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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If someone has neck pain after a significant injury, you should always suspect a cervical (C) spine injury. Whether they truly have one or not, holding the C-spine is imperative in these cases, as the cervical vertebrae (spine bones of the neck) could be shifted or damaged if the neck is twisted, compressed, or hyperextended.

A fracture or displacement of the C-spine—whether the result of the initial injury or a lack of immobilization after it occurred—can press on or cut the spinal cord.

There are many ways in which the neck could be injured in such a way as to cause a C-spine injury. Some common causes include:

  • Vehicle or bicycle accidents
  • Sports injuries
  • Falls
  • Assaults

Follow the first aid protocol for how to hold the C-spine properly if you find yourself coming to the aid of anyone who has hurt their neck, and proceed with caution until the injury is properly evaluated by medical personnel.

What to Do for a Suspected C-Spine Injury

First aid involves taking precautions to avoid further injury as much as treating issues that need attention. The benefits of immobilizing a potentially compromised C-spine are so significant that there should be no question about taking these important steps, whether they end up proving necessary or not.

1. Ensure that the environment is safe for both rescuer and patient before providing any first aid. Always practice universal precautions and use personal protective equipment, if possible, whenever you may come in contact with blood or body fluids.

2. Call 911 for an ambulance. Make sure you know your location, particularly if you are calling 911 on a cell phone.

3. Check to see if the patient is breathing:

  • If the patient is not breathing, begin CPR.
  • If the patient is unconscious but breathing, protect the patient's airway by placing them in the recovery position. Roll the person onto his or her side while supporting the neck and spine in a straight position. (If possible, have multiple people help with this.) Next, place padding, such as a pillow, under the patient's head to keep the neck straight.
  • 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.

4. Continue to immobilize the patient's head until medical help arrives.

Patients should also be encouraged to keep their bodies as still as possible, as any movement can put the C-spine at risk.

Important Tips

  1. Statistically, cervical spine injuries are very rare. You should not focus on immobilizing the cervical spine if the patient needs 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 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. All suspected cervical spine injuries must be assessed by an x-ray.
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Article Sources

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  • 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