The golden rule of first aid is do no harm. It may seem like an obvious concept, but it often conflicts with what every fiber in the body tells you to do as a reaction to an emergency. In the event of a severe head, spinal or neck injury, instinct leads you to want to move the victim to a more comfortable position or to transfer them to a safer area, but the movement can greatly aggravate the situation. If the victim is in immediate danger or is ready to be put in an ambulance and taken to the hospital, you can roll them on a backboard while keeping their body aligned, but only if you know the procedure and know how to do it.
Steps
Part 1 of 2: Moving an Injured Person
Step 1. Look for signs of spinal damage
If you are concerned that there is cervical or back trauma, do not move the victim unless absolutely necessary (continue reading the article for exceptions to this rule). You may have suffered a spinal injury if: you are unconscious or about to lose consciousness, have severe back or neck pain, cannot move your neck or limbs, your arms or legs are weak or numb, have lost control of your bladder or intestines, your spine appears deformed or in an abnormal position, you have fallen from a considerable height or hit a solid object.
- Moving a person with spinal trauma, even if initially mild, can cause permanent paralysis or other potentially life-threatening complications.
- Assume that there is a spinal injury every time the victim has been hit by a car or fell from a height of more than 3 meters - it is always better to err on the side of caution.
Step 2. Cardiopulmonary resuscitation begins if victim is not breathing
Regardless of whether or not you assume the person has spinal damage, if they are unconscious and not breathing, you should perform CPR. If you have clear signs of lack of blood circulation (you do not feel a heartbeat in the wrist or neck, the person is not coughing or moving), immediately start giving at least 30 chest compressions and a couple of mouth-to-mouth breaths. If you are concerned that there is a back injury, however, avoid tilting her head back to open her airways (as recommended by the resuscitation procedure). in that case, you must use two fingers to gently grasp her jaw and lift it forward before breathing.
- Repeat the CPR cycle (30 chest compressions and 2 breaths) until the victim regains consciousness or help arrives.
- If she has no pulse and is not breathing, she is already considered dead, so resuscitation is a priority over the risk of worsening spinal damage.
- Before performing CPR, call 911 or another emergency number so that the ambulance arrives as soon as possible.
Step 3. Provide basic first care in case of bleeding
If the victim is bleeding, practice basic first aid measures as much as possible without moving their head or neck. Rinse any residue or dust from wounds using clean, preferably distilled, water. Apply pressure to any bleeding lesions with a clean cloth or bandage preferably sterile. Do not remove large objects that have lodged in the body, as pulling them out could aggravate the bleeding.
- You should leave it to professionals to immobilize broken bones, but you can proceed if help is not available for a long time.
- Keep the victim warm (with a blanket or jacket) and well hydrated to prevent or delay shock.
Step 4. Determine how many people are there to help you move the injured person
If you have estimated that it absolutely must be rolled on its side to move it or to prevent it from suffocating, you need to understand how many people are around you willing to intervene. The more people there (up to five) the better, because more hands can stabilize the victim's body more effectively during movement and consequently avoid spinal damage. If you are alone, you must have a compelling reason to move the victim instead of waiting for the paramedics to arrive.
- To roll a person's body during an emergency without causing them to lose spinal alignment, at least two operators are required: the first stabilizes the neck and head, while the second keeps the pelvis and lower back aligned.
- The ideal would be to have five or six people available to be able to control the movement of the neck, head, arms, pelvis, lower back and finally the legs.
Step 5. Assume the correct position over the victim's body
The person who is in charge of coordinating the operation must get close to the victim's head (assuming that this is supine) in order to manage the synchronized movement. The individual near the head is in charge of stabilizing the neck (cervical spine) by firmly grasping the sides of the head above the ears, the lower jaw and the base of the skull. Other operators should hold and immobilize the arms, thoracic spine, lumbar, pelvis, and legs at knee level.
- If the person is conscious, prevent him from moving and reassure him to keep him calm.
- If you have extra towels, blankets or clothes on hand, wrap them and place them on the sides of your neck to provide extra stability and keep it from moving.
- Tell inexperienced helpers what you are about to do (move the victim by rolling them onto their side) and how to proceed; they may also need to calm down.
Step 6. Prepare a backboard, sheet, or sturdy tarp
If you have decided to roll the victim onto one of these objects in order to carry it, you must have it handy by placing it near the side of the victim you intend to lift. In this case, remember that you need an extra person to slide the board or fabric under the victim's body when on their side.
