Where a neck injury could be involved and you are the first to respond, please do not move the person unless…
- There is danger of fire or explosion…
- The person needs to be moved due to being on burning hot asphalt or road…
- There is danger of the vehicle rolling off of a drop…
- Respiration is impossible for the victim unless moved…
- If there is danger of the immediate area flooding…
Please be aware that if you have to move the victim before medical services can arrive with a neck brace and board…
You will need to move their body out of harms way while keeping them as immobile as possible…
If you have anything- bungee cords, a rope, a belt- that will strap arms to their body and legs together so your full attention can go to stabilizing the head and neck as you move them…as long as it is not causing additional injury…
You may not have anything but your hands with which to immobilize an accident victim with a neck injury, and if this is the case, if at all possible, flag down another motorist and ask them to help you…
It is imperative that if you are in one of the above listed situations that you keep the victims head and neck exactly as it lies, and move their entire body in a coordinated way…
*If the neck is injury suggests by its position that it has become destabilized…
*moving them can cause paralysis or death…
With that said, I will say again, do not move the victim unless absolutely necessary…!
Then check for :
- Respiration…check to feel breath against your cheek…
- Pulse…if none, give five compressions and two breaths…
- Reviving an Infant- put them on their back in your arms, if there is no breath against your cheek – using two fingers, place on chest bone and give five gentle compressions and two light puffs of air into the mouth, if they begin to vomit turn to the side supporting their head (same for an adult)…
- Bleeding…stop the bleeding with torn clothing strips – use compression…
Also, this may be difficult if there is the combination of a possible neck injury and no respiration…
This is because the neck needs to be lifted in order to tilt the head back in order to effectively produce the false respiration, and an injured neck should not be moved…
These situations are the most difficult and you will have to make a judgement call because that person is going to need air and their neck protected at the same time…
It may sound counter intuitive to get respiration and heartbeat going first as most people think to try to stop the bleeding right away…
But if there is no oxygen getting to the brain and no heartbeat, it will not matter if there is bleeding or not in the end…
So…In this order…
- Respiration…
- Pulse…
- Bleeding..
In that order, and you have approximately six minutes to do this depending on the temperature…
Colder climates can buy you a bit more time if hypothermia has set in…
Mouth to mouth and CPR require training to do properly and it is worth your time to do this course. You never know when you may need it.
At the scene of one motor cycle accident I attended, I was checking for respiration and noticed substansial bleeding at the level of the lower, inner thigh…
This man was unconscious, so I put some weight from my knee straight into the wound, and established breathing and a pulse at which point I could move back and bandage and pressurize the wound…
- Please do not do this with a conscious victim as the pain will be excruciating…
If you have never taken an emergency first aid or CPR course, are not medically orientated, but are all that person has, do the best you can until emergency services arrive…
If you are a non-professional please don’t worry about law suit to the point of costing someone their lives…
Most countries have a ‘Good Samaritan’ law that will cover you unless something overtly cruel and unusual has been carried out…
- Remember, a person who has done their level best is obvious to a professional…
Whiplash…
Neck injury as it relates to whiplash usually involves high impact collision…
If you or someone you know has walked away from a traffic accident and has refused immediate care, please encourage them to go and get looked at…
Imaging must be done to ensure that though there may be neck pain, there is not a neck injury in the form of a hairline fracture, or displaced fracture in the vertebral bones of the neck…
And that a structure called the ‘dens’ is not cracked or fractured…
The dens is part of the second bone in the neck called the ‘Axis’…
On top of the Axis sits the first bone – the Atlas…
Around this area are many ligaments, and muscles are holding your head in place and correctly positioned on top of your neck…
These structures are also protecting the spinal cord leading to the brain stem and the brain tissue itself …
Having neck injury around this area is very dangerous…
paralysis and death are more likely to occur when injury occurs in this area…
One basic rule of thumb…
- The higher up the neck (toward the head) the injury is, the more severe the trauma will be…and
- This carries with it a higher probability of fatality…
Other Traumatic Events That Can Produce Neck Injury
- Diving – a head getting smacked on the diving board or diving in too shallow of an area…
- Spearheading in Football- attacking another player head on…
- Hockey-getting smashed on the boards by another player from behind…
- Gymnasts – missing a catch on a bar or a vault gone bad…
- Rugby…
- You can get a neck injury even if your neck is as big as a tree stump…!
