It is wise to assume that any patient who is unconscious after trauma
might have spinal cord injury. Also, assume that any patient with head
trauma injury may have a spinal cord injury until you know otherwise.
5-15. MANDATORY TREATMENT FOR SPINAL INJURY
In some circumstances, it should be assumed that there is spinal injury,
regardless of whether or not the patient has signs or symptoms of such an injury.
Treating the patient as though he has injury to the spine may spare him further,
a. Initial Indications. Initial indications that the patient must be treated as if he
has a spinal injury include the following:
(1) The mechanism of injury was violent. Witnesses' statements, the way
the accident scene looks, and/or the situation indicate violence.
(2) The patient has a head injury and is in an altered state of
The patient is in a state of unconscious trauma.
(4) The patient has significant blunt trauma above the clavicles
(5) Accounts of the accident suggest that a sudden, violent movement,
deceleration of the spine, or signs of spinal injury occurred.
The patient was ejected from an automobile.
The patient's helmet was damaged in a motorcycle or sports injury.
The patient is experiencing pain when he moves and when he does not
(9) There is point tenderness surrounding the spine. (Point tenderness is
tenderness at the site of injury. The patient feels the tenderness when a rescuer
presses gently with one finger at the site of the injury.)
(10) There is a deformity in the patient's neck, or the patient guards (protects)
his head, neck, or back.
(11) The patient is experiencing paralysis, partial paralysis, numbing, or