Unfortunately, neck and spinal injuries are a potential risk of some outdoor activities, and obviously avoidance should be the priority when planning for any adventure. However, if a neck and spinal injury is suspected, there are several steps to take.
After ensuring their own safety, the number one priority for a first aider when neck and spinal injuries may be suspected is to minimise any movement. For a conscious patient, this should mean not moving the patient at all. However, the neck and spine should be supported in a neutral position to prevent any twisting or moving. The patient may be agitated if they realise something may be wrong so every effort should be made to minimise their movement and to reassure them. As soon as possible, medical assistance should be sought.
In water, or in another dangerous movement where a patient needs to be moved for their own immediate safety, every attempt should be made to minimise any twisting movement of the neck and spine. The use of a spinal board or other rigid board such as a surfboard will greatly assist in this process as the patient will be held in position. The emphasis remains for any first aider to minimise movement, so the head and neck is supported. When in a safe environment, no further movement should be made until professional medical help arrives. See below for an example of the training received by Surf Lifesaving clubs in managing suspected spinal injuries in the water.