- The operator who is stabilizing a part of the body cannot release the grip before the procedure has been completed.
- Determine which side is best to roll the person on. The determining factor for this choice could be the conformation of the ground on which the injured person fell or the presence of an arm fracture or shoulder dislocation.
- The spine board is a tool designed to transfer the victim into the ambulance. If you have to make your own, choose a material that is flat and sturdy enough to withstand a hundred kilograms of weight - thick plywood is fine.
Step 7. Coordinate the action
The leader should manage and synchronize the movement of all operators when they are each in the correct position and have stabilized the body part assigned to them. He declares that "on three" all rescuers must roll the victim towards the chosen side (right or left); at the end of the count, move his body without lifting him completely from the ground. Stop when he is on his side and do not let him fall prone, otherwise the spine may twist and stretch.
- Ideally, the victim's head and neck should remain perfectly aligned with the rest of the spine and pelvis during movement.
- Research shows that it is best to keep the injured person's arms snug at their sides (with the palms on their thighs), while the practitioners roll their body, as this posture minimizes spinal movement.
Step 8. Place the backboard or sheet under the victim's body and return the victim to the ground
When on his side, another operator must quickly push the board or sheet under his body, which should now be resting on the central part of the board (as far as possible), in order to completely cover it. The head and feet can be fixed to the board itself, to prevent some parts from dangling over the edge. When the spine board or sheet is in the correct position, roll the victim very carefully, agreeing with the other operators on the count to synchronize the movements.
- The rescuer who is near the head should continue to support it and provide cervical support until paramedics with a collar or other specific device to immobilize the neck arrive.
- From this position, the injured person can be transported to the emergency vehicle (ambulance or helicopter) or away from the danger zone.
- At least two strong individuals are required to lift and carry a person lying on the spine board, although four is the ideal number.
Part 2 of 2: Knowing when to Move the Victim
Step 1. Place the spine board under the victim's body
The technique described in the first part of the article involves partially rolling the victim (usually, from a supine position on his side), so that he can slide a spine board under his body. When the device is in the correct position and the person has been placed on it, paramedics can lift the device and transfer the injured person to an ambulance or other emergency transport. This handling technique minimizes involuntary movement of the spine and reduces the risk of causing other damage in the event of a spinal injury.
- Obviously, the spine moves a little while moving, but it is still the safest method of transferring a victim to the spine board when there are few operators available.
- If there are at least five other people ready to help you, you can perform a six-person lift to transfer the injured person to the spine board. This technique is considered safer than rolling, because it places less strain on the spine.
Step 2. Use a sheet to carry the victim
Another good reason to relocate is proximity to immediate danger or the threat that the situation may worsen. If there are no paramedics with a backboard and you need to transport the person out of harm's way, roll them onto their side and place a sturdy sheet, blanket, or plastic sheet under them. Afterwards, you can lift the tissue and transfer the victim who is in the supine position.
- You need the help of another person for this operation, even if it is better to be four.
- The reasons why it is necessary to move an accident victim without waiting for help to arrive are: proximity to a fire, exposure to cold, risk of flooding, acts of violence in the vicinity and / or potential danger from wild animals.
- If you are the only rescuer and you absolutely have to move the injured person, put a sheet or a cloth under his body and drag him on the ground to a safe place; this technique is not ideal, but certainly the best in such a circumstance.
Step 3. Avoid choking on his own vomit or blood
Another reason you have to roll the body of an injured or unconscious individual on your side is the risk of suffocation. People who have bit their tongues or lost teeth in an accident or trauma run the risk of choking on their own blood, especially if they are unconscious and supine. The same is true of vomiting, which is quite common when you are in severe pain and the body suddenly releases a lot of adrenaline into the bloodstream.
- By rolling the person on their side, you allow all fluids in the mouth (blood, vomit, mucus, saliva) to escape instead of falling back into the windpipe and lungs.
- The victim is also less likely to bite his tongue or choke from it when lying on his side than those lying on his back.
Advice
- If you are trying to prevent the injured person from choking on his own blood or vomit, move his arm that is downward to prevent the body from rolling on the abdomen. He also places towels, blankets, clothes rolled up behind his back to prevent him from going back on his back.
- If you are rescuing an athlete, never take off his helmet and shoulder protectors (if possible), while trying to move him while keeping his body aligned.
