c. Intervertebral Disks. The vertebrae that are not fused together are
separated by intervertebral disks. These disks act as a cushion between the
d. Spinal Cord. The spinal cord is composed of nerves that carry impulses
between the brain and the rest of the body. The spinal cord is protected by the spinal
column. The spinal cord begins at the base of the brain and extends through the
cervical vertebrae and thoracic vertebrae. The cord itself usually stops between the
second and third lumbar vertebrae. If the spinal cord is severed (cut completely), the
muscles controlled by the portion of the spinal cord below the cut will not function.
Muscle control may be lost even if the spinal cord is not severed. Pressure on the
spinal cord from a fractured vertebra or pressure due to swelling of the spinal cord can
also produce paralysis.
e. Cerebrospinal Fluid. The cerebrospinal fluid (CSF) is produced in the brain
and acts as a protective cushion by surrounding the brain and spinal cord. Leaking
cerebrospinal fluid (usually from the ears, nose, or site of a head injury) indicates a
serious head or spinal injury.
SURVEYING THE SCENE
When you arrive upon the scene, the first thing you should do is to perform a
general survey. This information will help you to determine if a spinal injury is probable.
A spinal injury should automatically be suspected if the casualty fell from a height, was
involved in a vehicle accident or cave-in, or had a heavy object fall across his body.
a. Always assume that a spinal injury is present until your survey of the casualty
b. If other soldiers are present, ask them how the casualty was injured.
c. Do not move a casualty with a suspected spinal injury unless it is necessary
to move him to a place of safety (his life is in immediate danger due to a burning
vehicle, and so forth) or it is necessary to position him for rescue breathing (the casualty
has inadequate breathing). Moving a casualty with a fractured spine can result in
permanent paralysis or death.
(1) If the casualty must be moved to safety, keep the head and back in
alignment while moving him.
(2) If the casualty must be in position for rescue breathing (mouth-to-mouth
or mouth-to-nose resuscitation), open the casualty's airway using the jaw-thrust method.
The jaw-thrust reduces movement and prevents hyperextension of the neck.
Procedures for performing the jaw-thrust and other methods for restoring breathing are