Spinal motion restriction at a trauma scene

Authors: Simulation and Certification Center

Editor: Rednenko V.V.

Clinical situation:  

While painting the house, your neighbor fell from the scaffolding from a height of 3 meters. You heard a call for help and arrived at the scene. The man lies on his back without moving. There are no signs of bleeding or open wounds. The scene of the incident is safe.  

Equipment for the practical skill:

• simulator (simulated patient);
• blanket (towels).

The procedure for performing a practical skill

• Check the scene.
• Call to bystanders for help.
• Check the casualty consciousness.
• If the casualty is in consciousness:
  • reassure the casualty and advise him not to move;
  • call 103 for emergency help, or ask a helper to do this;
  • kneel or lie behind the casualty’s head;
  • rest your elbows on the ground or on your knees to keep your arms steady;
  • grasp the sides of the casualty’s head; spread your fingers so that you do not cover his ears, so he can hear you; steady and support his head in this neutral position, in which the head, neck, and spine are aligned

• • ask a helper to place rolled up blankets, towels, or items of clothing on either side of the casualty’s head and neck, while you keep his head in the neutral position;

• • continue to support the casualty’s head until emergency services take over, no matter how long this may be.
• If the casualty is unconscious:
  • kneel or lie behind the casualty’s head;
  • rest your elbows on the ground or on your knees to keep your arms steady;
  • grasp the sides of person’s head;
  • support the person’s head so that the head, trunk, and legs are in a straight line;
  • check the casualty’s breathing:
    • if the person is breathing, continue to support his head;
      • call 103 for emergency help or ask a helper to do this;
      • open the casualty’s airway using the jaw-thrust technique:
        • place your fingertips at the angles of her jaw;
        • gently lift the jaw to open the airway;
        • take care not to tilt the casualty’s neck;
    • If the casualty is not breathing, begin CPR.
• If you need to turn the casualty, use the log-roll technique.
• Monitor vital signs – level of response, breathing, and pulse – while waiting for help.