2-3

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2-3. 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 injury.

CAUTION: 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.

(1) Have the casualty move his fingers slightly to assess for motor ability.

 

(2) Touch the casualty's hands and feet with your fingers and ask if the he feels your touch. Assess both sides at the same time to assess for differences in sensation.

g. Unconsciousness. Always treat an unconscious casualty as though he has a spinal injury.

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