Technique for Hand Placement During Transfer of the Spine-Injured Athlete

Abstract

PURPOSE: When moving a spine-injured athlete, care must be taken to prevent movement of the head and neck. This study was conducted to quantify the amount of head and neck movement with two hand placement techniques during 3 transfer conditions. The commonly practiced (standard) technique involves a rescuer at the head placing their hands on the patient's head (or helmet). However an alternative (modified) method has been suggested where the rescuer's hands are placed on the victim's shoulders and the victim's head is supported by the rescuer's forearms. METHODS: Movement of the subjects' cervical spine was evaluated by measuring the movement of the head in reference to the torso. The standard hand placement technique was compared to the modified hand placement technique while transferring the patient via the log-roll (LR), 6+ person lift (SIX), and the straddle lift (STRD). This was performed while the subject wore shoulder pads, both with and without a face mask. One subject served as a patient for each trial, while as many as eight rescuers performed the patient transfer. Motion analysis of the head and neck was measured using the Fastrak electromagnetic motion analysis device (Polhemus Inc., Colchester, VT). RESULTS: There was no difference between conditions when the face mask was present or not, so the data were pooled for analysis. There was no significant difference (p > 0.05) between the standard (S) and modified (M) hand placement positions for each plane of motion measured (flexion/extension, lateral flexion, and axial rotation). The mean movement [degrees (± SD)] for the combined data were: 12.04 (±4.94), 6.36 (±5.17), 9.1 (±6.77), 13.96 (±11.39), 4.33 (±1.45), and 7.09 (±4.02) for flexion/ extension-S, lateral flexion-S, axial rotation-S, flexion/extension-M, lateral flexion-M, and axial rotation-M, respectively. When evaluated with the presence of the face mask as the dependant variable, a significant difference (p < 0.05) was found for the flexion/ extension and lateral flexion variables, with less movement being produced when the face mask was removed. CONCLUSION: These data indicate no difference in cervical spine movement with either hand placement technique for the transfer techniques evaluated. These data also serve to reinforce the recommendation for face mask removal prior to patient transfer.