Log-roll Technique Research Articles

Time performance of scoop stretcher versus vacuum mattress for prehospital spinal stabilization: open-label simulation-based randomized controlled trial

Recent research has yielded conflicting results on the use of spinal stabilization in prehospital care, with some guidelines expressing concerns about its potential lack of benefit or harm. Transportation on a backboard can cause pain, discomfort, and pressure ulcers, whereas the log-roll technique can cause unnecessary movement and aggravate existing injuries. The scoop stretcher and vacuum mattress provide comparable or better immobilization and comfort than the backboard. Prehospital time is critical, and patients with life-threatening conditions should undergo rapid stabilization procedures. Despite this, some studies have overlooked the scoop stretcher as a spinal stabilization device. The primary goal was to compare the time required to achieve spinal stabilization using a scoop stretcher versus a vacuum mattress. This was a monocentric, parallel, randomized (sealed envelope), superiority, open-label, controlled simulation experiment. All student paramedics, registered paramedics, and EMTs who work in the participating EMS were eligible to participate in the study apart of the study team. The experimental group had to use a scoop stretcher, whereas the control group used a vacuum mattress. Fifteen participants were included. The scoop stretcher group required less time to complete the stabilization procedure (median [Q1; Q3]: 127 seconds [111;145] versus 212 [156;237], p=0.005). Using a scoop stretcher for spinal stabilization is more time-efficient than a vacuum mattress, making it a viable option for unstable trauma patients in the prehospital setting. More research is needed to determine its efficacy in actual clinical practice.

Modified log-roll technique in difficult terrain: a new solution for an old problem

Modified log-roll technique in difficult terrain: a new solution for an old problem

Development and validation of a new method for evaluating the log-roll technique in trauma patients

Background: Secondary spinal injury induced in trauma patients during transfer is of major concern. The logroll technique is used to transfer immobilize patients in many trauma centers. Healthcare trainees require a reliable objective tool for ensuring high competency and safety when handling trauma patients. This study aimed to develop and validate a novel method for assessing and evaluating the log-roll technique. Methods: This experimental validation study was conducted at the clinical skill lab of the Faculty of Medicine of Umm Al-Qura University from March 2018 to July 2019. A log-roll technique assessment sheet was developed using revised input from 20 content experts, current guidelines, and relevant literature. Simulated trials were filmed and reviewed by 10 content experts using the index and reference tests. Content validity, concurrent validity, internal consistency, and reliability were tested against the modified Global Rating Scale (GRS). Results: The current sheet was valid, reliable, and internally consistent compared to the GRS. The concurrent validity coefficient between the two scales was 0.75 (p 0.64 (p 0.75 (p < 0.01). Conclusion: The log-roll technique assessment sheet is a valid and reliable tool for testing trainee competency at performing the log-roll technique. This tool might be helpful for training healthcare professionals to handle trauma patients.

Techniques and tools used in trauma patients transfer: a review

Secondary spinal cord injury is a major concern for trauma patients. Thereby, proposing the necessity for the development and application of spinal immobilization techniques to guarantee minimal motion during transfer of the patients from the trauma scene to the trauma care center. Thus, this review aimed to provide an updated summary of the different techniques and tools used for the transfer of trauma patients with suspected spine injury. A retrospective PubMed search was conducted to collect the data for the most common methods used and effective tools and techniques for spinal immobilization. The log roll technique is commonly used in trauma settings and is recommended for prone patients. However, the hardboard is still preferable transferring tool, and the scoop stretcher is recommended to aid a more successful lift and slide. The trauma care providers should be aware of different transfer techniques to provide the appropriate care.

