In today’s micro-lecture, Australian Paramedical College Hon. Snr. Lecturer Sam Willis talks about the process of log rolling: ie. the need to roll a patient to assess their back or their spine to get them into the back of the ambulance using a range of different items of equipment.
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In today’s micro lecture we’re going to talk about the process of log rolling. So no, we’re not talking about chopping down trees and rolling them. We’re talking about when we need to roll our patient to assess their back or their spine and to get them into the back of the ambulance using a range of different items of equipment. So trauma is going to be something that you are going to come into contact with time and time again as a paramedic. When you are faced with trauma, you have a decision to make about whether or not you are going to immobilize the spine or not.
[00:00] Now the good news is there’s something called the NEXUS Criteria that will help you with this. Now, the NEXUS Criteria is a five staged approach to working out if the patient needs to be immobilized on not.
The first stage in this log rolling process is to work out if it’s even necessary, and the NEXUS Criteria will help you with that. So let’s say you’ve gone through the NEXUS Criteria points and you’ve realized this patient does need to be immobilized. Now the first thing you would do is take hold of the C-spine. So take hold of the head. There are different ways of doing this. For example, holding onto the shoulders and keeping the head still that way, and of course C-spine immobilization should occur as early as possible. And in the primary survey mnemonic, airway and C-spine come together when … You do that at the same time when you’re managing the trauma patient.
Once you’ve taken hold of the C-spine, you need at least two other people and possibly a third to slide the rescue board underneath the person. Now here you can see one person holding the head, which is fantastic. Two people who are log rolling. Now look at what they’re doing. They’re nice and close to their patient. They’re just holding onto the patient. There’s no particular method here. All I would say here is just be very careful when it comes to holding onto an injury. So for example, if the patient’s saying, “I’ve got a pain here in the lower ribs.” Try and avoid holding that part of the patient.
[00:00] Sometimes as well. Something that will increase the effectiveness is to cross your arms because it gives you a little bit more power and support of each other. So again, somebody on the head, two people close to each other, cross the arms, just hold onto a piece of the patient’s clothing, all their body. Generally speaking, the person at the top who gives the command ready, brace, role.
Now, as I’ve said, you’re going to need another person, a fourth person to slide the rescue board in. Now, just before they slide the board in or whichever piece of equipment they’re choosing, they would generally have a feel down the neck and the back because on the secondary head to toe survey, when they’re laying on their back, you can’t feel down the back. So that’s another thing that they can do. Also just be mindful that when you are log rolling you don’t really want to be moving them this much. You only wants to be moving them for approximately 15 degrees. Because if there has been any trauma and internal bleeding and you start moving them, you could actually dislodge any clotting and allow the bleeding to occur. So you would never roll them this high even when you’re putting them onto a piece of equipment, which again is why you would choose the equipment carefully.
Okay, so somewhat and that’s a snapshot of log rolling your patient.
For more information about courses and becoming a Medic / Paramedic or any other professional in the pre-hospital emergency health care sector Contact the Australian Paramedical College today:
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