Immobilisation and Log-Rolling
Need 4 people:
- 1 for manual inline immobilisation of the head and neck
- 1 for the torso
- 1 for the pelvis and legs
- 1 to direct and move the spine board.
Assumes any extremity suspected of being fractured is already
with log roll
- generally pre-hospital.
1. Place long spine board next to pt's side. Straps positioned
for fastening across thorax, just above iliac crests, thighs and just
above the ankles. Straps or tape must be used to secure the head
and neck on the long board.
2. Apply gentle manual immobilisation to the head and apply a semirigid
3. Straighten arms and place palm-in next to torso.
4. Straighten legs carefully into neutral alignment with spine.
Tie ankles together with roller-type dressing or cravat.
5. 1 person maintains head and neck alignment while another reaches
across and grasps the patient at the shoulder and wrist. A third
reaches across and grasps the pt's hip just distal to the wrist with 1
hand, and with the other hand firmly grasping the roller bandage or
cravat securing the ankles together.
6. At the direction of the head person, the pt is cautiously logrolled
toward the 2 assistants on the pt's side, but only to the minimal
degree that allows the spinal board to be positioned. Neutral
alignment must be maintained.
7. Spine board is placed eneat the pt, and the pt is logrolled as a
unit onto the board. Remember
it is used only for transporting and should not be left on for any long
period of time. Pressure sores develop at ~2 hrs and longer.
8. Padding may be required under the pt's head to avoid hyperextension
of the neck and for comfort.
9. Padding, rolled blankets or similar devices are placed on either
side of the pt's head and enck. and the pt's head is secured firmly to
the board. Tape is also placed over the cervical collar.
If a paediatric spinal board isn't available, pack blanket rolls along
the entire sides to prevent lateral movement.
Pad under the shoulders to elevate the torso: a child's head is
relatively large and will flex the c-spine otherwise; this padding
should extend from lumbar spine to top of shoulders and laterally to
Removal from a
Perform as early as possible on transferral to hospital.
- best when pt being rolled to examine the back.
Safe povement requires continous maintenance of anatomic alignment with
manual inline immobilisation of the head and neck.
1. Modified logroll
- as above
2. Scoop stretcher
- allows rapid safe transfer.
After transfer the pt must be securely immobilised again until spine