About one in ten casualties with a head wound who are unconscious also have a spinal injury.

If a casualty has a fractured spine, the sharp edge of a fractured bone could damage or sever the spinal cord. Always assume the casualty has a spinal fracture if he is unconscious or has signs of a severe head wound such as a fractured skull or clear or bloody cerebrospinal fluid leaking from the nose or ear.

If a spinal injury is suspected, do not move the casualty unless you must move him to save his life. For example, you would move the casualty (and yourself) out of a burning building or position the casualty for mouth-to-mouth resuscitation if he is not breathing and lying on his abdomen.

a. Immobilize any casualty with a suspected spinal injury. Subcourse MD0533, Treating Fractures in the Field, gives procedures for immobilizing a casualty with a suspected spinal fracture.

b. If an open head wound is present, dress the wound to protect it from further contamination. Do not apply pressure to the wound.

c. If cerebrospinal fluid is leaking from an ear, apply a loose field dressing to the ear using the procedures for applying a dressing to the side of the head (paragraph 5-9). Cover the ear with the dressing. The dressing will absorb the contamination. If there is also drainage from the other ear, pass the tails over the ear so they will provide protection to that ear also.