Neck & Spine Injuries
A fall from a ladder, a blow from a falling object or a vehicle crash can injure the spine. Moving the person the wrong way can turn a recoverable injury into permanent paralysis. Unless there’s immediate danger, keep them still and let EMS move them.
- All workers
- Construction
Photo: first aider kneeling at a worker’s head, holding the head and neck still in line while waiting for EMS
Suspect a spine injury after
- A fall from any height, especially headfirst
- Being struck by a heavy or falling object
- A vehicle or equipment crash or rollover
- Any serious head injury. See Head Injuries
- Diving or falling into shallow water
Signs
- Neck or back pain
- Numbness, tingling or weakness in arms or legs
- Loss of bladder or bowel control
- Head or neck in an odd position
- Confusion or unconsciousness (assume a spine injury)
What to do
- Call 911.
- Don’t move them unless they’re in immediate danger, like fire, traffic, a collapsing trench or rising water.
- Keep the head and neck still in the position you found them: kneel at their head and hold it gently with both hands.
- Tell them not to move and keep talking to them.
- Leave the hard hat on unless it blocks the airway or breathing.
- Watch breathing. If they stop breathing, start CPR. See CPR & AED.
- If they vomit, roll them onto their side with help, keeping the head, neck and body in a straight line (log roll).
Don’t sit them up or let them walk it off, even if they say they’re fine. Some spinal injuries don’t cause symptoms until the person moves.
Workers hanging in a harness
A worker who falls and is caught by fall protection needs prompt rescue, but may also have neck or back injuries from the fall. Follow your rescue plan. See Fall Rescue.
Standards & references
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