NEANN Long Spine Board Manual

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LOG ROLL

SUPINE - 2 PERSON

The following method of log roll which uses the arms by the side to splint the body, has been shown through x-ray studies to be the safest log rolling method currently available.¹ Techniques which elevate the arms above the head or place the arms across the chest result in thoracic-lumbar spine sagging,^1-3 and should therefore be avoided whenever possible.

The 2 person log roll has not been examined in any x-ray studies and therefore it’s use should be used only when other proven methods of placing a person onto the Long Spine Board (LSB) are not possible.

In this procedure, the Officer’s limb closest to the patient’s head will be referred to as the Officer’s upper limb, and the Officer’s limb closest to the patient’s feet will be referred to as the Officer’s lower limb.

Training Requirements:

2 x Staff
1 x Patient
1 x Cervical Collar
1 x Long Spine Board
1 x Triangular Bandage
1 x Blanket
1 x Towel
1 x Hand / Wrist Airsplint



	Step 1 While Manual In-Line Stabilisation is maintained by Officer 1 at the patient’s head, Officer 2 applies a Cervical Collar, and places the LSB alongside the Officer 1. The Manual In-Line Stabilisation is maintained until full spine immobilisation is achieved¹ as a Cervical Collar will at best provide only 50% immobilisation.^2-7
	Officer 2 now kneels at the patient’s mid-torso on the side to which the patient is to be log rolled. The patient’s legs are tied together and the knees bent up to a 90º angle.



	Step 2 The patient’s arms are extended beside their torso with their palms facing inwards.^8-10 Officer 2’s upper arm grasps the far side of the patient at the shoulder. Officer 2’s lower arm grasps the patient’s hip just distal of the wrist and runs their arm along the patients upper legs which will help assist with the log roll. Officer 2 also positions their lower foot so that on log rolling the patient, the patients knees will rest of Officer 2’s foot to reduce the patient’s pelvis drooping.



	Step 3 The patient is carefully log rolled until they are at right angles to the ground. Officer 2 at the patient’s torso is in charge and sets the pace (since he they have bear most of the weight). Officer 1 at the head watches the torso turn and maintains neutral in-line support of the head, rotating it exactly with the torso. Before rolling the patient down onto the LSB, and if appropriate, cut off the clothing covering the patient’s back and examine this area for injuries.



	Step 4 A folded blanket running the length of the patient’s posterior body (head to feet) can be placed against the patient to improve comfort after the patient is laid back on the LSB.^13-16 This will also assist in removing the patient from the LSB. Officer 2 slides the LSB in against the patient’s back and elevates the side of the LSB furthest from the patient at a 45º angle towards the patient’s back. Align the patient’s shoulders level with the shoulder markings on the LSB.



	Step 5 Lower the patient and elevated side of the LSB down onto the ground together, with the LSB assisting to maintain alignment of the patient, again with Officer 2 at the patient’s torso setting the pace. The LSB therefore acts a body splint for lowering the patient.



	Step 6 Straighten out the knees.




	Step 6 Apply appropriate padding under the patient’s head and lumbar spine to maintain proper alignment of the patient’s spinal column¹¹ and for comfort.¹² Immobilise the patient on the LSB for transport.¹⁷

Bibliography

^{1. Chandler

Annals Of Emergency Medicine October 1992

Emergency Cervical Spine Immobilisation

2. Cline

Journal Of Emergency Medicine 1990

Comparison Of Rigid Immobilisation Collars

3. Cline

Journal Of Trauma   25:649-653 1985

A Comparison Of Methods Of Cervical Spine Immobilisation Used In Patient
Extrication And Transport

4. Graziano

Annals Of Emergency Medicine October 1987

Radiological Comparison Of Prehospital Cervical Spine Immobilisation
Methods

5. Heurta

Annals Of Emergency Medicine October 1987

Cervical Spine Immobilisation In Paediatric Patients: Evaluation Of
Current Techniques

6. Manix

Eighth Annual Conference And Scientific Assembly Of The National
Association Of EMS Physicians

A Comparison Of Prehospital Cervical Immobilisation Devices

7. Podolsky

Journal Of Trauma No 6 1983

Efficacy Of Cervical Spine Immobilisation Methods

8. Suter

Prehospital And Disaster Medicine Vol 7 No 2 April -June 1992

Thoraco-Lumbar Spinal Instability During Variation Of The Log roll
Manoeuvre

9. McGuire

Journal Of Trauma May 1987

Spinal Instability And The Log rolling Manoeuvre

10. Seaman

Emergency   May 1992

Log roll Technique

11. Shriger

Annals Of Emergency Medicine   Vol 20:878-881 August 1991

Spinal Immobilisation On A Flat Board: Does It Result In Neutral
Position Of The Cervical Spine?

12. Goldberg

Annals Of Emergency Medicine

Effects Of Spinal Immobilisation On Healthy Volunteers

13.         Walton
R, DeSalvo JF, Ernst AA, Shahane A.

Acad Emerg Med 1995 Aug;2(8):725-

Padded vs unpadded spine board for cervical spine immobilization.

14.         Hauswald
M, Hsu M, Stockoff C.

Prehosp Emerg Care 2000 Jul-Sep;4(3):250-2

Maximizing comfort and minimizing ischemia: a comparison of four
methods of spinal immobilization.

15.         Cordell
WH, Hollingsworth JC, Olinger ML, Stroman SJ, Nelson DR.

Ann Emerg Med 1995 Jul;26(1):31-6

Pain and tissue-interface pressures during spine-board immobilization.

16. Hann

www.neann.com

Does proper padding reduce pain on Long Spine Boards

17.
Victorian Ministerial Task Force on Trauma

Review Of Trauma And Emergency Services     Report 1999}

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