If You Have to Move the Casualty

The two key reasons for moving somebody with a spinal injury are: to turn the person on to her back in order to resuscitate her; and to turn 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 on to her side as an alternative to the recovery position. It is also commonly used to move people with other injuries, such as a broken leg or pelvis, on to 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 casualty like a log, keeping the head and chin in line with the neck and spine.

If you are by yourself and the injured 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.

Whiplash

This is a common neck injury, particularly after car accidents. It accompanies a sudden impact accident when the person is wearing a seat belt and results from the head being thrown backwards and forwards violently. Whiplash is best described as a neck sprain. It is an injury to the soft tissue in the neck and can result in the need for long-term physiotherapy and the use of a neck collar. Whiplash may not appear until hours or even days after the injury.

It is very difficult to distinguish whiplash from spinal cord damage and a broken neck because the signs, symptoms and potential causes are very similar and the pain of the whiplash injury may be masking other, more serious, problems. For this reason, whiplash should be treated in the same way as other spinal injuries until professional medical staff rule out more serious damage.

Spinal injury recovery position

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

Alternatively, you can use the log roll technique.

Warning

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