How Prepared Is the Public to Respond to Spinal Cord Injuries? A Cross-Sectional Study from Al-Ahsa, Saudi Arabia

Background: Cervical spine injuries can result in permanent neurological impairment, and inappropriate first-aid management may aggravate spinal cord damage. Public recognition of these injuries and knowledge of safe initial responses are therefore essential for preventing secondary harm. Aim: This study aimed to assess awareness, attitudes, and intended first-aid practices regarding cervical spine injuries among adults in Al-Ahsa, Saudi Arabia, and to identify the factors associated with these outcomes. Methods: A cross-sectional survey was conducted among 389 adults residing in Al-Ahsa. Data were collected electronically using a structured questionnaire covering sociodemographic characteristics, awareness, attitudes, and intended first-aid practices. Descriptive statistics and multiple linear regression analyses were used to summarize participants’ responses and identify associated factors. Results: The mean awareness score was 63.8%, and 60.4% of participants had good awareness (score ≥60%). The mean attitude and intended practice score was 87.7%, and 92.8% of participants had a positive score. The importance of early recognition in preventing complications was correctly identified by 84.1% of participants; however, only 39.3% recognized all listed complications. Most participants reported that they would maintain head, neck, and spinal alignment (94.3%), contact emergency services before initiating first aid (93.8%), and avoid unnecessary patient movement while seeking emergency assistance (93.6%). First-responder training was independently associated with higher awareness and more favorable attitude and intended practice scores (both P<0.001). Female gender was also independently associated with a higher attitude and intended practice score (P=0.001). Conclusion: Participants reported highly positive intended first-aid responses, but important knowledge gaps remained, particularly regarding the complications of cervical spine injuries. Expanding structured, practical first-responder training may improve public knowledge and promote safer early management of suspected cervical spine injuries.