When (Not) to Move an Injured Person

Learning objectives

After completing this lesson learners should be able to:

• Understand why unnecessary movement can worsen injuries
• Recognize situations where an injured person should not be moved
• Identify exceptional circumstances where moving someone may be necessary to prevent greater harm
• Protect the head, neck and spine while waiting for emergency responders
• Provide safe assistance without increasing the risk of further injury

Why Movement Can Be Dangerous

During a road crash, the body is subjected to tremendous forces. An injured person may have a spinal injury, a neck injury, a fractured pelvis, broken ribs, internal bleeding or head injuries. Many of these injuries cannot be seen from the outside. Moving the person incorrectly may damage the spinal cord, increase bleeding, worsen fractures, cause additional pain or lead to permanent disability.

When You Should NOT Move an Injured Person

In most situations, do not move the injured person if they are breathing normally, the crash scene is reasonably safe, emergency services are on the way and there is no immediate danger. Instead, keep them calm, reassure them, prevent unnecessary movement and continue monitoring them until professional help arrives.

When Moving May Be Necessary

There are situations where leaving someone in place is more dangerous than moving them. Examples include fire, a significant fuel leak creating an immediate fire risk, oncoming traffic where another collision appears imminent, flooding or water, or structural collapse where the vehicle or surrounding structure may collapse. In these situations, move the person only as much as necessary to reach a safer location.

Protect the Head and Neck

If the injured person remains where they are, encourage them to stay still, avoid turning their head and avoid sitting up unless instructed by emergency responders. If they attempt to move unnecessarily, calmly explain that help is on the way and remaining still is safer.

Do Not Pull Limbs

Never pull an injured person by their arms, legs, clothing or helmet straps. Dragging someone incorrectly may worsen injuries. If an emergency evacuation is absolutely necessary, minimise movement and avoid twisting the body wherever possible.

Should You Remove a Helmet?

Helmet removal requires proper training. As a general rule, do not remove the helmet of an injured motorcyclist unless it is absolutely necessary to manage an immediate life-threatening situation, such as an inability to maintain an open airway or another imminent danger. Improper helmet removal may worsen neck injuries. If emergency responders are on their way and the person is breathing normally, leave the helmet in place.

Comfort the Injured Person

People involved in crashes are often frightened and confused. Speak calmly and tell them that help has been called, emergency services are on their way, they should remain still and you will stay with them until help arrives. Sometimes reassurance is as important as physical assistance.

What You Should Never Do

Do not force someone to stand, ask them to "walk it off," pull them from the vehicle unnecessarily, twist their neck or back, remove protective equipment without good reason, or crowd around the injured person. These actions may increase the severity of injuries.

Real-Life Scenario

Sunil witnesses a motorcycle crash on a city road. The rider is conscious but complains of severe neck pain. Some bystanders suggest lifting the rider and placing him inside an auto-rickshaw. Sunil asks everyone to stop. He explains that unnecessary movement could worsen the injury. After calling 112, he keeps the rider calm, prevents unnecessary movement and waits for the ambulance. Emergency responders later confirm that avoiding movement helped reduce the risk of further spinal injury.

Did You Know?

Many serious spinal injuries cannot be identified simply by looking at the injured person. Someone may appear alert and able to speak while still having an unstable spinal injury. This is why unnecessary movement should be avoided whenever possible.

Key Takeaways

Never move an injured person unless there is immediate danger. Suspected spinal injuries require minimal movement. Fire, fuel leaks and oncoming traffic may require emergency evacuation. Protect the head and neck whenever possible. Do not remove a helmet unnecessarily. Stay calm, reassure the injured person and wait for trained responders.

Real-world scenarios