How To Provide First Aid for a Suspected Cervical Spine Injury

The Spine Bones of the Neck Can be Fractured or Displaced

A group of Emergency Medical Technicians work on a patient in a field rescue.
Getty Images/David Ellis

The spine bones of the neck, known as the cervical vertebrae, may be fractured or displaced if the neck is twisted, compressed, or hyper-extended. A fracture, break, or displacement of the cervical spine (C-spine) can cut or press on the spinal cord.

If there is neck pain after a significant injury, you should always suspect a C-spine injury. There are a number of ways in which the neck could be injured in such a way as to cause a C-spine injury.

Some common causes of C-spine injuries include:

  • vehicle or bicycle accidents
  • sports injuries
  • falls
  • assaults

If you are in doubt, and you are not sure if it is a cervical spine injury, you should always consider the cervical spine injured until the injury is properly evaluated by medical personnel.

First Aid Steps for a Cervical Spine Injury

  1. Safety First! Make sure the environment is safe for both rescuer and victim before providing any first aid. Always practice universal precautions and use personal protective equipment whenever you may come in contact with blood or body fluids.
  2. Make sure that the victim is breathing. Breathing is obviously necessary for life, and thus is more important than immobilizing the cervical spine. Check to see if the victim is breathing. If they are breathing then you can begin to attend to the cervical spine injury. If the victim is not breathing, you may be facing a serious emergency, and you should contact 911 immediately.
  1. Even if you suspect a C-spine injury, it is imperative to make sure that is the issue. All suspected cervical spine injuries must be assessed by an x-ray. Call 911 to summon an ambulance. Make sure you know the differences between mobile phones and regular phones before calling 911 on a cell phone.
  2. If the victim is unconscious, protect the victim's airway by placing the victim in the recovery position. Place padding, such as a pillow, under the head of the victim in order to help keep the neck straight.
  1. If the victim is awake, place both hands on either side of the victim's head to steady it. Hold the victim's head gently but firmly to keep it from moving. Any movement of the cervical spine may make a C-spine injury worse. Only release the head to help with the victim's airway, breathing or circulation, or if the scene becomes unsafe.
  2. Continue to immobilize the victim's head until medical help arrives and remind the victim not to move. Remember, any extra movement of the already-injured cervical spine could cause additional damage, and make an injury worse. That is why it is so important to keep the victim's head immobilized and their body as still as possible.

Tips for a Cervical Spine Injury

  1. Statistically, cervical spine injuries are very rare. You should not commit yourself to immobilizing the cervical spine if the victim may need other types of first aid.
  2. If more than one rescuer is available, you should use the two person technique in order to roll the victim into the recovery position.

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