Neymar Jr., Vertebral Injuries and First Aid

In the final minutes of the Brazil-Colombia World Cup quarterfinal match, Brazil’s heartbeat, Neymar Jr. suffered a traumatic blow to the back. He was quickly carted off by trainers and taken to a hospital. In hindsight, I do wish they had applied a c-collar to the affected player as they were moving him off the field. First Aid is all about training and instinct. There is very little time or clarity of thought to try and think through such a situation on the field. So, thorough training and established protocols are paramount. Thrust of this article will be a thorough review of First Aid protocol to be followed during and after a suspected spinal or vertebral injury.

Shortly after the unfortunate young Brazilian was taken to the hospital, it was announced that he had broken a vertebrae and was done with this World Cup. Brazil’s team doctors have announced that surgery will not be needed in Neymars case and that immobilization should suffice in allowing his injuries to heal.

This may be surprising to contemplate, but not all back injuries or back problems in general need surgery. Surgery is only necessary if the injury is unstable (if the shattered pieces of bone are moving unnaturally when the back moves), if there’s a neurologic injury (numb/tingling legs, paralysis), and in patients who can’t be immobilized. It is incredibly important to understand that GOOD FIRST AID can minimize the need for surgery later in the patient’s recovery process.

First Aid in Suspected Spinal or Vertebral injuries:    

If you suspect a back or neck (spinal) injury, do not move the affected person, except to get them and yourself out of harm’s way. Permanent paralysis and other serious complications can result from excessive movement.

It’s really tough to diagnose a spinal injury of any magnitude in the field without X-rays and CT scans, so you have to have a high level of suspicion. In general assume that there is a spinal injury if the patient displays any of the following signs and symptoms:

1. Head injury with an ongoing change in the person's level of consciousness
2. Severe pain in his or her neck or back
3. Won’t or can’t move his or her neck voluntarily
4. An injury has exerted substantial force on the back or head
5. The person complains of weakness, numbness or paralysis or lacks control of his or her limbs, bladder or bowel.
6. The neck or back is twisted or positioned oddly

If you suspect someone has a spinal injury:

• Call an ambulance or equivalent emergency service for help. Attempting to transport the patient on your own to the hospital while admirable in spirit can cause devastating injury. Paramedics and ambulances have the training and equipment to move the patient quickly and safely.
• Keep the person still. Place heavy towels on both sides of the neck or hold the head and neck to prevent movement. If you don’t have towels, then, jackets, heavy tarp, anything that can conform to the curvature of the neck and back will do.
• Provide as much first aid as possible without moving the person's head or neck. If the person shows no signs of circulation (breathing, coughing or movement), begin CPR, but do not tilt the head back to open the airway. Use your fingers to gently grasp the jaw and lift it forward. If the person has no pulse, begin chest compressions.
• If the person is wearing a helmet, don't remove it.
• If you absolutely must roll the person because he or she is vomiting, choking on blood or in danger of further injury, you need at least one other person. The maneuver is called a “Log Roll”.
• With one of you at the head and another along the side of the injured person, work together to keep the person's head, neck and back aligned while rolling the person onto one side.