Log roll transfer from Spinal Board

Published

Hi,

I am in the process of putting together a guideline/protocol for transfering patients from a spinal board onto a trolley.

My sticking point is whether the body straps are undone before the head is out of the blocks and manually stabilized, or whether the C-Spine is cleared and the head manually stabilized before the body straps are removed.

I have done the TNCC where we transferred a pt onto the board but not off the board. Emphasis was placed on securing the body straps before the head blocks went on, so the point of axis is not the C-Spine if the pt vomits/aspirates/slides/has a siezure etc. It makes sense to me that transferring off the board is the reverse of this but I am getting a lot of resistance from my colleagues and can not find much evidence apart from there is no standardised method, and much of the research focussed on length of time spent on the board.

It also raises the question of whether the pt then has body straps when on the trolley with head in blocks pre-X-Ray?

Any help or thoughts much appreciated.

Billy

Up Vote Up Vote ×
Specializes in Trauma ICU, MICU/SICU.

I work Trauma ICU so we don't transfer off of backboard. However, I would think you need to know how to XFR prior to clearing C-spine considering it is often impossible to clear a c-spine. For example, intoxicated, drugs, neck pain. All reasons NOT to clear the C-spine.

I'm sure lots of trauma ppl will be able to give further insight.

:)

Up Vote Up Vote ×
Specializes in Pediatrics.

working PICU at a level 1 trauma center we were allowed to transfer our patients off the backboard even if they were in full spinal precautions. this involved at least 3-4 nurses/docs. one person would stabalize the head and they would be the "leader" and all counts were done by them. then it was log-rolling to the bed, then usually putting them in reverse trendelenberg (if they had ICP issues) or just supine.

no one started until the "head" person was ready and had a good hold.

i hope that somewhat helped...

Up Vote Up Vote ×
Specializes in Emergency & Trauma/Adult ICU.

We remove CIDs & straps (if patient is cooperative with lying still), then log-roll off of backboard utilizing 3 staff.

If patient unable to lie still r/t intoxication, pain, agitation, etc. then the straps & CIDs stay on.

Up Vote Up Vote ×

Thanks everyone.

I am in the UK, what are CIDs & XFRs?????

Up Vote Up Vote ×
Specializes in Trauma ICU, MICU/SICU.
Thanks everyone.

I am in the UK, what are CIDs & XFRs?????

XFR is short for transfer. Don't know what CID's are though!

Up Vote Up Vote ×

CID = cervical immobilization device

Up Vote Up Vote ×

Whatever you come up with, the head should not be restrained if the body is not. If the backboard straps can come off, the head should be free.

9309

Up Vote Up Vote ×
Specializes in Emergency & Trauma/Adult ICU.
Thanks everyone.

I am in the UK, what are CIDs & XFRs?????

CIDs are the "blocks" you were referring to.

Whatever you come up with, the head should not be restrained if the body is not. If the backboard straps can come off, the head should be free.

9309

Agree.

Up Vote Up Vote ×
Whatever you come up with, the head should not be restrained if the body is not. If the backboard straps can come off, the head should be free.

9309

That's the way I see it.

Thanks everyone!

Up Vote Up Vote ×
Specializes in Critical Care, Med-Surg.

Head is always immobilized LAST when backboarding, and released FIRST when transferring off the backboard.

This prevents spinal injury, because if the patients head were immobilized and the body free to move, the patient's torso could move/slide/etc, while the head is stationary.

Up Vote Up Vote ×
+ Join the Discussion