Healthcare BLS + First Aid

73 videos, 5 hours and 32 minutes

Course Content

Head, Neck, and Back Injuries

Video 48 of 73
3 min 49 sec
English, Español
English, Español

If you come upon a patient who appears to have taken a fall, or was injured in an accident, and there are no bystanders around who witnessed the accident, you'll need to figure out the mechanism of injury. Hopefully the victim will be able to help, who in this lesson, we are assuming is conscious, alert, and not exhibiting more serious issues involving airway, breathing, circulation, etc.

The most important thing to keep in mind as you deal with someone who has sustained potential injuries to their head, neck, and/or back, is minimizing movement, as you inquire more into what happened and how the patient is feeling.

Pro Tip #1: Part of your job is to figure out if EMS is required as you tend to them. It may be a situation where the victim is able to get up and has no significant injuries. Or it could be a situation that doesn't appear serious initially, but suddenly becomes serious. If at any point the situation warrants it, call 911 immediately.

How to Handle a Patient with Head, Neck, and Back Injuries

As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim.

Are you OK? Can you hear me?

If the patient is conscious and responsive, ask yourself if there are other medical emergencies that would warrant calling 911 and activating EMS? If not, continue with your assessment. When dealing with potential back and neck injuries, it's best not to touch the patient while you assess them.

Introduce yourself to the victim: "Hi, my name's _____. I'm a paramedic. I'm going to ask you some questions; try not to nod. Answer with yes or no. And try not to move other parts of your body."

"Do you remember what just happened?"

"Do you know if you hit your head?"

"Do you know what day it is?"

"Do you know what year it is?"

If the victim answers the last two questions incorrectly, you're likely dealing with someone who has hit their head and may have a concussion. This altered mental state is enough of a concern to call 911 and activate EMS if you haven't already done so.

The fact that you're able to talk with the patient is a good sign. It indicates that they're awake, breathing normally, and have a pulse, all of which indicate a lack of an immediate emergency. However, that doesn't mean the situation cannot suddenly change.

As you're talking with the victim, you're also looking them over for injuries, beginning with their head.

  • Is there blood in the ears?
  • Is there blood in the nose?
  • Does the patient have any broken teeth?
  • Are the pupils equal size and responsive to light?

Pro Tip #2: Put your hand over the victim's eyes for a second or two then remove it and see if their pupils react. If they do not, it could be due to a concussion and swelling in the brain.

Determine how injured they are by seeing how much they can move and with open-ended questions.

"Can you tell me what hurts?"

"Can you wiggle your fingers?"

"Can you wiggle your toes?"

A victim in paralysis is prone to going into spinal shock. Remember, shock is a progressive condition in which the circulatory system fails to adequately circulate oxygenated blood to all parts of the body.

Early signs of shock to look for include:

  • Nervousness
  • Rapid heart rate or breathing
  • Anxiousness
  • Sweaty
  • Fearful
  • Clammy skin

Continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock.

Warning: Should you begin seeing signs of shock, cover the patient with a blanket or coat and try to keep them as warm as possible. Any signs of shock demand an immediate 911 call.

If at any point during your assessment, the patient goes unresponsive, appears to be having trouble breathing normally, or goes into full cardiac arrest, activate EMS and treat the patient accordingly until help arrives, an AED arrives, or the patient is responding positively.

A Word About Injuries to the Neck and Spine

Injuries to the neck and spine can damage soft tissue and bone, including the spinal cord. Unfortunately, assessing the level of this damage on the scene, and without proper diagnostic equipment, is very difficult. Which is why you should always proceed with caution.

Some common situations in which serious neck and spine injuries tend to be seen include:

  • Swimming pool diving accidents
  • Vehicular accidents
  • Accidents that include a broken hard hat or helmet

Some common symptoms for serious neck injury are:

  • Obvious lacerations or swelling
  • Impaled object
  • Excessive external bleeding
  • Difficulty speaking
  • Air escaping through the trachea and/or larynx
  • An airway obstruction

Some common symptoms for serious spine injury are:

  • Back pain or pressure
  • Pain with movement
  • Numbness, weakness, tingling in limbs or extremities
  • Loss of feeling in limbs or extremities
  • Breathing problems
  • Loss of bladder and bowel control