01.06 Spinal Precautions & Log Rolling

Overview

1. Purpose
   1. Patients in spinal precautions should be kept flat (0 degrees at the hips) at all times to prevent twisting, bending, or turning the spine
   2. C-spine precautions should be held during any movements or turning
   3. Log-Rolling is used to turn patients to the side while stabilizing their spine
      1. True log-rolling with c-spine precautions requires 3 people to turn and one person to wash or change linens, etc.

Nursing Points

General

1. Supplies needed
   1. Cervical collar in place if needed
   2. 3-4 team members
   3. Draw sheet

Nursing Concepts

1. 1. Steps and Nursing Considerations for Log Rolling (without cervical-spine precautions)
      1. Perform hand hygiene
      2. Explain procedure to patient
      3. Have the patient cross their arms across their chest, if not contraindicated
      4. Prep – Staff member #1
         1. Stand next to patient’s shoulder
         2. Place one hand one patient’s shoulder on the opposite side
         3. Place other hand on patient’s upper thigh on the opposite side
      5. Prep – Staff member #2
         1. Stand next to patient’s hip
         2. Place one hand on the patient’s upper hip bone on the opposite side
         3. Place other hand behind patient’s knee on the opposite side
         4. **Arm should cross over Staff member #1’s arm
      6. Designate one person to be in charge – usually person #1.
      7. Person #1 counts to 3
      8. On 3 – both staff members lift/pull patient towards them together, maintaining alignment in spine
      9. Staff member #3 can then perform back/skin/perineal care or linen change
      10. When it’s time to lay the patient back, Staff Member #1 counts to 3 again, and both lower the patient back to flat together
      11. Repeat on opposite side if necessary to complete a linen change or other procedure
2. With Cervical Spine precautions
   1. Staff Member #1 holds C-spine and is in charge of counting/controlling the movements
   2. Staff Member #2 and #3 log roll as above
   3. Staff Member #4 does the patient care

Patient Education

1. Importance of holding still and letting the staff members do all the work so that they don’t twist/turn at the spine