Gentle spinal handling is really important in our trauma patients. Here are a few tips to make it look and feel great for you and the patient.
- Only log roll just enough to get a hand behind the patient’s back. About 6 inches off the bed at most. DO NOT LOG ROLL SPINAL INJURY PATIENTS TO 90 DEGREES unless you want to make things worse. It’s bad for the spine, but also bad for chest, pelvic and pretty much any other injury too. Excessive rolling causes more movement, more pain, more injury, and more bleeding. Don’t do it.
- Have a separate person ready to examine the back. Make sure they have access to scissors (to cut clothes if needed), dressings for wounds, chest seals if open chest wounds suspected, and a brush (or something you can brush with) as it’s not uncommon to find bits of road/glass/wood/unmentionables on the back of the patient at scene, or even when they get to the ED.
- Use a standard form of words when moving patients. We recommend you ask if anybody is NOT ready to move as opposed to is everybody ready. You will get more information and cooperation if you ask for the negative rather than just some random half hearted affirmatives.
- When moving a patient use ready, brace, move/slide/roll etc. Do not use 1,2,3 or any other number combination as it is confusing. Always make the last word the action word so people know when to start their movement. When you use 1,2,3, people don’t know whether to move on the ‘3’ or on a later action word. Be consistent and use action words, not numbers.
- The head end calls the movement.
- Remember the basics of where people are supposed to put their hands. Head end checks before movement.
- Learn how to use the scoop stretcher. Everyone should know the trick of undoing the scoop by bracing it laterally, first downwards and then upwards whilst someone else holds their thumbs on the release mechanism. If the scoop gets stuck it’s usually because the bars at top and bottom are not aligned. If you apply gentle pressure to the release buttons and then. stress the joint upwards and then downwards it will at one point pass through the point of neutrality, and at that point it will magically open. This is probably the most valuable tip you’ll hear this month!
