01.06 Spinal Precautions & Log Rolling

In this video we’re going to talk about some mobility when it comes to patients in spinal precautions. Remember they can’t bend, twist, or turn, so we HAVE to be so careful when we’re moving them. If they’re also in c-spine precautions, make sure you also have someone holding c-spine.

Now, if you check out our positioning lesson in Fundamentals, we talk about reverse trendelenburg. Reverse trendelenburg is a great position for patients in spinal precautions to get their head up without bending them at the waist.
Now, let’s say you need to roll this patient who is just in spinal precautions, maybe to wash their back or change their sheets. You’ll lay them back flat and raise the bed to a working height. Then, you will need THREE staff members. Two to do the log roll turn and one to do the patient care.
One staff member stands next to patient’s shoulder and places one hand on patient’s shoulder on the opposite side, then places their other hand on patient’s upper thigh on the opposite side.
Then, another staff member stands next to the patient’s hip and places one hand on the patient’s upper hip bone on the opposite side and places their other hand behind patient’s knee on the opposite side. You’ll see that the staff members arms should cross over each other.
Have the patient cross their arms over their chest if they can. Then, the staff member closest to the head will be the one in charge of the turn. So they’ll count to 3. On 3, both staff members will gently turn the patient towards themselves together. The whole goal here is to prevent twisting and turning in the back. So you don’t just pull as hard as you can!
Then the third staff member can wash the back or change the sheets or whatever needs to happen. Then, when it’s time to roll back, the staff member in charge is going to count to 3 again.
On 3, both staff members will gently turn the patient back down onto the bed at the same time, without twisting or turning the patient.

Then, of course, if you need to you can repeat this on the other side.
If the patient is in c-spine precautions, you’d also have someone holding c-spine and THEY would be the one in charge of counting.

We hope that was helpful, remember to NOT twist or turn the patient. Be gentle!

Now, go out and be your best selves today. And, as always, happy nursing!