“SPINAL” rule

One simple way of recognising the potential for spinal cord injury is by using the “SPINAL” RULE.

This simple memory aid utilises the letters of the word SPINAL.

S stands for suspicious mechanism of injury, and refers to those mechanisms which we know can result in spinal injury. This includes falls from a height of at least 1 m (3 feet) or the equivalent of five stairs.

Likewise an axial load to the head, whether it is an object falling onto the head or the person’s head impacting the ground (e.g. diving into a swimming pool, beach or river) constitutes a suspicious mechanism of injury.

Motor vehicle and motor bike accidents, particularly those involving high-speed, rollover or ejection are common causes, as are collisions involving pedestrians or recreational vehicles.

P stands for pain (a symptom) or tenderness (a sign) in spinal region, and is elicited by gently running a hand along the vertebra

I stands for intoxication of any kind, which makes it difficult to elicit the signs and symptoms of injury but should always make one suspicious that a spinal injury may have occurred.

N stands the numbness or tingling (symptoms) or loss of sensation or motor function (signs)

A stands for any distracting or painful injury, which suggests that in the presence of multiple or massive trauma, or obvious other injuries to the individual or those around them, a spinal cord injury may have occurred

L stands for level of consciousness alteration, which reminds us once again that all head injuries are spinal injuries until proven otherwise, such that if an injury can cause an alteration or loss of consciousness then it certainly has enough force to cause a spinal cord injury