UNCONTROLLED WHEN PRINTED
Introduction
  • At times due to airway concerns and adequate ventilation a patient may need to be positioned in such a manner that the airway is not compromised, in the suspected spinal injured patient this may require placing the patient in the lateral position whilst taking spinal precautions
  • Maintaining an airway and adequate ventilation is the overriding priority in managing a patient with a suspected spinal injury (1).
  • If the patient is breathing but remains unconscious, it is preferable that they be placed in the recovery position. The patient should be handled gently with no twisting. Aim to maintain spinal alignment of the head and neck with the torso, both during the turn and afterwards. In victims needing airway opening, use manoeuvres which are least likely to result in movement of the cervical spine. Jaw thrust and chin lift should be tried before head tilt(2).
Indications
  • To place the unconscious trauma patient in a lateral position. The aim is to maintain spinal alignment of the head neck and torso both during and after the procedure.
Contraindications
Contraindications
Patient Factors & Considerations
  • Officer at the head initiates the command to roll the patient.
  • Where possible roll the patient so they are on their right-hand side to facilitate patient care whilst in the ambulance.
  • Suitable padding will be required to maintain the lateral position whilst on the stretcher
Procedure
  • A team of 3 is optimal to perform this task (this may include a bystander)
  • The officer in charge of the head and neck must direct the procedure
  • Where indicated, apply a c-spine collar before rolling the patient
  • if the patient is on the floor kneel at the head end and take support of the head with both hands and fingers spread.
  • If patient is on a bed/stretcher place forearms either side of patient’s head, support under the shoulders with your palms. Utilise your forearms to support the head and neck when moving if there are no IPC Concerns
  • The other two persons are to position themselves at the side of the patient; one at the chest area and one at the pelvic area.
  • The person closest to the chest grasps the shoulder and the pelvic/waistband area.
  • The person at the pelvic area grasps above the waistband and under lower leg.
  • Under direction of the officer controlling the head, roll the patient as a unit until they are on their side.
  • Bend the uppermost knee and bolster with suitable padding to assist with maintaining this position.
  • Bolster the head with padding to maintain neutral alignment of the neck
  • Use ambulance stretcher straps to secure patient to the stretcher

Log roll 1

Log roll 2

Lateral trauma position 1

Lateral trauma position 2

Success
Success
Discontinue
  • If the patient regains consciousness and is able to maintain their own airway. In this instance a log roll will be required to place patient supine. 
Additional Information
Additional information

References

Resuscitation, 2005. Part 2: Adult basic life support. 67(2-3), pp.187-201.

Revive2survive.com.au. 2021. ANZCOR Guideline 9-1-6. [online] Available at: <https://www.revive2survive.com.au/wp-content/uploads/2016/09/anzcor-guideline-9-1-6-spinal-jan16.pdf> [Accessed 29 July 2021].

Fig. 3 the lateral trauma position on an ambulance gurney. The patient... (2017, January 19). Retrieved from https://www.researchgate.net/figure/The-Lateral-Trauma-Position-on-an-ambulance-gurney-The-patient-will-be-secured-with-the_fig3_282044307


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