Head and Neck Injuries

To move or not to move

One of the questions that always comes up on our Safe and Sound first aid courses is  --  "if you  think someone  may have broken their neck  should they be moved?"  Clearly the concern is that if you  move somebody with a supected broken neck then you  might paralyse them. But if they are not breathing or  are about to choke on their own vomit, then you have to move them, as it is your job as a first aid to help preserve life.

Reading Melanie Reid’s feature in the Saturday Times Magazine brought this question back to my mind. Melanie fell from her horse in 2010 and has been partially paralysed since the accident. Her weekly column in the Saturday Magazine is a ‘must read’. 

Melanie says, “I fell off my horse. The first job was to survive. And I managed that, thanks to the friends at the scene, paramedics, the crew of a Navy search and rescue Sea King, and the NHS at its most superb.” 

I don’t know if Melanie stopped breathing and yes she is paralysed, but alive and I also  don’t know whether she was glad that she was saved but  I suspect she is as she continues to fight for a recovery.

So what should you  do?

Suspect a spinal injury if someone has:

Had a blow to the head neck or back (especially resulting in unconsciousness).

Fallen from a height – like Melanie did from her horse

Dived into shallow water

Been in an accident involving speed – such as a car accident

Been involved in a ‘cave in’ accident – such as crushing or collapsed in a rugby scrum

Multiple injuries

Pain or tenderness in the neck or back after an accident - be careful not give pain killers before seeing a paramedic as they may mask other severe injuries

If in doubt treat the casualty as if they have a spinal injury.

What next?

If they are  conscious:

Reassure them and tell them not to move. Staying calm is so important in all first aid incidents. Because your anxiety ill transfer and even if you are  falling apart inside, the behaviour needs to show the opposite. 

Keep them in the position in which you find them. Don’t  allow them to move, unless they are in severe danger

Hold their head still with your hands. Keep the head and neck in line with the upper body.

Call 999/112 for emergency help. Keep them still and warm until help arrives.

 If they are unconscious

 If they are breathing normally this means the airway must be clear, so there is no need to tip the head back - you may have to gently tip it back and resuscitate if they are not!

Call 999/112 for emergency help

Hold the head still with your hands and keep the head and neck in line with the upper body.

If you have to leave the casualty, if they begin to vomit, or if you are concerned about their airway in any way, you should put them in the recovery position. KEEP THE HEAD AND NECK IN LINE WITH THE SPINE WHILY YOU TURN THE CASUALTY, Try to get help in doing this if you can.

Keep them warm and still. Constantly monitor breathing until help arrives. Only move them if they are in severe danger

I know this isn’t a very uplifting blog but I was reminded of the importance of knowing what to do when I read Melanie’s feature.  I hope you never have to use it – but at least should an emergency arise you will have some knowledge.  Better still come on one of our first aid courses and practice it yourself. www.safeandsound.uk.net