Spinal-cord injuries are often associated with unsafe conditions such as traffic accidents, falls, rock slides, and avalanches, so it's critical for you to check the safety of the scene before helping. Call 911, and after assessing for ABCs, ask the injured person what their name is, if they know where they are and what time of day it is, and if they remember what happened, in order to determine their level of consciousness. An incorrect answer to the first three questions is an indicator of head injury and possibly a corresponding spinal-cord injury.
Any signs of drug or alcohol use or other injuries that are causing the person enough pain to ignore spinal discomfort need to be taken into consideration. Pressing lightly on a fingernail on each hand and a toenail on each foot and not seeing pink coloring return within two seconds of the release of pressure may indicate loss of circulation due to a spinal injury. Ask the person to move his fingers and toes, because difficulty moving or lack of movement indicates a spinal injury. Numbness or tingling when gently squeezing the fingers and toes also indicates possible spinal injury.
If you have any doubt, always assume a spinal-cord injury is present. You must stabilize the neck by remaining at the injured person's head, holding the neck immobile gently but firmly with one hand on each side of the head. If you have to move the person for any reason, you must logroll the person as outlined in Chapter 2. Keep the injured person's neck stabilized until help arrives.