, dizziness

• Tenderness, pain

• Altered sensations such as numbness, tingling, pins and needles in the hands or feet

• Loss of movement to arms and/or legs

Signs

• Abnormal position of head or neck

• Head injury

• Altered conscious state

• Breathing difficulties

• Shock

• Change in muscle tone - flaccid or stiff

• Loss of function in limbs

• Loss of bladder or bowel control

• Priapism (erection in males)

Special considerations – The possibility of spinal injury must be considered for ALL trauma incidents.

• If the spinal cord is partially damaged, there may be loss of feeling or loss of normal movement below the injury site

• If the spinal cord is completely severed, there will be loss of movement below the injury site

First aid

Conscious casualty:

• Ensure that the casualty stays still and is not moved unless in immediate danger

• If there is no other choice and they must be moved, support the injured area and minimise movement of the spine

• Manually support the neck, this is vital

• Keep them comfortable and reassure until help arrives

Unconscious casualty:

• Immobilise the neck immediately with your hands, manual support is the best

• Airway management takes priority over a suspected spinal injury. It is acceptable to gently move the head into a neutral position to obtain a clear airway

• If breathing, with as much assistance as possible, gently roll the casualty onto their side and ensure an adequate airway