b'Chapter hapterHow to Suspect a Neck and Spinal InjuryThe symptoms and signs of a spinal injury depend on two factorsthe location of the injury and the extent of the injurywhether there is just bone injury or associated spinal cord injury and whether the spinal cord injury is partial or complete.It will be difficult to obtain symptoms and signs in a patient with an altered conscious state.The most important indicator is the History and any of the following should alert you to the possibility of neck and spinal injury damage.A road accident (sudden deceleration) or being struck by a vehicle.Falling from a height or awkwardly while at sport - skydiving, trampolining, gymnastics.Being thrown from a horse or motorbike.Diving into shallow water.Being dumped in the surf.Significant head or face injury (assault).Stabbing injury.Gunshot or other firearm injury.Heavy object falling on top of a person.Landing heavily onto the buttocks.A fall in the elderly.Any accident resulting in unconsciousness.How to RecogniseAn awareness of potential spinal injury and careful patient handling, with attention to spinal alignment, is the key to harm minimisation.Conscious PatientWhen the vertebrae are damaged, there may be the following:Patient may complain of pain at the injury site (in the neck or back). A noticeable irregularity or twist in the normal curvature of the spine. Tenderness over the injured area.Ask the patient to remain still but do not physically restrain if unco-operative. A patient with significant spinal pain will likely have muscle spasm which acts to splint the injury.When the spinal cord is damaged there may be: Loss of sensation or tingling and burning feelings. The patient may describe a heaviness or stiff feeling in the limbs. The patient may describe floating sensations (as if they have become detached from their body).Loss of control or weakness in the limbs. All movement may be absent. Loss of bladder and or bowel control.Difficulty in breathing. Priapism (erection in males).Head, Neck and Spinal Injury 95'