Spinal Injury--Jaw Thrust

A patient may be in pain while you are examining them. Perhaps they fell down a flight of stairs, for instance. While examining the patient, care should be taken to minimize the amount of contact done to them.

Assess The Patient

  1. Introduce yourself, and instruct the patient to not move too much (in case of injury) and to answer questions via nods or descriptions.
  2. Check the head for injuries.

   

  1. Check the eyes, ears, and mouth for any signs of bleeding. Get the patient to smile; did they lose a tooth?
  2. Check the pupils. Are they of equal size, and do they respond normally to light?

       1. Pupils that do not react normally or are of unequal size indicates a medical emergency--this patient may have a concussion.

  1. Check for patient breathing, heartbeat, and responsiveness.

   

  1. A patient that is talking to you and answering your questions in a clear manner indicates that these vitals are ok.
    1. If possible, ask the patient open-ended questions about their condition and if they remember what happened. Ask some basic questions as well, such as the day and the year, to assess for orientation.

   

  1. If the patient answers these orientation questions incorrectly, assume that the patient has hit their head, even if they say otherwise. In this instance, call for help!

Ask the patient about where they feel pain, and if they can move certain parts of their body, such as their arms.

  1. If you see any signs of shock, such as the patient getting pale, cool, and sweaty, cover the patient with a sheet and reassess for breathing and a pulse.
  2. Be ready to perform CPR and/or rescue breathing should the patient go unconscious, not breathe, or lose a pulse.

Spinal Injury

Spinal injury can become a complication when performing CPR. If you have another rescuer, use the Jaw Thrust procedure.

  1. Ensure the scene is safe and that you have the rescue mask.
  2. Place one hand on the forehead to ensure you do not move the head and neck as you check the patient.
  3. Call for help if the patient is unresponsive.
  4. Check for a pulse for no more than 10 seconds.
  5. Have one rescuer begin CPR. The second rescuer should position themselves at the head of the patient (removing glasses if they have them).
  6. After 30 compressions, give two rescue breaths using the Jaw Thrust technique.

   

  1. Place the apex of the mask over the bridge of the nose and seal the bell portion of the mask just below the bottom of the lip and above the chin
  2. Use both thumbs to push down on the mask and the four fingers to grab the jaw and pull the jaw up into the mask.
    1. Continue CPR until help arrives, an AED arrives, or the patient revives.