If you come upon a person who appears to have taken a fall, or was injured in an accident, and there are no bystanders around who witnessed the accident, you'll need to assess the victim to determine the exact injuries and their severity. Hopefully the victim will be able to help, who in this lesson, we are assuming is conscious, alert, and not exhibiting more serious issues involving airway, breathing, circulation, etc.
The most important thing to keep in mind as you deal with someone who has sustained potential injuries to their head, neck, and/or back, is minimizing movement, as you inquire more into what happened and how the victim is feeling.
How to Provide Care
You're going to begin the same way you do with all accidents and illnesses, by making sure the scene is safe, that your gloves are on, and that you have your rescue mask with one-way valve handy if you have one. Begin calling out to the victim to assess whether or not he or she is responsive before touching them.
Are you OK? Can you hear me?
If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, check the victim for breathing, airway, or circulation problems.
If you've determined that the victim is not responsive, not breathing normally, and doesn't have a pulse, call 911 immediately and go right into CPR.
Pro Tip #1: Are there any bystanders around that can assist you in calling 911, locating an AED, etc.? Also, if you're ever unsure how to handle a rescue situation, call 911, put the phone on speaker, and follow the instructions from dispatch while you wait for help to arrive.
For the sake of this lesson, we'll assume the victim is breathing normally, has a pulse, and is at least partially responsive. In these cases, proceed with the following steps.
- Introduce yourself to the victim: "Hi, my name's _____. I'm here to help you. I'm going to ask you some questions; try not to nod. Answer with yes or no. And try not to move other parts of your body."
"Do you remember what just happened?"
"Do you know if you hit your head?"
"Do you know what day it is?"
"Do you know what year it is?" - If the victim answers the last two questions incorrectly, you're likely dealing with someone who has hit their head and may have a concussion. This altered mental state is enough of a concern to call 911 and activate EMS if you haven't already done so.
- Otherwise, begin doing a head-to-toe exam in case there are other potentially serious injuries. On the victim's head:
- Is there blood in the ears?
- Is there blood in the nose?
- Does the patient have any broken teeth?
- Are the pupils equal size and responsive to light?
Pro Tip #2: Put your hand over the victim's eyes for a second or two then remove it and see if their pupils react. If they do not, it could be due to a concussion and swelling in the brain.
- Check their arms and legs for any deformities. If the victim is responsive, you can ask them to squeeze one of your fingers or try to wiggle a toe.
Pro Tip #3: When looking over the victim, remember not to move them. Instead, move your body for better assessment angles. Head, neck, and back injuries should be taken seriously; in most cases, it's going to be best to call 911 and activate EMS. Remember, we can always send them away when they arrive – so, better safe than sorry.
- Reassure the victim while you wait for EMS to arrive. Let them know you'll stay with them until help arrives, and comfort them if they get agitated.
A Few Common Head, Neck, and Back Questions
How do I know if the injuries are serious enough to call 911?
It's not always going to be easy to figure out if EMS is required as you tend to a victim with head, neck, or back injuries. It may be a situation where the victim is able to get up and has no significant lasting injuries. Or it could be a situation that doesn't appear serious initially but suddenly becomes serious.
If at any point the situation warrants it, call 911 immediately. There's a tremendous amount of gray area there, but also remember that it's better to call 911 and not need them … than it is to NOT call 911 and suddenly realize that you need them.
What are some signs and symptoms of a concussion?
Concussion symptoms include those that are physical, emotional, and behavioral, all of which are listed below.
Physical symptoms include:
- Headache
- Blurry vision
- Nausea or vomiting
- Dizziness
- Sensitivity to noise or light
- Balance problems
- Feeling sluggish
Emotional symptoms include:
- Irritability
- Sadness
- Heightened emotions
- Nervousness or anxiety
Behavioral symptoms include:
- Sleeping more or less than usual
- Difficulty falling asleep
- Changes in playing habits for kids
- Changes in eating habits
How can I know if the victim has pain or injuries that aren't visible to me?
The answer to this question is simple – ask them. In all the confusion, something this simple may escape you. But while you're doing a head-to-toe exam of the victim, try and remember to ask them if anything hurts and where their pain is located.