Which emergency move technique is appropriate for a patient with a neck injury?

If you suspect a back or neck (spinal) injury, do not move the affected person. Permanent paralysis and other serious complications can result. Assume a person has a spinal injury if:

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If you suspect someone has a spinal injury:
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Questions to Ask
Self-Care/First Aid
What position would you put a victim with a head neck or back injury?
What transfer method is used to move a patient with a suspected spinal injury?
Which of the following is an appropriate situation in which to use an emergency move?
What is the most appropriate method to use when moving a patient?

There's evidence of a head injury with an ongoing change in the person's level of consciousness
The person complains of severe pain in his or her neck or back
An injury has exerted substantial force on the back or head
The person complains of weakness, numbness, or paralysis or lacks control of his or her limbs, bladder or bowels
The neck or body is twisted or positioned oddly

If you suspect someone has a spinal injury:

Get help. Call 911 or emergency medical help.
Keep the person still. Place heavy towels or rolled sheets on both sides of the neck or hold the head and neck to prevent movement.
Avoid moving the head or neck. Provide as much first aid as possible without moving the person's head or neck. If the person shows no signs of circulation (breathing, coughing or movement), begin CPR, but do not tilt the head back to open the airway. Use your fingers to gently grasp the jaw and lift it forward. If the person has no pulse, begin chest compressions.
Keep helmet on. If the person is wearing a helmet, don't remove it. A football helmet facemask should be removed if you need to access the airway.
Don't roll alone. If you must roll the person because he or she is vomiting, choking on blood or because you have to make sure the person is still breathing, you need at least one other person. With one of you at the head and another along the side of the injured person, work together to keep the person's head, neck and back aligned while rolling the person onto one side.

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May 25, 2021

EmergencyCareForYou: Neck or back injury. American College of Emergency Physicians. http://www.emergencycareforyou.org/emergency-101/neck-or-back-injury/#sm.0001pfsh0ksz9fdgr3c1gytcsyycs. Accessed Dec. 27, 2018.
Walls RM, et al., eds. Spinal injuries. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed Dec. 27, 2018.
Spinal trauma. Merck Manual Professional Edition. https://www.merckmanuals.com/professional/injuries_poisoning/spinal_trauma/spinal_trauma.html?qt=spinal trauma&alt=sh. Accessed Dec. 27, 2018.
First Aid/CPR/AED participant's manual. American Red Cross. https://embed.widencdn.net/pdf/plus/americanredcross/8chdrkbqij/FA_CPR_AED_PM_Optimized.pdf?u=0aormr. Accessed Dec. 27, 2018.

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First Aid for Neck/Spine Injury

Anything that puts too much pressure or force on the neck or back can result in a neck and/or spinal injury. Common causes are:

Accidents - with cars, motorcycles, snowmobiles, toboggans, roller blades, etc.
Falls - especially from high places
Diving mishaps - from diving into water that is too shallow
A hard blow to the neck or back while playing a contact sport such as football
Violent acts such as a gunshot wound that penetrates the head, neck or trunk

Suspect a neck injury, too, if a head injury has occurred.

Some neck and spinal injuries can be serious because they could result in paralysis. These need emergency medical care. Others, such as whiplash, can be temporary, minor injuries.

A mild whiplash typically causes neck pain and stiffness the following day. Some people, though, have trouble raising their heads off the pillow the next morning. Physical therapy and a collar to support the neck are the most common types of treatment. It often takes three to four months for all symptoms to disappear.

Prevention

Use padded headrests in your car to prevent whiplash.
Drive carefully and defensively.
Wear seatbelts, both lap belts and shoulder harnesses.
Buckle children into approved car seats appropriate for their age.
Wear a helmet whenever you ride a bicycle or motorcycle or when you roller skate or roller blade.
Wear the recommended safety equipment for contact sports.
Take care when jumping up and down on a trampoline, climbing a ladder or checking a roof.
Check the depth of the water before diving into it. Do not dive into water that is less that 9 feet deep. Never dive into an above-ground pool.

NOTE: IF YOU SUSPECT A NECK OR BACK INJURY IN YOU OR SOMEONE ELSE,

YOU MUST KEEP THE NECK AND/OR BACK PERFECTLY STILL UNTIL AN EMERGENCY CREW ARRIVES.

DO NOT MOVE SOMEONE WITH A SUSPECTED NECK OR SPINE INJURY UNLESS THE PERSON MUST BE MOVED BECAUSE HIS OR HER SAFETY IS IN DANGER.

