Bridging the Knowledge-Practice Gap in Cervical Spine Injury First Aid: A Cross-Sectional Study in Southern Saudi Arabia.

BACKGROUND/

OBJECTIVES

Cervical spine injuries (CSIs) are life-threatening conditions commonly resulting from road traffic accidents and falls; improper first aid management can significantly worsen neurological outcomes. Public awareness and correct first aid response are critical for preventing secondary injury; despite this, available data from the southern provinces of Saudi Arabia remain insufficient. This study aimed to assess public awareness and first aid preparedness for CSIs across four southern regions of Saudi Arabia.

METHODS

A cross-sectional design was employed across multiple regions, encompassing 1179 adults from Jazan, Aseer, Al-Baha, and Najran between 2025 and 2026. A validated online questionnaire was employed for data collection to assess CSI awareness, recognition of injury signs, and appropriate first aid responses. Awareness scores of ≥60% were classified as good. Multiple linear regression analysis was performed to identify independent predictors of awareness.

RESULTS

The mean awareness score was 16.0 ± 4.8 out of a possible total of 20 points, corresponding to 80% of the total score, with 87% of participants demonstrating good awareness. The majority of respondents recognized the importance of spinal immobilization (89%), maintaining head-neck alignment (95%), and contacting emergency services before intervention (93%). Correct responses to emergency scenarios were recorded in 83% of participants. Notably, only 39% had attended formal medical or trauma training, and merely 3% reported real-life first aid experience. Training attendance (β = 1.39, p < 0.001) and marital status (married; β = 1.37, p = 0.004) were identified as independent predictors of higher awareness scores.

CONCLUSIONS

Although general public awareness of CSI first aid is high, formal training participation remains critically low, revealing a substantial gap between knowledge and practice. Integrating structured first aid training into community, workplace, and primary healthcare settings is essential to improve trauma outcomes and reduce preventable disability.