Recognizing Back and Spinal Injury

The spine is made up of a number of small bones called vertebrae. These form the backbone or spinal column, through which runs the spinal cord (the part of the central nervous system connecting all parts of the body with the brain) and major blood vessels. Injuries to the back are caused in a number of ways: through direct impact (such as a heavy blow to the neck or back); indirect impact (landing on the head or feet without bending the legs, thus allowing the force to travel up the body); and whiplash, when the head is violently thrown forward and backward (common in traffic accidents).

COMPLICATIONS WITH BACK INJURY. The biggest danger with back injuries is the risk of nerve damage. The spinal cord containing the spinal nerves runs down the center of the vertebrae and fractures can sever or pinch these nerves, leading to partial or full paralysis. If the fracture is high in the neck, breathing may stop. Displaced vertebrae or swelling due to blood loss can also apply pressure to the spinal cord, leading to nerve damage.

     Not all broken backs result in immediate damage to the spinal cord. However, the risk of spinal cord injuries is greatly increased if bones are broken, and any suspected fracture of the spine should be treated with extreme care.

Suspect a broken back or potential nerve damage if the accident involved:

• Rapid slowing down of movement.
• A fall from height.
• A sharp blow directly to the back
• Injury to the face or skull (because this often results from the head being thrown backward and forward).

SIGNS AND SYMPTOMS

• Dent or step in the spine, which may indicate a displaced vertebra.
• Bruising or swelling over the backbone
• Complaint of pain in the back
• Tenderness over the area of the break.

TREATMENT. Any spinal injury is potentially serious and you should seek emergency assistance immediately. The treatment for injuries to the back is to keep the injured person still while monitoring and maintaining airway and breathing. The general rule for dealing with broken bones or spinal cord damage is to keep the victim in the position that you found him until a doctor arrives, taking particular care to ensure the head is immobilized.

     Unless the person is in danger or unconscious and requires resuscitation, do not move him from the position in which he was found. If you have been trained to do so, you can move the head into the neutral position before immobilization. Remain in this position until emergency help arrives.

1. If the victim is conscious and already lying down, leave him where he is. If the victim is still walking around, support him in lying down on the ground. If you can, put a blanket or coat underneath before you lie the person down.
2. Ensure that an ambulance has been called at the earliest opportunity.
3. Tell the person to keep still until medical help arrives and reassure him.
4. Hold the victim's head still by placing your hands over the ears and your fingers along the jawline.
5. Do not remove your support from the head until help arrives.

If the victim is unconscious, maintaining a clear airway is your first priority.

BACK PAIN. There are many causes of back pain. Among the most serious is damage to the spinal cord, which may lead to paralysis or meningitis. More commonly, neck or lower back pain can be caused by muscle strain or damage to the ligaments or the disks between the vertebrae (the back bones). Broken ribs or damage to the muscles between the ribs at the back may also cause back pain.

TREATMENT

• Check the nature of the incident carefully-- if the pain is related to a recent heavy fall or other accident, assume that there may be spinal cord damage and treat as for a broken back.
• Help the person to lie down. Usually the most comfortable position will flat on the back on a hard surface.
• If the symptoms do not ease, seek medical attention promptly.

SIGNS AND SYMPTOMS

• Dull or severe pain, usually made worse by movement
• Tension in the neck or shoulders
• Pain travelling down limbs

If back pain is accompanied by signs of spinal cord damage, such as numbness,tingling, or by headaches, nausea, vomiting, fever, or a deterioration in the level of consciousness (e.g. increasing drowsiness), call 911.

THE SPINE

The spine or backbone enables the body to stand upright, supports the head, and protects the spinal cord. Joints between vertebrae give the spine flexibility; ligaments and tendons stabilize the spine and control movement.

SIGNS AND SYMPTOMS OF SPINAL CORD DAMAGE

• Loss of movement below the site of the break
• Tingling in the fingers or toes or throughout the body
• Feeling strange, perhaps "jelly-like"
• Numbness

If any of these signs and symptoms is present, or if the nature of the accident indicates a potential fracture, assume that a bone is broken and keep the person still until help arrives.

WARNING!

