Wilderness Medicine, First Aid, and Outdoor Skills
Neck Fractures

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US Army First Aid Manual
Fundamental Criteria for First Aid
Basic Measures for First Aid
First Aid for Special Wounds
First Aid for Fractures
First Aid for Climatic Injuries
First Aid for Bites and Stings
First Aid in Toxic Environments
First Aid for Psychological Reactions
Appendix A: First Aid Case and Kits, Dressings, and Bandages
Appendix B: Rescue and Transportation Procedures
Appendix C: Common Problems/Conditions
Appendix D: Digital Pressure
Appendix E: Decontamination Procedures
Appendix F: Glossary

Neck Fractures

4-10. Neck Fractures (081-831-1000)

A fractured neck is extremely dangerous. Bone fragments may bruise or cut the spinal cord just as they might in a fractured back.

a. If the Casualty Is Not to Be Transported (081-831-1000) Until Medical Personnel Arrive--
  • Caution him not to move. Moving may cause death.

  • Leave the casualty in the position in which he is found. If his neck/head is in an abnormal position, immediately immobilize the neck/head. Use the procedure stated below .

    o Keep the casualty's head still, if he is lying face up, raise his shoulders slightly, and slip a roll of cloth that has the bulk of a bath towel under his neck (Figure 4-28). The roll should be thick enough to arch his neck only slightly, leaving the back of his head on the ground. DO NOT bend his neck or head forward. DO NOT raise or twist his head . Immobilize the casualty's head (Figure 4-29). Do this by padding heavy objects such as rocks or his boots and placing them on each side of his head. If it is necessary to use boots, first fill them with stones, gravel sand, or dirt and tie them tightly at the top. If necessary, stuff pieces of material in the top of the boots to secure the contents.

    o DO NOT move the casualty if he is lying face down. Immobilize the head/neck by padding heavy objects and placing them on each side of his head. DO NOT put a roll of cloth under the neck. DO NOT bend the neck or head, nor roll the casualty onto his back.

b. If the Casualty Must be Prepared for Transportation Before Medical Personnel Arrive--

  • And he has a fractured neck, at least two persons are needed because the casualty's head and trunk must be moved in unison. The two persons must work in close coordination (Figure 4-30) to avoid bending the neck.

  • Place a wide board lengthwise beside the casualty. It should extend at least 4 inches beyond the casualty's head and feet (Figure 4-30 A).

  • If the casualty is lying face up, the number one man steadies the casualty's head and neck between his hands. At the same time the number two man positions one foot and one knee against the board to prevent it from slipping, grasps the casualty underneath his shoulder and hip, and gently slides him onto the board (Figure 4-30 B).

  • If the casualty is lying face down, the number one man steadies the casualty's head and neck between his hands, while the number two man gently rolls the casualty over onto the board (Figure 4-30 C).

  • The number one man continues to steady the casualty's head and neck. The number two man simultaneously raises the casualty's shoulders slightly, places padding under his neck, and immobilizes the casualty's head (Figures 4-30 D and E). The head may be immobilized with the casualty's boots, with stones rolled in pieces of blanket, or with other material.

  • Secure any improvised supports in position with a cravat or strip of cloth extended across the casualty's forehead and under the board (Figure 4-30 D).

  • Lift the board onto a litter or blanket in order to transport the casualty (Figure 4-30 E).

Back to First Aid for Fractures

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