All victims with a suspected spinal injury require ambulance assessment. You will need to provide spinal care while waiting for the ambulance to arrive.
Unconscious victims
An unresponsive, breathing victim with a suspected spinal injury should be placed in the lateral position, to maintain an adequate airway. The victim should be:
- turned onto their side using the log roll technique (see Log roll technique)
- handled gently, with no twisting or forward movement of the head and spine
- rolled with spinal alignment maintained and the head in a neutral position
- kept warm and continuously monitored.
An unconscious victim may present themselves lying down in a face-up (supine) or face-down (prone) position. Maintain spinal alignment of the head, neck and torso at all times.
Conscious victims
A conscious victim may walk up to you or present themselves lying down.
Walk up victim
It is common for victims with a possible spinal injury to walk up to lifesavers on duty and complain of neck pain following a collision with a sandbank or from beach activity. Where the victim approaches the lifesaver on foot, the victim should be instructed to lower themselves carefully to the ground while keeping their head still.
If the victim has difficulty lowering themselves to the ground, they may be supported by two lifesavers each taking a victim’s upper arm as they assist the victim lowering to the ground.
When approaching the suspected spinal injury victim, you should approach front on to minimise any movement of the head and neck. Approaching from the side or the back of the person will normally result in that person turning to look at the first responder to listen and talk, resulting in unnecessary head/neck movement.
Once the victim is lying face up on the ground, one lifesaver should then ensure the manual immobilisation of the victim’s head and neck in the neutral position (see Trapezius grip).
Victim lying down and face up
A conscious victim with a suspected spinal injury who is found on land lying face upwards should be left where they are found unless movement is necessary to extract them from danger. If the victim can be safely left where they are found, manually stabilise their head while keeping them warm, monitoring their condition and reassuring the victim until medical help arrives.
If the victim starts to regurgitate/vomit, immediately roll the victim into the lateral position using the log roll technique and recommence primary assessment.
A conscious victim lying face down should be log rolled onto their back if their airway requires management. A log roll (see next section) should be used whilst stabilising the victim’s head and neck in a neutral position, taking care to ensure spinal alignment during the roll. Unconscious victims should be log rolled into the lateral position and a primary assessment commenced.
Victim lying down on a spinal board
Victims do not need to be routinely placed on a spinal board unless they need to be extracted from danger. Where a victim with suspected spinal injury has been moved onto a spinal board (for example after removal from the water) and placed on the ground, they must be removed from the spinal board using the log roll technique. They should not be routinely left on the board for any extended period of time.
Trapezius grip
The trapezius grip is used to support a supine victim’s head and neck. This is achieved as follows:
- Grip the upper trapezius muscle between the thumb and fingers
- Support the head between the forearms (using a vice-like grip along the side of the head).
When manually immobilising a victim’s head, you should:
- spread your fingers across the side of the victim’s head to obtain maximum contact
- stabilise your hands by resting your elbows firmly on the ground (if in supine position), or by locking your elbows in place.
Align the victim’s head in the neutral position, remembering contraindications