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Subskill of Spinal Immobilization Adult

After log-rolling a patient onto the longboard, you may notice that they are slightly out of place. Oftentimes a patient will be either not be centered on the board's long axis or they will be too high/low and will need to be repositioned. Patient repositioning on a longboard should be completed with as little lateral movement as possible to avoid exacerbation of any potential spinal injures. When repositioning the patient, a minimum of two rescuers is needed (if spinal precautions are in place, a third rescuer should be used to manually stabilize the head).

General patient movement[edit | edit source]

When moving the patient, it is important that the rescuers actions be concerted and do not place unnecessary torque on the patient's spine. With this in mind, the patient should be gripped in areas that do not move. These areas often include the armpits, top of the shoulder/lateralis, and belt (with the exception of a belt, using the patient's clothes as a grip point can be dangerous as the natural elasticity of the clothes increases the chances of "see-saw" movement). If there is a rescuer at the patient's head, that rescuer is in charge of patient movement and will call out all movements using easy to follow commands ("On 3, move the patient down and to their right 6 inches"). If there is a fourth rescuer available, they may take control of the patient's feet which will often slide contralaterally to the direction of the body if a large movement is being performed.

Movement towards head/foot of longboard[edit | edit source]

The patient may sometimes be too low/high on the backboard after a log roll procedure or extrication. In this case it is necessary to reposition the patient as smoothly as possible while avoiding substantial compression of the spine. When moving the patient up or down the longboard, choose grip points that will promote success; i.e. do not grab the armpit when moving the patient down the board. Your grip points may change between movements, be aware that if you are using clothes or a belt as a grip point that there will be some slack that needs to be accounted for.

Lateral patient movement[edit | edit source]

Occasionally the patient may be off-center on the backboard and will need to be repositioned. This "lateral" patient movement can be the most dangerous movement performed, especially by new rescuers. The patient should NEVER be moved laterally on a backboard, doing so risks serious spinal injury. To perform a "lateral" patient movement, the patient should be moved in a "V" shape (up/down on a shallow diagonal then back on another shallow diagonal). This "V" shaped movement significantly reduces the chances of a rescuer-induced spinal injury by reducing the lateral load on the spine. This movement procedure takes practice, and the rescuer at the head should be experienced at such maneuvers so as to promote repositioning of the patient in the least amount of movements possible.

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Keywords supine patient, patient movement, trauma
SDG SDG03 Good health and well-being
Authors Catherine Mohr
License CC-BY-SA-4.0
Language English (en)
Related 0 subpages, 2 pages link here
Impact 288 page views
Created November 5, 2020 by Emilio Velis
Modified May 25, 2023 by Felipe Schenone
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