Spinal immobilization with a long spine board. Team work (four responders)

Authors: Simulation and Certification Center

Editor: Rednenko V.V.

Clinical situation:  

You are part of a rescue team (3 persons) after an earthquake. Your group's equipment includes an universal first aid kit and a spinal board. Rescuers pulled the victim out from under the rubble. The victim is unconscious and has signs of life. The victim was given first aid. Spinal injury is suspected. The scene of the incident is safe. Prepare the victim for evacuation to the location where the ambulance arrives by immobilizing the spine using a spinal board.  

Equipment for the practical skill:

• simulator (simulated patient);
• long spine board with straps and side head supports.

The procedure for performing a practical skill

• Check the scene.
• Call to bystanders for help.
• Check the casualty consciousness.
• If the casualty is conscious: reassure the casualty and advise him not to move.
• Call 103 for emergency help, or ask a helper to do this.
• Place the casualty in the lateral position using log-roll technique
  • 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 headЖ
    • 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.
  • Call 3 bystanders for help. Explain to these assistants that we need to turn the victim on his side to avoid asphyxia if vomiting starts.
  • Ask one assistant place the casualty’s arms crossed over chest.

• • Position assistants and explain their roles:
    • You support the person head.
    • All assistants position themselves on one side of the victim.
    • First assistant:
      • body position is at mid-chest level;
      • one hand is on the upper third of the shoulder;
      • second hand is on the hip joint.
    • Second assistant:
      • body position is mid-thigh level;
      • one hand is at the level of the pelvic region;
      • second hand is on the knee joint.
    • Third assistant supports the person legs together by holding the ankles.

• If everyone is in proper position, you (the person securing the head) direct your helpers to roll the casualty in the agreed upon direction, keeping the casualty’s head, trunk, and legs in a straight line at all times; the upper leg should be supported in a slightly raised position to keep the spine straight.

• Place the victim on the backboard:
  • place the spinal board along the person's back using the free hand of one of the rescuers;

• • press the spinal board firmly against the person’s back and using the log-roll technique, turn the victim and the spinal board so that the victim is positioned on it;

• Place on both sides of the head side head supports.

• Secure the victim to the spinal board using straps:
  • at forehead level (the strap should secure the head and side head supports together);
  • at chest level (V-shape strap);
  • at the lower third of the abdomen level (the same strap secures the arms at the level of the forearms);
  • at mid-thigh level;
  • at the level of the lower third of the legs (ankles);

• • check that the securing straps are applied correctly and, if necessary, correct their position.
• Monitor vital signs – level of response, breathing, and pulse.