The central nervous system forms the main controlling system of the body and can be damaged quite easily. Any injury or illness that affects this system must be handled with extreme caution and care. The spinal cord runs through the centre of the spinal column, and is thus easily susceptible to injury. The cervical and lumbar vertebrae are often damaged, e.g. in whiplash injuries and by incorrect lifting of heavy objects.

You must always suspect head or spinal trauma when the patient has been injured as a result of:

• Motor vehicle accidents
• Being thrown from any motorised and / or moving vehicle
• Contact sports
• Diving accidents
• Falls (greater than patient’s own height)
• Head injuries.

Along with the actual cause of injury (history), certain signals suggest head or spinal injury. They include:

Signs and symptoms of head or spinal injury

• A change in consciousness – memory loss, disorientation
• Pain – headache or point of impact
• Nausea and / or projectile vomiting
• Impaired vision
• Inability to move a body part or weakening of strength
• Tingling or numbness in hands, fingers, feet and/ or toes
• Difficult/ depressed breathing
• Sensory and/ or motor nerve damage
• The patient often lies on their back with their arms raised above their head (Serious sign)

Treatment

• Stabilise head and neck. Stop movement
• Maintain an open airway
• Apply a cervical collar
• If available, place the casualty on a spinal board (or any improvised surface) by using the log-roll method. Alternatively, activate the EMRS and wait for them to arrive before moving the patient.

It is important to remember that you should never move the patient unless life-threatening factors are present at the location of the emergency.