TEKNIK EVAKUASI CEDERA KEPALA PASCA BENCANA KETEPATAN TEKNIK EVAKUASI PADA KORBAN CEDERA KEPALA DALAM MENGURANGI KEJADIAN CEDERA SEKUNDER

Evacuation is an effort to redeploy the victims from the affected area to a safer region to acquire the rescue. Nowadays the lack of a adequate transfer to evacuate disaster victims are the phenomenom which occur in social case spesifically the health workers who get high potency to increase the occurence of secondary injuries to victims. ratio of the results of health research at 2007 and 2013, point out the enhancement of prevalence of head injury from 7,5% being 8,2% and one of the hospital in Indonesia has held a data which made into a vocal point assert that head injury cases from year to year have increased. The aim of this literature review is to mitigate morbidity and mortality of head injury which go up every year and underpin the health workers to simplify in carry out evacuation to prevent secondary injuries. This literature review was conducted by seeking the electronic databases journal with engage corresponding keywords. The result of the study postulate the victim of injuries particularly post disaster need rapid and appropriate evacuation, assesment and management techniques to rescue suffers live. The treatment carried out when get a head injury is preserve the patients airway, oversee bleeding and preventing shock, immobilizing patient, avert complication and secondary injuries each circumstances which engage in abnormal and dangerous must be given resuscitation. The handling is done alluding to the necessity of ABCDE method by using the START method and mantain stabilization of the cervical technique using the log roll technique.

Controlled Laboratory Comparison Study of Motion With Football Equipment in a Destabilized Cervical Spine: Three Spine-Board Transfer Techniques.

BackgroundNumerous studies have shown that there are better alternatives to log rolling patients with unstable spinal injuries, although this method is still commonly used for placing patients onto a spine board. No previous studies have examined transfer maneuvers involving an injured football player with equipment in place onto a spine board.PurposeTo test 3 different transfer maneuvers of an injured football player onto a spine board to determine which method most effectively minimizes spinal motion in an injured cervical spine model.Study DesignControlled laboratory study.MethodsFive whole, lightly embalmed cadavers were fitted with shoulder pads and helmets and tested both before and after global instability was surgically created at C5-C6. An electromagnetic motion analysis device was used to assess the amount of angular and linear motion with sensors placed above and below the injured segment during transfer. Spine-boarding techniques evaluated were the log roll, the lift and slide, and the 8-person lift.ResultsThe 8-person lift technique resulted in the least amount of angular and linear motion for all planes tested as compared with the lift-and-slide and log-roll techniques. This reached statistical significance for lateral bending (P = .031) and medial-lateral translation (P = .030) when compared with the log-roll maneuver. The lift-and-slide technique was significantly more effective at reducing motion than the log roll for axial rotation (P = .029) and lateral bending (P = .006).ConclusionThe log roll resulted in the most motion at an unstable cervical injury as compared with the other 2 spine-boarding techniques examined. The 8-person lift and lift-and-slide techniques may both be more effective than the log roll at reducing unwanted cervical spine motion when spine boarding an injured football player. Reduction of such motion is critical in the prevention of iatrogenic injury.

Total motion generated in the unstable thoracolumbar spine during management of the typical trauma patient: a comparison of methods in a cadaver model.

The proper prehospital and inpatient management of patients with unstable spinal injuries is critical for prevention of secondary neurological compromise. The authors sought to analyze the amount of motion generated in the unstable thoracolumbar spine during various maneuvers and transfers that a trauma patient would typically be subjected to prior to definitive fixation. Five fresh cadavers with surgically created unstable L-1 burst fractures were tested. The amount of angular motion between the T-12 and L-2 vertebral segments was measured using a 3D electromagnetic motion analysis device. A complete sequence of maneuvers and transfers was then performed that a patient would be expected to go through from the time of injury until surgical fixation. These maneuvers and transfers included spine board placement and removal, bed transfers, lateral therapy, and turning the patient prone onto the operating table. During each of these, the authors performed what they believed to be the most commonly used versus the best techniques for preventing undesirable motion at the injury level. When placing a spine board there was more motion in all 3 planes with the log-roll technique, and this difference reached statistical significance for axial rotation (p = 0.018) and lateral bending (p = 0.003). Using logrolling for spine board removal resulted in increased motion again, and this was statistically significant for flexion-extension (p = 0.014). During the bed transfer and lateral therapy, the log-roll technique resulted in more motion in all 3 planes (p ≤ 0.05). When turning the cadavers prone for surgery there was statistically more angular motion in each plane for manually turning the patient versus the Jackson table turn (p ≤ 0.01). The total motion was decreased by almost 50% in each plane when using an alternative to the log-roll techniques during the complete sequence (p ≤ 0.007). Although it is unknown how much motion in the unstable spine is necessary to cause secondary neurological injury, the accepted tenet is to minimize motion as much as possible. This study has demonstrated the angular motion incurred by the unstable thoracolumbar spine as experienced by the typical trauma patient from the field to positioning in the operating room using the best and most commonly used techniques. As previously reported, using the log-roll technique consistently results in unwanted motion at the injured spinal segment.

