SIGNS AND SYMPTOMS OF A SPINAL INJURY
When you begin your primary survey, check for signs and symptoms of a spinal
injury. If you suspect the casualty has a spinal injury, treat him as though you know he
has a spinal injury. Some signs and symptoms of a spinal injury are given below.
a. Spinal Deformity. If the casualty is lying with his back, neck, or head in an
abnormal position, suspect a severe spinal injury.
b. Severe Head Injury. If the casualty has a severe head injury (depressed
area in the skull or brain matter visible), assume the casualty also has a spinal injury.
c. Pain in the Spinal Region. If the casualty is conscious, ask him about the
presence of pain or tingling in his neck or back. The pain may be localized or defused.
The presence of any pain in the spinal region is sufficient reason to suspect a spinal
If your survey of the casualty does not indicate a spinal injury but the
casualty has spinal pain when he attempts to move, assume a spinal
injury is present.
d. Lacerations and Contusions. Look for lacerations (cuts) and contusions
(bruises) over the spine.
e. Tenderness in the Spinal Region. If the casualty is conscious and does not
report spinal pain, gently palpate the spine for tenderness (pain). If the casualty says
an area of his spine is tender, assume that a spinal injury is present. As you check,
also feel for deformity and look for lacerations and contusions. If the casualty is lying on
his back, use the following procedures to check for spinal injury.
(1) Carefully insert your hand under the casualty's neck and feel along the
cervical spine as far as can be done without disturbing the casualty's spine.
(2) Carefully insert your hand into the cavity formed by the small of the back
and feel along the thoracic spine and down to the lumbar spine as far as possible
without disturbing the casualty's spine.
f. Numbness or Paralysis. If the casualty is conscious, ask him if his
extremities (especially his legs) feel numb, weak, or paralyzed. Numbness or paralysis
of all four extremities usually indicates an injury to the cervical spine. Numbness or
paralysis of only those areas below the waist usually indicates an injury to the lower part
of the spine. Check for pulse, motor, and sensory (PMS) function during your
assessment of the casualty.
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