ANY MOVEMENT OF THE HEAD, NECK OR BACK COULD RESULT IN PARALYSIS OR DEATH.

Questions to Ask

Is the injured person not breathing and has no pulse?
	Perform CPR, but without moving the neck or spine and Seek Emergency Care. (See "CPR") But when you do the "Airway and Breathing" part of CPR, do not tilt the head back or move the head or neck. Instead, pull the lower jaw (chin) forward to open the airway.
Is the injured person not breathing, but has a pulse?
	Perform "Rescue Breathing" without moving the neck or spine and Seek Emergency Care. (See "Airway and Breathing".) But do not tilt the head back or move the head or neck. Instead, pull the lower jaw (chin) forward to open the airway. Give first aid before emergency care: Tell the victim to lie still and not move his or her head, neck, back, etc. Immobilize the neck and/or spine. Place rolled towels, articles of clothing, etc. on both sides of the neck and/or body. Tie and wrap in place, but don't interfere with the victim's breathing. If necessary, use both of your hands, one on each side of the victim's head, to keep the head from moving. Note: If you must move someone with a suspected neck or spinal injury follow the above procedures and: Select a stretcher, door or other rigid board. Several people should carefully lift and move the person onto the board, being very careful to align the head and neck in a straight line with the spine. The head should not rotate or bend forward or backward. Make sure one person uses both of his or her hands, one on each side of the victim's head, to keep the head from moving. If you can, immobilize the neck and/or spine by placing rolled towels, articles of clothing, etc. on both sides of the neck and/or body. Tie and wrap in place, but don't interfere with the victim's breathing. Note: If you suspect someone has injured his or her neck in a diving or other water accident: Protect the neck and/or spine from bending or twisting. Place your hands on both sides of the neck and keep in place until help arrives. If the person is still in the water, help the person float until a rigid board can be slipped under the head and body, at least as far down as the buttocks. If no board is available, several people should take the person out of the water, supporting the head and body as one unit, making sure the head does not rotate or bend in any direction.
Does the injured person have any of these signs or symptoms? Paralysis Inability to open and close his or her fingers or move his or her toes. Feelings of numbness in the legs, arms, shoulders or any other part of the body. Appearance that the head, neck or back is in an odd position.

Are any of these present following a recent injury to the neck and/or spine that did not get treated with emergency care at the time of the injury? Severe pain. Numbness, tingling or weakness in the face, arms or legs. Loss of bladder control.

Do you suspect a whiplash injury or has pain from any injury to the neck or back lasted longer than one week?

Self-Care/First Aid

If you suspect a whiplash injury:

See your doctor as soon as you can so he or she can assess the extent of injury.
For the first 24 hours, apply ice packs to the injured area for up to 20 minutes an hour.
- To make an ice pack, wrap ice in a face towel or cloth.
After 24 hours, use ice packs or heat to relieve the pain.
- Taking a hot shower for 20 minutes a few times a day is a good source of heat to the neck.
- Use a hot water bottle, heating pad (set on low), or heat lamp, directed to the neck for 10 minutes several times a day. (Use caution not to burn the skin.)
Use a cervical pillow or a small rolled towel positioned behind your neck instead of a regular pillow.
Wrap a folded towel around the neck to help hold the head in one position during the night.
If you arm or hand is numb, buy or rent a cervical-traction device. Ask your doctor how to use it.
Take aspirin, acetaminophen, ibuprofen or naproxen sodium for minor pain. [Note: Do not give aspirin or any medication that has salicylates to anyone 19 years of age or younger unless a doctor tells you to.]
Get plenty of rest.

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What position would you put a victim with a head neck or back injury?

Do not move the patient unless in danger. Support head, neck and spine in a neutral position at all times to prevent twisting or bending movements. If the ambulance is delayed, apply a cervical collar, if trained to do so, to minimise neck movement. Ensure an ambulance has been called: triple zero (000).

What transfer method is used to move a patient with a suspected spinal injury?

The current guidelines dictated that a trauma patient with suspected spinal cord injury should be transferred with care using spine immobilization techniques [6,7]. The most used techniques are the log-roll technique, the straddle lift and slide (LS), and the six plus lift (6+ lift).

Which of the following is an appropriate situation in which to use an emergency move?

There are three situations that may require the use of an emergency move: The scene is hazardous, care of life-threatening conditions requires repositioning, or you must reach other patients.