Total Motion Generated in the Unstable Cervical Spine During Management of the Typical Trauma Patient

Biomechanical cadaveric study. We sought to analyze the amount of motion generated in the unstable cervical spine during various maneuvers and transfers that a trauma patient would typically be subjected to prior to definitive fixation, using 2 different protocols. From the time of injury until the spine is adequately stabilized in the operating room, every step in management of the spine-injured patient can result in secondary injury to the spinal cord. The amount of angular motion between C5 and C6, after a surgically created unstable injury, was measured using an electromagnetic motion analysis device (Polhemus Inc., Colchester, VT). A total sequence of maneuvers and transfers was then performed that a patient would be expected to go through from the time of injury until surgical fixation. This included spine board placement and removal, bed transfers, lateral therapy, and turning the patient prone onto the operating table. During each of these, we performed what has been shown to be the best and commonly used (log-roll) techniques. During bed transfers and the turn prone for surgery, there was statistically more angular motion in each plane for traditional transfer with the spine board and manually turning the patient prone as commonly done (P < 0.01). During spine board placement, there was more motion in all 3 planes with log-rolling, and this reached statistical significance for axial rotation (P = 0.015) and lateral bending (P = 0.004). There was more motion during board removal with log-rolling in all 3 planes. This was statistically significant for lateral bending (P = 0.009) and approached significance in flexion-extension (P = 0.058) and axial rotation (P = 0.058). During lateral therapy, there was statistically more motion in flexion-extension and lateral bending with the manual log-roll technique (P < 0.001). The total motion was decreased by more than 50% in each plane when using an alternative to log-roll techniques during the total sequence (P < 0.006). We have demonstrated the total angular motion incurred to the unstable cervical spine as experienced by the typical trauma patient from the field to stabilization in the operating room using the best compared with the most commonly used techniques. As previously reported, using log-roll techniques consistently results in unwanted motion at the injured spinal segment.

Effectiveness of cervical spine stabilisation techniques

BackgroundProper stabilisation of suspected unstable spine injuries is necessary to prevent (worsen) spinal cord damage. Although the lift-and-slide (L&S) technique has been shown superior to the log-roll (LR) technique to...

Effectiveness of Cervical Spine Stabilization Techniques

To compare head motions that occur when trained professionals perform the head squeeze (HS) and trap squeeze (TS) C-spine stabilization techniques. Cross-over design. Twelve experienced lead rescuers. Peak head motion with respect to initial conditions using inertial measurement units attached to the forehead and trunk of the simulated patient. We compared both HS and TS during lift-and-slide (L&S) and log-roll (LR) placement on spinal board, and agitated patient trying to sit up (AGIT-Sit) or rotate his head (AGIT-Rot). The a priori minimal important difference (MID) was 5 degrees for flexion or extension and 3 degrees for rotation or lateral flexion. The L&S technique was statistically superior to the LR technique. The only differences to exceed the MID were extension and rotation during LR (HS > TS). In the AGIT-Sit test scenario, differences in motion exceeded MID (HS > TS) for flexion, rotation, and lateral flexion. In the AGIT-Rot scenario, differences in motion exceeded MID for rotation only (HS >TS). There was similar intertrial variability of motion for HS and TS during L&S and LR but significantly more variability with HS compared with TS in the agitated patient. The L&S is preferable to the LR when possible for minimizing unwanted C-spine motion. There is little overall difference between HS and TS in a cooperative patient. When a patient is confused, the HS is much worse than the TS at minimizing C-spine motion.

