Spinal cord injuries (SCI) are one of the many severe situations you could encounter in the field or in the woods while camping or hunting. If the accompanying person happens to fall from a significant height, their spine could be seriously damaged. Time is crucial between the moment the incident happens and when medical assistance arrives. In this time, you can both identify their spinal injuries and attempt to clear them.
Spinal injuries are caused when vertebrae—the bones protecting the spinal column—are broken or dislocated by trauma from falls, car accidents, intense lifting, and more. This can cause pressure, pinching, and even severing, which can result in paralysis. There are two types of spinal injuries: complete and incomplete. A complete spinal injury means that there is total paralysis at the trauma site. The patient cannot move one or more of their lower extremities. Complete spinal injuries are, unfortunately, permanent. Incomplete indicates that there is a pinched or squeezed nerve, and disks between the vertebrae may be dislocated. Incomplete spinal injuries involve temporary or limited paralysis.
To properly identity spinal injuries on your own, look for the following symptoms:
- Uncontrollable muscle spasms or twitching
- Extreme pressure in the back, neck, or head
- Impaired breathing patterns post-injury
- Inability to control motor functions, bladder, and bowels
- Loss of tactile sensation; numbness and tingling
- Difficulty balancing
If you can determine if the patient demonstrates any of these symptoms, they may be crucially injured. No matter what, it is important to never attempt to move them unless the situation calls for it. If the patient is in danger, then you would naturally need to move them, keeping in mind to stabilize their spine as much as possible. In some situations, you may be able to clear the spine, meaning you determine if the patient's spine is damaged. Should you be able to attempt this, ensure the patient is able to coherently understand and respond to your questions. Essentially, to clear a spine, the person must be able to discern between dull and sharp sensations in each extremity. They must also be able to move all of their limbs and feel no point of tenderness in the spine.
You'll first palpate the patient's spine, pressing firmly on each vertebra for point tenderness. If it is too painful, you should end the test and instead seek medical assistance immediately. If they are good to move on, check their motor functions. If they can push down on your hands with their feet and resist force when you press down on them, then the spine may be alright—continue on with the test to make sure of this. Have the patient bend their arms to a 90 degree angle and fold their wrists towards their waist. Here, you'll have them push and pull on your hands. If all is good after this, you may test their sense of touch with something slightly sharp like a pine needle. Starting at their forehead, press the object on the left and right sides of their hands and feet. They should be able to tell you when you're pressing it into their skin. If they've gone through the test and you believe their spine is cleared, still take caution as you attempt to help them exit the area. If spinal damage is evident, you will need to ensure they're totally immobilized before seeking help. Note that you should only attempt to clear a spine if you are comfortable and confident in the process. Practice it at home so as to not misjudge these situations and further injure your partner.