Information for the public
Assessment at the scene
Assessment at the scene
Assessing for life-threatening injuries
When the ambulance arrives at the scene, the ambulance team should assess the person who is injured straightaway to check that their airway is clear, their breathing is stable and if they have any bleeding that needs to be controlled or any nerve damage.
Assessing for spinal injury
The person's spine should be protected, or 'immobilised', to prevent any damage. This involves the person lying flat on their back with their head positioned straight, in line with their spine (this type of immobilisation is called manual immobilisation). Once the spine is immobilised they should then be assessed for any injury to their spine.
During the assessment the ambulance team should check if the person has any injuries, spinal pain, weakness or 'pins and needles' (or no feeling at all) in their hands or feet, and also check how alert they are or whether they seem confused. They should ask them if they have had any previous problems with their spine. They should also check things such as their age, the type of injury they have had and how they became injured. All of this will help them to find out how likely it is that the person has a spinal injury, and which part of the spine might be injured.
Immobilising the spine
If the assessment suggests that someone has injured their spine, or if the assessment can't be done (for example, because of other injuries that happened at the same time), the ambulance team should fully immobilise the spine. This is a more secure way of stopping the spine from moving while the person is being taken to hospital. It usually involves fitting the person with a collar, placing them on a special stretcher, and using head blocks and tape to keep their head still. However, how this is done may vary depending on the circumstances. If someone is finding this difficult (for example, they are very distressed or anxious), they may be asked to find a position in which they feel comfortable without having full immobilisation.
The ambulance team may ask the parents or carers of a child who has been injured to help with immobilising their spine to make things easier for the child. For example, they may be asked to hold the child's head still or talk to them to distract them from what is happening. Infants who have been injured in a road traffic accident might be kept in their car seat while they are taken to hospital.
If the assessment shows that the spine is unlikely to be injured, the person shouldn't need to have full spinal immobilisation.
Getting to the ambulance
If the person has had a road traffic accident (or they are in a confined space), they may need the ambulance team to help them get out of the vehicle, for example. But the team may ask them to get out themselves if it is safe for them to do so – for example, if the person is conscious, they don't have any pain in their spinal area or any distracting injuries (injuries that takes their focus away from any pain in their spine), they don't have any weakness or numbness, and the assessments show that their spine is unlikely to be damaged. But if they start having any pain in their spine, numbness, tingling or weakness in their body, they should stop moving and wait for the ambulance team to help them.
Once the person has got out of the vehicle (or confined space), they should lie down on a stretcher. They will then be taken to the ambulance and re‑assessed to see if they need to be immobilised.
Transporting people to hospital
A person who might have injured their spine will be taken to a hospital that has either a major trauma centre or a trauma unit for more tests. Where they are taken will depend on their injuries and whether they are a child or an adult. It may not be the nearest hospital but in some cases it will be the best one to go to because it can provide the specialist care the person needs. However, if someone needs emergency life‑saving treatment (for example, to help them breathe) they should be taken straight to the nearest trauma unit.