Cervical spine injuries among submersion victims

Background. Submersion victims are frequently considered at high risk for c ervical spine (C-spine) injury regardless of whether they sustain a traumat ic injury. We hypothesized that C-spine injury is unlikely in submersion vi ctims who do not sustain high-impact injuries. Methods. The study was a cohort study of all people who submerged between J anuary 1974 and July 1996 and received medical care or were seen by the med ical examiner in King, Pierce, and Snohomish counties in Washington State. Results. Eleven (0.5%) of 2,244 submersion victims had C-spine injuries. Al l I I had submerged in open bodies of water; had clinical signs of serious injury; and had a history of diving, motorized vehicle crash, or fall from height. No C-spine injuries occurred in 880 low-impact submersions. Conclusion: Submersion victims are at risk for C-spine injury only if they have also sustained a traumatic injury. Routine C-spine immobilization does not appear to be warranted solely on the basis of a history of submersion.