NREMT Skillset/Strap Tightening

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While it may seem benign and unimportant, correct strap tightening procedure is important to good patient care. Slack, new or increased pain/discomfort, and injury can be caused by improperly tightened straps. For example, if there is slack in the straps after the patient is secured to a long board for spinal immobilization the patient could slide around the board while being moved. This could seriously negatively affect the patient's outcome as their head would be fully secured to the board by the head block. Additionally, overtightening straps can lead to decreases in available lung volume and reduction or cessation of blood flow to distal extremities. The feed and pull tightening technique is an example of a strap tightening technique that seeks to mitigate issues caused by improper strap tightening.

Feed-and-pull tightening technique

• Grasp the portion of the strap and create a little slack in the strap.
• Feed the slack into the buckle with the other hand.
• Repeat until the strap is snug or tight.

Special Cases: Tightening over the chest, tightening over a wound.