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Spinal injuries: first aid and safety

Emergency numbers differ by country. This page uses 911, the number for the United States and Canada. Many other countries use 112, 999, or another number. Find the number for your country.

Spinal cord injuries can cause permanent paralysis or death if the spine is moved incorrectly after severe trauma. Keeping the head and neck stabilized is the single most important rule.

Do this now

  1. Call your local emergency number (911 in the United States, 112 in Europe, 999 in the United Kingdom) immediately.
  2. Keep the person completely still. Tell them not to move their head, neck, or body.
  3. Place your hands firmly on both sides of their head to keep it still in the position you found it.
  4. Do not move the person unless they are in immediate, life-threatening danger (such as a burning car or building).
  5. Monitor their breathing and alertness until emergency medical technicians arrive.

When to suspect a spinal injury

Always suspect a spinal injury after high-impact accidents, including:

  • A car, motorcycle, or bicycle crash.
  • A fall from a height greater than the person's own standing height (such as a ladder or roof).
  • A diving accident in shallow water.
  • A severe blow to the head or torso during sports.
  • An explosion or falling heavy debris.

Symptoms of a spinal cord injury

  • Severe pain or pressure in the neck, head, or back.
  • Loss of feeling, numbness, or tingling in the hands, fingers, feet, or toes.
  • Inability to move arms, legs, or limbs.
  • Loss of bladder or bowel control.
  • Difficulty breathing or chest weakness.
  • An abnormal angle or twisting of the neck or back.

How to immobilize the neck safely

If you must wait for emergency responders, hold the person's head in alignment with their spine:

  1. Kneel behind the person's head.
  2. Place one hand on each side of their head, covering the ears gently.
  3. Hold the head steady without pulling, twisting, or tilting it.
  4. If the person is wearing a helmet (such as a bicycle or motorcycle helmet), do not remove it unless their airway is blocked and they cannot breathe.

Moving a person only in extreme danger

Only move someone with a suspected spinal injury if staying put means certain death (fire, rising floodwater, or imminent collapse).

If you must move them: - Try to enlist at least two or three other helpers. - Keep the head, neck, and torso perfectly straight in one line. - Avoid bending or twisting their neck or waist at any point during movement.

Never guess with spinal trauma

Medical guidelines from resuscitation councils and trauma associations emphasize leaving neck and back stabilization to trained emergency medical technicians whenever possible.