Suspected spinal injury in water

man doing a backflip off a boat into the water

Spinal injuries can occur in the water, typically when a person’s head has collided with a hard surface (for example, diving into shallow water). Most aquatic spinal injuries occur in the area of the neck due to the bending of the neck on impact (flexion). Permanent spinal damage can occur if too much pressure is placed on the spinal cord contained within the vertebrae.

Signs of spinal injury – what to look for

A person who has sustained a spinal injury may have broken the bones of the spine, or damaged the spinal cord contained within it. If the spinal cord is damaged, there will be a lack of movement, weakness and numbness or tingling of the muscles. If conscious, the casualty will be experiencing pain and shock, and may complain of visual problems. There may be deformity, redness or lacerations at the site of the injury.

If a person is found unconscious in the water, unless the circumstances leading to the lack of consciousness were witnessed and neck or back injury is deemed highly improbable, the casualty must be treated as having a suspected spinal injury.

Establishing the airways is the immediate priority but it is also critically important to prevent any twisting of the head or spine. If there is only one rescuer, immobilisation may not be possible if resuscitation is required. With more than one rescuer it is possible to immobilise using the vice grip technique and perform rescue breathing in the water. 

If CPR is required, the casualty must be removed from the water – taking extreme care to prevent movement of the spine – and CPR commenced on land.

Watch the videos below to learn more about managing potential spinal injuries in shallow and deep water.


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