One of the most frightening injuries a person can sustain is a spinal injury. The effects of a spinal injury may be chronic or may affect a person for the rest of their life. Permanent loss of strength, sensation and function below the site of the spinal injury are often what individuals are left to deal with in the aftermath of their accident.
Man aquatic spinal injuries occur in shallow water and involve the neck. Alcohol is often a factor in the accident, and most sufferers fall into the demographic of teen, or male in their early twenties.
Understanding how to correctly manage an aquatic spinal injury before professional help arrives can save lives. To understand the recommended procedure for assisting an injured person, read on.
The Conscious Breathing Casualty
Aquatic spinal injuries present differently, and the conscious breathing casualty is a common occurrence. The person will either remain in or leave the water after injuring themselves and will immediately (or very soon after) begin complaining of pain in the neck.
They may also have symptoms like pins and needles in the limbs or limb weakness. If this is the case, you must immediately assume that a spinal injury has occurred. The most experienced people on the scene, whether these be lifeguards, medical professionals or people with First Aid experience, must seek to immobilise the neck and spine of the injured person immediately.
Firstly, if the incident has occurred at a patrolled beach or pool, attract the attention of the lifeguards. If there are no lifeguards present, ring for an ambulance by dialling 000. If your conscious patient is still in the water, you must get them into a supine position so that a spinal immobilisation device can be attached to them.
Patrolled beaches and pools will have designated spinal immobilisation devices, but unpatrolled beaches and most backyard pools will not. If you are in the latter situation, you will have to improvise with something similar, like a surfboard or body board, the frame from a hiking backpack or plank of wood. (More on spinal immobilisation to come.)
Whilst waiting for professional help to arrive, calm the patient, loosen any tight clothing and immobilise them as best you can if you are still in the water. You can do this by standing alongside them and placing one hand behind their neck and your other arm along their spine.
You will need to constantly support the head, neck and spine in a neutral position, whilst ensuring that your patient is still breathing. If the patient is in deep water, they need to be floated to shallow water so that a spinal immobilisation device can reach them.
Removal of a person with a spinal injury from the water is very difficult without adequate numbers. Lifeguards are trained in this sort of removal and will know how many individuals are needed to assist. However, if you are on an unpatrolled beach or in a private pool, you will need to call on the help of those surrounding you for assistance. At least four people would be preferable to assist in the immobilisation of your patient.
The Unconscious Casualty
You will likely find this person floating face down in the water. Your first priority is to remove their face from the water (whilst stabilising their neck in a neutral position), so that you can keep their airway clear.
To get your victim in a supine position, do the following:
- Place one of your forearms along the length of the victim’s sternum and support the patient’s lower jaw with the hand of that same arm.
- Place your other forearm along the length of the patient’s spine and, with the hand of that same arm, support their head at the base of their skull.
- With an inward and upward pressure, support the victim’s head and torso with your forearms and hands.
- As you do this, submerge the victim while maintaining this support position, and rotate the patient to a supine position.
If breathing is noticeably absent once the patient is rotated, rescue and resuscitation should immediately take place, with the rescuers taking as much care of the individual’s neck as possible.
Resuscitation takes priority over a spinal injury if the patient is unconscious and not breathing. If the patient is breathing, rescuers can take their time and focus more on preventing further aggravation of the spinal injury.
The Spinal Immobilisation Device (SID)
Once a SID can reach the victim in the water, it is floated alongside the patient. Rescuers will position themselves at either end of the device. Following a signal, the rescuers will lower the SID beneath the floating patient, and slowly allow the SID to rise until it completely supports the patient’s spine.
As the SID rises beneath the patient, the rescuers are responsible for ensuring that the SID is properly aligned to the supine patient’s spine.
Once the SID is adequately supporting the patient, the patient is then immobilised to the SID. This is done by first immobilising the head and neck with the lateral restraints that come with purpose-built SIDS, or in an emergency, rescuers can use substitutes like a rolled towel or sandbags to keep the head and neck motionless.
The conventional straps and bandages that come with a purpose-built SID will then go:
- Across the chest
- Above the waist to immobilise the arms to the patient’s sides.
- Below the waist to immobilise the hands to the patient’s sides
- Above the knees
- Below the knees
- Across the forehead
These bandages reduce the risk of further injury to the spine should the patient move due to the waves or the water. Rope or similar material can be used as a substitute if an officially SID is not available.
To reduce the likelihood of aquatic spinal injuries, safe behaviour should always be practised around water. Do not swim if you have been drinking, and do not dive into water if you are unsure of its exact depth. Families with backyard pools should be proficient in CPR and basic pool rescue skills. If possible, never swim at unpatrolled beaches and never swim alone.
Sara is the marketing strategist for Survival Emergency Solutions, Australia’s leading provider of first aid products for the home, workplace, vehicle and outdoors. Their Emergency First Aid Handbook is the only book to win the Australian Design Award and has sold over two million copies.