When emergency nurses should drop the log-rolling manoeuvre

Abstract

Spinal injury can result in morbidity and mortality. Research suggests that only a small percentage of patients assessed for spinal fracture have sustained the injury, however, and even fewer have unstable fractures. Protection of the spine and spinal cord is critically important and although many trauma patients leave hospital having had no spinal trauma, despite their mechanism of injury, most arrive with spinal precautions in place. Such patients must be moved and it is common practice to do this using the log-roll procedure. This article examines the literature on spinal motion during the log-roll procedure and transfer devices, and asks if there is still a place for the manoeuvre in modern trauma practice.

Assessment and management of pelvic fractures from high-energy trauma in adults

“…Binders must be placed at the level of the greater trochanters to bring the pelvic bones closer together and therefore splint the pelvis [Bonner et Log rolling is a manoeuvre which allows the patient to be turned whilst minimising movement of the neck and spine to reduce the risk of further injury. Patients with suspected pelvic fractures should not be log rolled before CT imaging as it causes movement of the pelvis and is linked to haemodynamic instability caused by clot disruption [Rowell, 2014]. Once imaging is completed and any bleeding has been ruled out, the patient can safely be log rolled [NICE, 2016].…”