b'Chapter hapterHow to RecogniseUnconscious PatientSuspected spinal injuries of the neck, particularly if the patient is unconscious, pose a major dilemma for the first aider because correct principles of airway management often cause some movement of the cervical spine. The principles of management of a suspected spinal injury are: Calling for Ambulance 000. Management of airway and normal breathing. Management of the spine.An awareness of potential spinal injury and careful patient handling, with close attention to spinal alignment, is the key to minimise harm.How to ManageApply DRSABCD.Call Ambulance 000.Handle the patient gently without twisting and with minimal movement of the head,neck and spine. It is acceptable to gently move the head into a neutral position (normal alignment) to obtain a clear airway. Airway management takes precedence over any suspected spinal injury. If the patient is breathing but remains unconscious, it is preferable that the patient be placed in the recovery position.Aim to maintain spinal alignment of the head and neck with the torso, both during the turn and afterwards.If the airway is not clear:If there are airway problems or if you are on your own and you need to leave thepatient to call for Ambulance, gently turn the patient into the recovery position. If there are other helpers, gently turn the patient into the recovery position using the log roll technique(refer page 59) .The mouth should be opened and turned slightly downwards to allow any obvious foreignmaterial (food, vomit, blood, secretions) to drain using gravity. Loose dentures should be removed however well fitting ones can be left in place. Visible materials can be removed by the rescuers fingers (finger sweep). Closely monitor patient for response, airway, normal breathing while waiting for Ambulance.Head, Neck and Spinal Injury 97'