• Do not give anything to eat or drink-- the victim may need a general anesthetic in hospital.
• Do not move the victim unless he is in danger or requires resuscitation.

IF YOU HAVE TO MOVE THE VICTIM

The two key reasons for moving someone wit a spinal injury are: to turn the person onto her back in order to resuscitate her; and to move her into the recovery position if she is unconscious and in a position that does not allow her to maintain a clear airway.

NEUTRAL POSITION. The best position for a person with a suspected neck or spinal injury is the neutral position. Here the head is in line with the neck and spine. To move a person into the neutral position, grip the head firmly over the ears and move it slowly into line. Once in this position, do not give up this support until medical help arrives to take over from you.
     Only use this technique if you have been trained to do so.

LOG ROLL. One of the most effective ways of turning a person over is the log roll technique. Log roll can also be used to turn somebody with a spinal injury onto her side as an alternative to the recovery position. It is also commonly used to move people with other injuries, such as broken leg or pelvis, onto a stretcher or blanket.
     Ideally, six people should be used to carry out this technique, with one person taking the lead and control of the head.

1. Place your hands over the ears with your fingers along the chin. Hold the head in the neutral position.
2. Ask the supporters to gently move the arms to the side of the body and to move the legs together.
3. Ask the supporters to support the spine and limbs and to follow your commands.
4. Roll the victim like a log, keeping the head and chin in line with the neck and spine.

If you are by yourself and the injure person is not breathing, do not waste time searching for help. Turn the person as carefully as you can with any help available to you.

WARNING!

• Do not give anything to eat or drink-- the victim may need a general anesthetic in hospital.
• Do not move the victim unless she is in danger or needs resuscitation.

SPINAL INJURY RECOVERY POSITION

1. Support the victim's head as described above. Make yourself comfortable, because you will have to continue to do this until the ambulance arrives.
2. Ask a bystander to put the arm nearest the victim's shoulder gently underneath the victim's body, ensuring that the fingers are flat and the elbow straight. Bring the furthest arm across the body. The first responder must support the face.
3. The victim's furthest leg should be bent upward and the bystander's arm placed on the thigh just above the knee.
4. Working under orders from the first responder at the head. the victim should be gently turned, unsuring that the head, trunk, and toes stay in line.
5. Once the victim has been turned over, the neck should continue to be supported while the bystander ensures that the victim is stable, either by supporting the body himself or by placing coats or rolled-up blankets, for example, around the victim.

Alternatively, you can use the log roll technique.

UNCONSCIOUS VICTIM
This is a particularly difficult situation to deal with. The victim's airway is always your first priority. The person may have a broken back that could cause nerve damage and paralysis, but if you do not protect the airway and ensure that the victim continues breathing, she will die.

TREATMENT.  If you come across an unconscious person for whom the nature of the accident or the positioning indicates that she may have broken her back (for example, a bystander tells you the victim fell, or the person is wearing motorcycle leathers and lying next to a damaged motorcycle), your priority remains to check the airway.

1. Ask a question to find out if the victim is conscious. Do not shake the victim.
2. Carry out your ABC checks, taking care to tilt the head gently. If the head is already extended a suitable way, do not move it any further. Instead, just use the chin lift and carefully check the mouth.
3. If the victim is not breathing, provide rescue breathing and full CPR as needed. Call 911 as soon as possible.
4. If you have to roll the victim onto her back to resuscitate, then you should aim to keep the victim's head, trunk, and toes in a straight line. If possible, get bystanders to help move the victim over, but do not waste time looking for help because the victim needs air as soon as possible.
5. If the victim is unconscious and lying in such a way that the head is extended and she is on her side, allowing fluid to drain from the mouth, then leave her alone.
6. Hold the victim's head still by placing your hands over the ears and your fingers along the jawline. Ensure that the airway is monitored.
7. If the victim is unconscious and either the head is not extended or she is not lying on her side, you need to move her into the recovery position, ideally, with enough bystanders, you should use the log roll, if not, be prepared to roll the victim into the recovery position with all available help.

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Frederick Luneta is a 24-year old guy and he is a Computer Engineering student and a young part time blogger. Currently lives in the Philippines. He knows a lot about computer.