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If you suspect a back or neck (spinal) injury, do not move the affected person. Permanent paralysis and other serious complications can result. Assume a person has a spinal injury if:

• There's evidence of a head injury with an ongoing change in the person's level of consciousness
• The person complains of severe pain in his or her neck or back
• An injury has exerted substantial force on the back or head
• The person complains of weakness, numbness, or paralysis or lacks control of his or her limbs, bladder or bowels
• The neck or body is twisted or positioned oddly

If you suspect someone has a spinal injury:

• Get help. Call 911 or emergency medical help.
• Keep the person still. Place heavy towels or rolled sheets on both sides of the neck or hold the head and neck to prevent movement.
• Avoid moving the head or neck. 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.
• Keep helmet on. If the person is wearing a helmet, don't remove it. A football helmet facemask should be removed if you need to access the airway.
• Don't roll alone. If you must roll the person because he or she is vomiting, choking on blood or because you have to make sure the person is still breathing, you need at least one other person. 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.