How to use a spinal board and head blocks
Remember, a spinal board is not a stretcher and should not be used as one.
A spinal board is an extrication device, used in pre-hospital trauma care.
Designed to provide rigid support during movement of a patient with suspected spinal or limb injuries.
Used mostly by ambulance staff, as well as search and rescue teams and event medics.
Outside the first aid industry, or pre-hospital care, few really understand when, where and how to move a patient with suspected spinal injury, or as a precaution due to the mechanism of injury.
To jump in and move a patient, even according to what you can vaguely remember from that 20 minute slot of your last first aid course, can cause more injury to the patient than the actual injury they sustained in the incident.
The job of the spinal cord is to carry messages from the brain to the rest of the body and is connected to the brain, going down to the pelvis, protected by the spine itself.
Everything it does affects our walking, breathing, movement, blood pressure and controls our bowels and bladder.
So, any injuries to the spinal cord can easily affect these functions, and quite often seriously, thus leading to loss of movement and control control of bodily functions.
Imagine how a ‘first aider’ would feel if they wrongly moved a casualty and crippled them for life.
You cannot and must not simply manhandle a patient onto a spinal board, despite the comedy training videos.
In order to position a patient on a spinal board, the ‘log roll’ maneuver needs to be carried out, this requires log-rolling the casualty to 90⁰ on their side.
Logrolling a patient
You have carried out your primary survey and made the decision to transport the patient on a spinal board.
The patient’s body must remain in alignment with the spine.
Ensuring C-spine immobilisation is in place. This means a person is at ‘head end’ and maintaining head and neck is inline with the spine.
You will size and form the cervical collar and place it on the patient.
Make sure the cervical collar is in place and begin the logrolling technique by turning them to protect from injury and discomfort, and to prevent further complications.
Logrolling requires about four people. The more the better.
At least one person should be ready to slide the spinal board under the patient.
The person at the head end is in charge of this maneuver and must turn the head at exactly the same time as the patient’s body is turned, so it does not twist.
Once ‘head end’ is ready, they will give the command; “prepare to roll”, they may ask everyone to confirm readiness or may say; “on the count of three… ONE, TWO, THREE”.
Different people have different methods but you must comply with that moment.
As the patient is rolled towards the medics who are rolling, and away from the person with the spinal board, the patients back and underside can be checked and assessed for injuries.
Feeling along the spine and frequently checking your gloves for blood.
The person with the spinal board will slide it under the patient and give the command “Prepare to lower….. and now lower”
Once the patient is on the spinal board, they may need adjusting so they are on central.
You must not move them from side to side, only along upwards or downwards.
Head end is still control the patient’s head movement even though the patient is wearing a cervical collar.
One medic will stand and straddle across the middle of the patients holding the hips and another medic straddled and holding above the patient’s knees.
Head head will take command: “we are going to move the patient down one inch on my command. When I say stop, you stop, Is that clear?” – “Prepare to move DOWN. One, Two, Three move….STOP!”
You may need to repeat this upwards to ensure the patient is central.
Once all concerned is satisfied with the position of the patient on the spinal board, you can prepare the straps.
Spider straps are used, as shown above.
Align the straps on the patient where the straps will be placed, shoulders, chest, hips, above the knees (never on joints) and above the ankles.
The Y part goes over the shoulders.
Start with the hips, undo the Velcro connection, thread the strap the the adjacent slot and return to the Velcro, then the other side.
Always use the same opposing slots at either side of the spinal board.
Then the shoulders, chest and above the knees, then ankles.
Once you are satisfied with the positioning, you need to tighten each strap.
Hip first then the shoulders.
If the patient begins to vomit from that point, you will be able to tip the spinal board side-wards for drainage.
Now tighten legs and ankles
The last strap to be secured is the chest strap. Before you tighten, ask the patient to breath in, then tighten, so you provide that breathing space for their comfort.
The next piece of kit to be secured is the head immobilizer blocks or ‘chocks’.
Head end, doing C-Spine control continues until the head immobilizers are secure.
The under straps go under the patient’s head and the over strap goes on the plastic chin guard of the cervical collar.
DO NOT PLACE HE STRAP ON A PATIENT’S AIRWAY.
The second strap goes over the patient’s forehead.
The patient is now secure on a spinal board.
There is no substitute for proper hands-on training and no matter how many videos are watched, or online courses are attended, proper physical training is paramount.
Prices vary from less than £10 upwards, being mindful that when you put one on a patient, you wave goodbye to it, as with most medical equipment, unless the ambulance crew are kind enough to give you a replacement.
Multi-Grip Head Immobiliser
A Disposable Adjustable Head Immobiliser
The Multi-Grip Head Immobiliser is a complete system for head immobilisation and costs around £10.00
Head Wedge – Cervical Immobilisation Device sells for around £6.00.
Moving up the price ladder and missing out on many rungs with a price increase of £10 per step is:
Head Immobiliser for the Ferno 65 EXL Scoop Stretcher