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When dealing with a patient who may have a spinal injury, it's vital to follow some basic rules. The spine contains a spinal cord, which is where the messages are sent from the brain to any part of the body. If damaged, the spinal cord cannot be repaired. The area where the spinal cord is damaged will affect the level of paralysis that occurs. Damaging the spinal cord in the lower lumbar region of the back can result in a loss of the use of the legs. Damage higher up can result in a loss of control to the vital life support organs such as respiration. The simple rule for spinal injury management is, if you are dealing with someone who has hurt their back, do not move them. And if you think someone may have hurt their back or there is a possibility they have hurt their back, again, do not move them.

When dealing with a patient with a suspected spinal injury, as a first-aider, your responsibilities are to support the person's head and neck, explain to them not to move and look straight ahead. Leave their body in exactly the same position as you found it. In many cases, there will not be a spinal injury, but we always treat as if they have damaged their back. The only exceptions to the rule about not moving somebody with a suspected spinal injury would be if the patient is in immediate danger, for example, a burning car, if the patient is not breathing and you will need to perform CPR, which would mean turning them onto their back, you need to carefully move the head into the neutral position to stabilise their head and finally, the patient's vomiting may choke if the vomit cannot be drained away. If you do have to move a patient with a suspected spinal injury to perform CPR, for example, you would use the log roll, this moves the patient in one single motion. If they are vomiting, they will choke if they remain on their back, so this would be a situation where they would need to move. Again, you would use the log roll to move them onto their side so the vomit can come out.

To help you remember what to do, the mnemonic spinal can help, S, safety; make sure the patient and you are safe, P, patient; tell the patient not to move, I, immobilise; protect and maintain the airway and hold their head still, N, neutral; keep the head in a neutral position, A, assess; assess for other injuries, but only if it is safe to do so and finally L is leave them alone or use the log roll only if you absolutely have to.

As a first-aider, remember, do not move someone if you suspect they may have a spinal injury unless it is absolutely necessary. Leave the patient in the position found, support their head and neck, make sure the emergency services are on their way, reassure the patient and keep them as calm as possible.