Neck/spinal injury; Spinal cord injury

• Bullet or stab wound
• Direct trauma to the face, neck, head, or back (e.g., car accidents)
• Diving accident
• Electric shock
• Extreme exertion
• Extreme twisting of the trunk
• Sports injury (landing on head)

• Stiff neck
• Head held in unusual position
• Weakness
• Difficulty walking
• Shock (with pale, clammy skin; bluish lip and fingernails; and decreased consciousness)
• Paralysis of extremities
• Headache, neck pain, abdominal pain, or back pain
• Numbness or tingling that radiates down an arm or leg
• Loss of bladder or bowel control
• Unconsciousness

1. Check the victim's airway, breathing, and circulation. If necessary, begin rescue breathing and CPR. If you think the victim might have a head, neck, or spinal injury; lift the chin rather than tilt the head back when attempting to open the airway. Keep the victim's head, neck and back in line and roll him or her as a unit.

2. Immobilize the victim's head and torso in the position in which they were found. Do not attempt to reposition the neck.

3. If the victim must be moved, get several people to help. Use a sturdy support (such as a plank) as a stretcher. Together, roll the victim's entire body as a unit -- keeping the head, neck, and back in the same position relative to each other as they were -- onto the stretcher.

4. Immobilize the victim's head and torso in the position found. Place rolled-up towels, clothing, or blankets around the victim's head and torso. Use ropes, belts, tape, or strips of cloth to hold the victim in place on the stretcher. Carry the stretcher as horizontally as possible.

5. If a stretcher is not available and the injured person must be turned over, use the logrolling technique. One rescuer stationed at the victim's head keeps the head and shoulders in a fixed position while the second rescuer extends the victim's arm (the one on the side the victim will be rolled toward) above his head. Then the first rescuer takes this arm and uses it as additional support for the head. Both rescuers gently roll the victim without moving his neck.

6. If you are the only rescuer and the victim must be moved, drag the person by his or her clothing, leaving the victim lying face up or face down (however he or she was found).

7. If the victim vomits or is choking on blood, carefully roll him or her on one side. Vomiting can signal internal injuries.

8. Keep the victim warm to help prevent shock.

9. Give first aid for obvious injuries, but keep the victim in the position found.

• Bend, twist, or lift the victim's head or body.
• Attempt to move the victim before medical help arrives unless it is absolutely necessary.
• Remove a helmet if a spinal injury is suspected.

If there has been any injury to the neck or spinal cord, call immediately for emergency medical assistance. Keep the victim absolutely immobile. Unless there is urgent danger, keep the victim in the position where he or she was found.

• Regular exercise, good posture, and lifting heavy objects correctly (letting your leg muscles do most of the work) all help prevent back problems.
• Wear seat belts.
• Avoid alcohol with driving.
• Avoid diving into pools, lakes, rivers and surf, particularly if you cannot determine the depth of the water, or if the water is not clear.
• Avoid motorcycles and all-terrain vehicles.
• Avoid "spearing" (tackling with head)
• Back pain, if it occurs, should be discussed with the doctor.