1. Caring for Head Neck and Back Injuries on Land
When deciding how to treat a HNB Injury you must think about what caused the injury.
HNB Injuries can happen on land or water.
In aquatic environments, examples of land injuries include:
Tripping or falling on pool decks.
Slipping in the locker room
Falling from greater than standing height.
Falling off pool features.

2. Signs and Symptoms of HNB Injuries
Unusual bumps, bruises or depressions on the HNB
Heavy external bleeding of the HNB
Bruising of the head around the eyes or behind the ears
Blood or fluid in the nose or ears
Seizures
Changes in LOC
Impaired breathing or vision
Nausea or vomiting
Loss of movement to body areas
Loss of balance
Victim holding HN or B
Behavior resembling Intoxication
Severe pain or pressure of HNB
Back pain, weakness or tingling of fingers or toes
Persistent headaches

3. Caring for Head Neck and Back Injuries on Land
HNB on Land Video – 4:00
Stabilization of standing victim
Stabilization of laying victim
When things do not go as practiced Video– 5:00
Front Head Hold Escapes
Rear Head Hold Escapes
In Water Ventilations – Shallow and Deep

4. Caring for Head Neck and Back Injuries in Water
HNB Injuries are caused by high impact/high risk activities.
Water related activities include:
Entering head first into shallow water
Entering the water from a height….diving board, slide, cliff, tower.
Striking a submerged or floating object
Receiving a blow to the head
Colliding w another swimmer.
Striking the water w/ high impact such as falling from skiing or surfing.
Goal is to minimize movement.
Always examine a victim having them speak the words yes or no and not allowing them to shake their head to answer.

5. Caring for Head Neck and Back Injuries in Water
Care for life threatening conditions comes first. Even if you suspect a HNB injury – you must perform proper CPR/AED first. Get them out of the water and resuscitated first – then stabilize. Do not strap them to the board first and get them out then perform CPR. Get them out, perform CPR then worry about immobilizing the victim.
If the victim is breathing in the water, strap them in quickly and immobilize the person, then get them out and care for injury.

6. Caring for Head Neck and Back Injuries in Water
The type of care you provide depends on:
The victims condition: conscious and breathing?
The victims location: shallow/deep, surface/submerged, land?
The availability of other help: LGs, bystanders, police, ambulance?
The facilities procedures
The air and water temperature

7. Team Backboarding
Requires communication by all lifeguards and each one knowing their role.
A minimum of 2 is need for backboard use, but more is better.
LGs must maintain stabilization of HNB throughout the entire process.
Rescue tubes aid in floatation of the backboard. Additional LGs can also help.
Communicate with the victim the entire time.
Once the victim is secure, get them out of the water ASAP.
After the victim is out of the water, assess his/her condition and provide care. Cover with blankets or towels if needed.