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Transcript of SPINAL INJURIES
An injury to the spinal column should be viewed as serious because of paralysis, partial paralysis or loss of sensation.
It takes a huge amount of force to damage the spinal column and the spinal cord.
Almost all spinal injuries in water damage the neck area, the fifth, the sixth and the seventh vertebrae.
Two main mechanisms in accidents
- Vertical compressions
- Forward bending
Ligaments and vertebrae may be damaged. The blood supply, the spinal cord and the nerve tissue can be damaged. The most severe is quadriplegia.
Most neck injuries are due to the neck flexion. In the surf, being dumped on a sandbank causes cervical spine injury. Running and diving into the surf and striking the sandbank of an inshore gutter is a cause. In still water, cervical spine injuries are due to diving into shallow water. People who dive from piers and jetties forgetting tidal variations, suffer neck injuries.
RECOGNIZING NECK INJURIES
A common occurrence for you as a surf lifesaver could be:
The person who leaves the water and immediately complains of a painful neck.
There may also be limb symptoms or weakness. Spinal injury must be assumed and the neck immobilized immediately. The patient is first advised NOT to move the neck at all.
If the patient is still standing on the beach.
If the patient is already lying down, and does not need to be moved, the neck should be immobilized immediately and the patient left in position until the ambulance arrives.
If the patient needs to be moved, immobilize the neck with a collar prior to moving.
Anyone found floating in shallow water must be managed as a spinal injured.
Principles of rescue and management of neck injuries
1- At the earliest opportunity the ambulance or helicopter must be notified.
2- Remove the person’s face from the water while at the same time stabilizing the neck in the neutral positional. Removal of the patient’s face from the water is clearly the first step in creating a clear airway, which must then be maintained at all times.
3- Breathing must be assessed as quickly as possible and this is done in the usual way (look, listen, feel).
4- If breathing is absent, the rescue should proceed as a normal rescue and resuscitation, taking as much care of the neck as possible. Airway, breathing and compressions always take priority over any other suspected injury.
5- If breathing is present, the rescuers can usually be unhurried in their rescue. Other factors may dictate the need for speed.
6- During the rescue, the neck must be kept in the neutral position and the whole of the spine kept in normal alignment
7- It's needed to have an adequate number of helpers to remove of a person with a spinal injury from the water.
8- Without an equipment remove a person from water requires a maximum number of assistants, care and lack of speed to ensure that the neck and the rest of the spine are kept in the positions we have just told you.
9- The spinal collar is always used as an adjunct and not during airway management. It should not be used on a patient who requires CPR.
10- Administer oxygen therapy to the patient if equipment and appropriately trained personnel are present.
EFFECTS & CAUSES
By Virginia Beverini, Ludovica Toja, Luca Torre & Lapo Veca