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Aquatic Spinal Injury Management
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Aquatic spinal injury management is the highest-consequence skill a guard holds. It is performed rarely, badly under stress without practice, and its failures are permanent.
What are the steps of aquatic spinal injury management?
1. Recognise the mechanism. A dive into shallow water, a fall on the deck, a slide or starting block entry, a collision, or any unresponsive casualty whose cause you do not know. Mechanism, not symptoms, is what triggers the protocol.
2. Enter without making a wave. Slide-in entry only. Any surface disturbance moves the casualty.
3. In-line stabilisation. Bring the head, neck and spine into alignment and hold. The head-splint technique, using the casualty’s own arms alongside the head, is the standard because it works with one rescuer and holds alignment while the casualty is rotated face up.
4. Do not move the head to open the airway. Use a jaw thrust without head tilt.
5. Board in the water. Slide the backboard under the casualty, strap the body first and the head last, and only then move toward the exit.
6. Remove and hand over without changing alignment.
Why shallow water produces most of them
People dive into water they have not checked. Head strikes on the bottom in 3 or 4 feet of water produce cervical injuries, and they happen at pools, at lakes with shifting bottoms, and in shore break where a wave drives a swimmer head first into packed sand.
Strap the body before the head
This is the sequence guards most often reverse under pressure. Securing the head first means any shift of the torso levers against a fixed skull, which is precisely the movement the whole procedure exists to prevent.
Practise it more than you think you need to
Aquatic spinal injury management decays faster than almost any other skill because it is multi-person, sequenced and rarely used. It belongs in monthly in-service, not in the two-yearly certification cycle alone.
Aquatic spinal injury management: frequently asked questions
What is aquatic spinal injury management?
Aquatic spinal injury management is the protocol for a suspected head, neck or back injury in water: a slide-in entry with no wave, in-line stabilisation using the head-splint, a jaw thrust without head tilt to open the airway, and backboard extrication with the body strapped before the head.
What triggers the protocol?
The mechanism, not the symptoms. A dive into shallow water, a deck fall, a slide or starting block entry, a collision, or any unresponsive casualty whose cause is unknown.
Why strap the body before the head?
Because securing the head first means any movement of the torso levers against a fixed skull, which is exactly the movement the procedure exists to prevent.
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