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Head and Spinal Injuries

Patient Safety Considerations
How to Turn a Patient from Prone To Supine

Whenever circumstances call for a patient to be moved before he is completely im-
mobilized you should ensure the following three sections of his body move as a
unit, the head, shoulders and pelvis. If a rescuer is assigned to each of these three
locations, the patient with a suspected neck or spinal injury can be safely moved.

As a general rule, patients should be immobilized before they are moved. An ur-
gent move is required when the patient’s condition is so unstable their chance of
survival is endangered. If the benefits of moving the patient outweigh the potential
risks, then an urgent move is medically justified.

Such situations could include:

• The patient’s position or location restricts access to other more seriously
injured patients.
• The patient’s position or location prevents you from providing life-saving care.

In these situations a Log Role may be required. To perform a log role safely you
will need at least three rescuers. One should stay at the head to maintain manual
stabilization and to coordinate the move. The other two should position themselves
along one side of the patient’s body. At the signal of the rescuer at the head, the
two at the side should reach to the far side of the patient. One rescuer should posi-
tion his hands on the shoulder and hip. The second rescuer should position his
hands at the thigh and lower leg. On the signal the rescuers should simultaneously
role the patient onto his side. On signal the rescuers should simultaneously roll the
patient back down and onto a board, if available. There are many variations of this
technique, but the basic principles are always the same. This technique may need
to be modified depending on the situation.

In situation(s) where you are a sole rescuer or have limited help you must weigh
the benefits of moving the patient against the potential risks. The critical thinking
skills you have learned as part of assessing life-threatening patient priorities should
be applied.

Caution

Due to the complexity of signs and symptoms, first aid providers can find
the recognition of concussion difficult,resulting in a delay in receiving proper
management,advice and treatment.

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