Your bones, ligaments, tendon and muscle are housing some precious things in that neck of yours…
For example the upper part of your spinal cord as it connects to the brain stem and then on in to the brain tissue itself…
No matter what size and strength your neck is, it was not made to push a line of people weighing over two hundred pounds a piece backward with your head…!
Your neck might stay strong but your spinal cord and brain tissue will receive a shock…
- If people smash into you from the back your brain is going to be concussed no matter how thick your head and neck are…!
It is also not built to receive impact from a floor, a diving board or the bottom of a swimming pool …
If you play or participate in sport: Please learn correct defensive strategies, use spotters, make sure there are trained individuals near to you should you come up short and need assistance…
If you do a sport that has a high risk of neck injury, you want to make sure that you have people around you that can give you assistance on the spot…
Because should the worst happen, time will be of the essence – immediacy is essential…
So with big or small accidents, get an x-ray and some treatment to avoid chronic joint pain in your neck in the future…
What To Avoid Before Having Imaging Tests Done After
A Neck Injury:
- Applying Traction..
- Ice for more than 10 minutes…
- Cervical manipulation…
The best thing you can do is get checked out and get some images taken before you or anyone else does anything with your neck…
Even if you are Herschel Walker (The Refrigerator)…
Get a diagnosis and a set of x-rays or MRI…
The other day I was reading someone’s website who recommended doing traction as a home treatment for someone with neck pain…
The instruction was to lay on a flat surface and have another person use a towel around the base of the head and then apply traction…
Please NEVER do this if:
- There are no images such as x-ray or MRI to show a clean bill of health…
- If you are not a health care professional…
To appreciate how delicate the neck area is, I once had a woman with a type II dens fracture come into the clinic where I was a student…
A Type II dens fracture can allow the neck to become destabilized and is a very dangerous condition…
She was a new patient who had been assigned to me, so I was having a review of her chart and the x-rays that had been taken last time she was in before her appointment time…
Everything looked fine…
Until I noticed her fracture line…
And indeed she had been in a car accident and had refused care immediately after and had walked away from it…
To sum it up, had I not had a close look at her pictures, there could have been disastrous consequences had I adjusted her that day…
A cervical rotary break or even a thump from an Activator gun could have destabilized her neck…
The moral of the story is this:
If you do not know everything that is happening in the neck of a person who is in pain – you need to find out before doing anything else…!
Be Wise And
Immobilize…!
If you have been in a collision, with a vehicle or on a sports field or in the gym, and have sustained a neck injury and cannot get seen by a physician right away, you need to immobilize yourself…
The way to do this :
- Apply cold, flexible gel packs on your neck for 10 minutes every two hours -if this increases the pain, stop!
- You can take pain killers to give yourself some relief, but do not mistake masked pain for wellness in your neck, you will still need to get a picture…
- Do not let anyone (amateur or professional) manipulate your neck! Find out what is going on with it first!
- Rest – seating yourself in bed at a forty -five degree angle with pillows holding your head up to take the stress off the neck…you may wish to add rolled towels on either side so your head does not roll when you sleep…
A neck injury is nothing to take lightly. You may need treatment even if you do not think you do. It is common not to feel the full extent of what has happened to you because chemicals in the endorphin family are released upon impact and lessen the pain…for a while…
Endorphin is produced by the central nervous system and your pituitary gland and behave like a corticosteroid injection – it literally stops the pain…
But that can change within a matter of hours…
So it is imperative to immobilize yourself until you can get checked out and have a few diagnostic pics taken…!
Disclaimer – This is information on joint pain. I teach but do not diagnose, prescibe or treat people who contact me. You are responsible for your condition using your own best judgement combined with what you have learned. Just a heads up – bodies carry unusual differences from time to time, in saying that, you could be one of those rare and unusual beings; if you are in doubt, please contact a physician in your area, so you can rule it out.
Move Freely and Knowledgeably and Be Well!
Dr. Jo
P.S… “Greater certainty of your condition alone can be a powerful form of pain relief.”