Cervical Spine Motion Generated With Manual Versus Jackson Table Turning Methods in a Cadaveric C1–C2 Global Instability Model

STUDY DESIGN.: Cadaveric biomechanical study. OBJECTIVE.: To quantify spinal motion created by transfer methods from supine to prone position in a cadaveric C1-C2 global instability model. SUMMARY OF BACKGROUND DATA.: Patients who have sustained a spinal cord injury remain at high risk for further secondary injury until their spine is adequately stabilized. To date, no study has evaluated the effect of patient transfer methods from supine to prone position in the operating room, on atlantoaxial cervical spine motion. METHODS.: A global instability was surgically created at the C1-C2 level in 4 fresh cadavers. Two transfer protocols were tested on each cadaver. The log-roll technique entailed performing a standard 180 degrees log-roll rotation of the supine patient from a stretcher to the prone position onto the operating room Jackson table (OSI, Union City, CA). The "Jackson technique" involved sliding the supine patient to the Jackson table, securing them to the table, and then rotating them into a prone position. An electromagnetic tracking device registered motion between the C1 and C2 vertebral segments. Three different head holding devices (Mayfield, Prone view, and blue foam pillow) were also compared for their ability to restrict C1-C2 motion. Six motion parameters were tracked. Repeated measures statistical analysis was performed to evaluate angular and translational motion. RESULTS.: For 6 of 6 measures of angulation and translation, manual log-roll prone positioning generated significantly more C1-C2 motion than the Jackson table turning technique. Out of 6 motion parameters, 5 were statistically significant (P < 0.001-0.005). There was minimal difference in C1-C2 motion generated when comparing all 3 head holding devices. CONCLUSION.: The data demonstrate that manual log-roll technique generated significantly more C1-C2 motion compared to the Jackson table technique. Choice of headrest has a minimal effect on the amount of motion generated during patient transfer, except that the Mayfield device demonstrates a slight trend toward increased C1-C2 motion.

Effect of Ice Hockey Helmet Fit on Cervical Spine Motion During an Emergency Log Roll Procedure

To investigate cervical spine motion during a log roll technique in ice hockey players under different helmet fit conditions. Prospective counterbalanced design. University research laboratory. Eighteen club ice hockey players were recruited to participate in this study. A standard emergency log roll was performed 3 times under each of 3 different helmet fit conditions: properly fit, improperly (competition) fit, and helmet-removed. Frontal, sagittal, and transverse plane cervical spine motion were used as outcome measures. Significantly less sagittal and transverse plane motion occurred during the helmet-removed condition. No differences in frontal plane motion among the 3 conditions were observed. Presence of helmet (whether properly fit or not) resulted in increased of sagittal and transverse plane movement. This suggests that when an ice hockey helmet is stabilized, the head within it is not. We recommend the helmet and face shield be removed before performing an emergency prone log roll.

Comparison of Thoracolumbar Motion Produced by Manual and Jackson-Table-Turning Methods

Patients who have sustained a spinal cord injury remain at risk for further neurologic deterioration until the spine is adequately stabilized. To our knowledge, no study has previously addressed the effects of different bed-to-operating room table transfer techniques on thoracolumbar spinal motion in an instability model. We hypothesized that the conventional logroll technique used to transfer patients from a supine position to a prone position on the operating room table has the potential to confer significantly more motion to the unstable thoracolumbar spine than the Jackson technique. Three-column instability was surgically created at the L1 level in seven cadavers. Two protocols were tested. The manual technique entailed performing a standard logroll of a supine cadaver to a prone position on an operating room Jackson table. The Jackson technique involved sliding the supine cadaver to the Jackson table, securing it to the table, and then rotating it into a prone position. An electromagnetic tracking device measured motion--i.e., angular motion (flexion-extension, lateral bending, and axial rotation) and linear translation (axial, medial-lateral, and anterior-posterior) between T12 and L2. The logroll technique created significantly more motion than the Jackson technique as measured with all six parameters. Manual logroll transfers produced an average of 13.8 degrees to 18.1 degrees of maximum angular displacement and 16.6 to 28.3 mm of maximum linear translation. The Jackson technique resulted in an average of 3.1 degrees to 5.8 degrees of maximum angular displacement (p < 0.001) and 4.0 to 10.0 mm of maximum linear translation (p < 0.05). Compared with the logroll, the Jackson-table transfer method provides superior immobilization of an unstable thoracolumbar spine during transfer of supine cadavers to a prone position on the operating room table. This study addresses in-hospital patient safety. Performing the Jackson turn requires approximately half as many people as required for a manual logroll. This study suggests that the Jackson technique should be considered for supine-to-prone transfer of patients with known or suspected instability of the thoracolumbar spine.

