How should spinal injuries be managed during casualty handling and movement?

• A. Suspect spinal injury by mechanism
• B. Maintain inline immobilization
• C. Use cervical collar and log roll with manual stabilization
• D. All of the above

Answer: (D)

The key idea is to prevent any further damage to the spinal cord during casualty handling by keeping the spine stable and aligned throughout movement. If the mechanism of injury suggests a potential spinal injury—such as a high-energy impact, fall from height, or signs like neck pain, numbness, weakness, or loss of sensation—you should treat the casualty as having a spinal injury until proven otherwise.

Maintain inline immobilization at all times, keeping the head, neck, and torso in a straight plane and preventing any rotation or bending. A cervical collar is used to limit neck movement and add support. When movement is unavoidable, use a controlled log roll with multiple responders, and have one person continuously stabilize the head and neck with manual support to preserve alignment as the patient is rolled and transferred onto a spine board or other immobilization device.

Once immobilized on the backboard, secure the body with straps at the head, torso, and legs to maintain alignment during transport. Keeping the spine in a neutral, immobilized position from the moment of assessment through transport minimizes the risk of turning a spinal injury into a more severe one. All of these steps together form the proper approach to spinal injury management during casualty handling.