How to Rule Out a Spinal Cord Injury During First Aid

After you perform a primary and secondary survey of an injured person (see Related eHows), it is important to determine whether a spinal injury is involved. If you can rule out a spinal injury, then the person can be moved much more easily.

Difficulty: Easy

Instructions

1. Ask the injured person his or her name, the location, the time of day and what happened. If the person cannot accurately answer at least the first three questions, he or she is not a "reliable patient," and a spinal cord injury cannot be ruled out.

2. Look for any signs of drug or alcohol use. If any are present, the patient is not reliable.

3. Check for "distracting injuries" - injuries painful enough to distract the injured person from spinal discomfort. If any are present, a spinal cord injury cannot be ruled out.

4. Press lightly on one fingernail on each hand, and one toenail on each foot. Watch for the pink coloring to return within two seconds of the release of pressure. If it takes longer, it may be an indication of bad circulation resulting from a spinal injury.

5. Have the injured person move his or her fingers and toes. If any motion is difficult or impossible, or if the person is abnormally weak, there may be a spinal injury.

6. Squeeze the fingers and toes gently. If there is any numbness or tingling, the spine may be injured.

7. Touch each of the injured person's vertebrae with moderate pressure, from the top of the neck to the bottom of the back. If any pain is present, there may be a spinal injury.

Tips & Warnings

• If another rescuer is present, have him or her stabilize the injured person's head and neck while you perform the above steps. Stabilize the head and neck by holding the head firmly with a hand on each side, allowing no motion.
• Contact the Wilderness Medicine Institute or the National Outdoor Leadership School for information about wilderness medicine courses and books.
• When in doubt, always assume a spinal cord injury is present.
• If you can't rule out a spinal cord injury, you should treat the injured person with full spinal precautions. This means, among other things, that he or she should not be moved except by medical professionals or others trained in such matters.
• If you have specific medical conditions or concerns, we recommend you contact a physician. This information is not intended as a substitute for professional medical advice or treatment.

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on 7/31/2008 Any trauma patient should be treated with full spinal precautions regardless of the information posted. Spinal injuries (particularly those to the cervical spine) can present with no pain and no palpable deformities, no change in level of consciousness and no abnormalities in CSM. If there is a significant mechanism of injury (falls of greater than twenty feet, car collisions, any significant twisting or crushing trauma) spinal precautions should be maintained until injury can be ruled out at the hospital.