Log-rolling technique producing unacceptable motion during body position changes in patients with traumatic spinal cord injury

The purpose of the present study was to compare spinal motion generated during log-rolling and kinetic therapy with that generated when using a kinetic treatment table (KTT). The authors' hypothesis was that the KTT would produce less spinal motion while maintaining the benefits of body position changes. Cervical and lumbar instability was created in three fresh, unembalmed cadavers. Electromagnetic sensors were fixed to the C5-6 and T12-L2 segments to measure cervical and lumbar spine segmental motion. Body position changes were performed using the traditional log-roll method and a KTT. Spinal motion was measured during each maneuver. Turning the cadaveric specimens on the KTT bed caused significantly less cervical motion than the log-roll technique as measured in flexion and axial rotation. The log-roll technique caused significantly greater cervical motion during body position changes than turning using the KTT. Although the global instability will require surgical stabilization, consideration should be given to initial immobilization on a KTT to decrease the likelihood of secondary injury.

The effectiveness of extrication collars tested during the execution of spine-board transfer techniques

Background context In the prehospital stages of emergency care, cervical collars are (supposedly) used to aid rescuers in maintaining in-line stabilization of the spinal column as patients with potential or actual injuries are shifted onto a spine board to achieve full spinal immobilization. Unfortunately, not a single study has examined the effectiveness of cervical collars to control motion during the execution of spine-board transfer techniques. Purpose To evaluate the controlling effect of three cervical collars during the execution of spine-board transfer techniques. Study design This was a repeated measures investigation in which a cadaveric model was used to test the effectiveness of the Ambu (Ambu, Inc., Linthicum, MD), Aspen (Aspen Medical Products, Inc., Long Beach, CA) and Miami J (Jerome Medical, Moorestown, NJ) collars during the execution of the log-roll (LR) maneuver and the lift-and-slide (LS) technique. Methods Six medical professionals executed the LR and the LS on five cadavers. An electromagnetic tracking device was used to capture angular movements generated at the C5–C6 vertebral segment during the execution of both transfer techniques. The types of motion that were analyzed in this study were flexion-extension, lateral flexion and axial rotation motion. To test the three cervical collars, an experimental lesion (ie, a complete segmental instability) was created at the aforementioned spinal level of the cadavers and sensors from the electromagnetic tracking device were affixed to the specified vertebrae to record the motion generated at the site of the lesion. Results Statistical tests did not reveal a significant interaction between the independent variables of this study (ie, transfer technique and collar type), lending no support to the notion that there may be a combination of collar and transfer technique that could theoretically offer added protection to the patient. Although there was a decrease in the amount of motion generated in every one of the planes of motion as a result of wearing each of the three collars, none of the changes that emerged proved to be significantly different. A significant difference was noted between the LR and LS techniques when the amount of lateral flexion and axial rotation motion generated with each of the procedures were compared. In both cases, execution of the LR maneuver resulted in significantly more motion. Conclusions The data presented here suggest that the collars tested in this study are functionally similar. It is recommended that this study be repeated with a larger sample size.

Thoraco-Lumbar Spinal Instability during Variations of the Log-Roll Maneuver

AbstractIntroduction:The “log-roll” maneuver is a common method of moving patients with suspected spinal injuries despite the fact that there is very little published information concerning its effectiveness.Methods:Lateral thoraco-lumbar motion and rotation during five variations of the log-roll maneuver were examined radiographically in fourteen healthy adults. Variations included the addition of axial traction and alterations in subject arm position.Results:While no rotational differences were noted between variations, substantial differences in lateral displacement were identified between individual subjects and techniques. This variability seemed to be due to differences in individual body habitus, particularly the shoulder/thorax to pelvis proportions and the amount of periabdominal fat. The addition of traction decreased motion in 59% of attempts but increased motion in 18%. While definitive recommendations cannot be made based upon these data, only one variation of the log-roll techniques examined consistently minimized lateral spinal motion in subjects tested. This variation involved positioning the subject with arms fully extended at their sides with palms resting on the lateral portion of their thighs and maintaining this position throughout the procedure.Conclusions:Pending further studies, it may be advisable to utilize this variation in patients with suspected thoraco-lumbar trauma.