How to Provide First Aid for a Suspected Cervical Spine Injury

A group of Emergency Medical Technicians work on a patient in a field rescue.

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The spine bones of the neck, known as the cervical vertebrae, may be fractured or displaced if the neck is twisted, compressed, or hyper-extended. A fracture or displacement of the cervical spine (C-spine) can cut or press on the spinal cord.

If there is neck pain after a significant injury, you should always suspect a C-spine injury. There are a number of ways in which the neck could be injured in such a way as to cause a C-spine injury. Some common causes of C-spine injuries include:

  • vehicle or bicycle accidents
  • sports injuries
  • falls
  • assaults

If you are in doubt, and you are not sure if it is a cervical spine injury, you should always consider the cervical spine injured until the injury is properly evaluated by medical personnel.

First Aid Steps

  1. Safety First! Make sure the environment is safe for both rescuer and patient before providing any first aid. Always practice universal precautions and use personal protective equipment whenever you may come in contact with blood or body fluids.
  2. Make sure that the patient is breathing. Breathing is obviously necessary for life, and thus is more important than immobilizing the cervical spine. Check to see if the patient is breathing. If they are breathing then you can begin to attend to the cervical spine injury. If the patient is not breathing, contact 911 immediately and begin CPR.
  3. Even if you suspect a C-spine injury, it is imperative to make sure that is the issue. All suspected cervical spine injuries must be assessed by an x-ray. Call 911 to summon an ambulance. Make sure you know the differences between mobile phones and regular phones before calling 911 on a cell phone.
  4. If the patient is unconscious, protect the patient's airway by placing him or her in the recovery position. Place padding, such as a pillow, under the head of the patient after rolling the patient onto his or her side. The pillow helps to keep the neck straight.
  1. If the patient is awake, place both hands on either side of the patient's head to steady it. Hold the patient's head gently but firmly to keep it from moving. Any movement of the cervical spine may make a C-spine injury worse. Only release the head to help with the patient's airway, breathing or circulation, or if the scene becomes unsafe.
  2. Continue to immobilize the patient's head until medical help arrives and remind the patient not to move. Remember, any extra movement of the already-injured cervical spine could cause additional damage, and make an injury worse. That is why it is so important to keep the patient's head immobilized and their body as still as possible.


  1. Statistically, cervical spine injuries are very rare. You should not commit yourself to immobilizing the cervical spine if the patient may need other types of first aid or if there are other patients to attend to.
  2. Don't wrestle with a patient to keep his or her head straight. You could actually do more damage by forcing a patient not to move than just to allow it to happen. Evidence suggests that patients unconsciously restrict movement in the presence of a cervical spine injury.
  3. If more than one rescuer is available, you should use the two-person technique in order to roll the patient into the recovery position.
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Article Sources

  • Hong, R., Meenan, M., Prince, E., Murphy, R., Tambussi, C., Rohrbach, R., & Baumann, B. (2014). Comparison of Three Prehospital Cervical Spine Protocols for Missed Injuries. Western Journal Of Emergency Medicine15(4), 471-479. doi:10.5811/westjem.2014.2.19244
  • Morrissey, J., Kusel, E., & Sporer, K. (2014). Spinal Motion Restriction: An Educational and Implementation Program to Redefine Prehospital Spinal Assessment and Care. Prehospital Emergency Care18(3), 429-432. doi:10.3109/10903127.2013.869643