When it comes to spinal injuries, it’s important to proceed with extreme caution. As advanced first aid courses teach: Any wrong move could worsen the injury, which is why knowing how to stabilise and transport a casualty safely on a spinal board is fundamental. But first things first—before we even talk about spinal boards or scoop stretchers, there’s a fundamental principle to understand: a casualty should only be moved if it’s absolutely necessary.
Whether it’s a traffic accident, a fall, or a sports injury, spinal injuries are serious business. The wrong kind of movement can aggravate the situation, leading to permanent damage. And here’s the big one: airway management always takes precedence over a potential spinal injury. If a casualty’s airway is compromised, your priority is to ensure they can breathe, even if it means moving them.
Table of Contents
Cervical Collars: ANZCOR Recommendations
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Manual in-line stabilization of the Cervical Spine.
In Australia, the use of cervical collars by first aiders is not recommended. According to the Australian and New Zealand Committee on Resuscitation (ANZCOR), the head and neck should be manually supported in a neutral position instead. This guideline aims to prevent unnecessary complications and discomfort, as cervical collars have not been proven to provide more benefit than simple manual support. So, remember: hands-on support is your go-to.
Stabilisation Devices: When and How to Use Them
Now that we’ve established the essentials, let’s get into the tools used to immobilise and transport casualties safely. We’ll cover spinal boards, the scoop stretcher, and extrication devices, explaining when and how to use them.
1. Spinal Boards (Backboards)
When to Use: Spinal boards are the go-to device for suspected spinal injuries, especially in situations where the casualty must be moved, like at the scene of a car accident or when extracting a person from a confined space.
How to Use:
- After ensuring the casualty’s head is supported in a neutral position, the casualty should be log-rolled onto the spinal board (more on log-rolling later).
- The head, neck, and body must be aligned straight to prevent any twisting or bending.
- Use securing straps to immobilise the casualty in place. In many cases, head immobilisers (blocks) are placed on either side of the head and secured with straps across the forehead to further prevent movement.
Key Point: Spinal boards provide rigid support from head to toe, but they are quite uncomfortable for prolonged periods. If transportation is delayed, moving the casualty onto a vacuum mattress (if available) may be more appropriate.
2. Scoop Stretchers
When to Use: Scoop stretchers are fantastic for transferring casualties with suspected spinal injuries when they cannot be rolled easily, such as when they’re lying on uneven terrain or trapped in a small space.
How to Use:
- The stretcher splits into two halves. Each half is placed carefully under the casualty, avoiding any unnecessary movement.
- Once the halves are connected, the casualty can be lifted onto a spinal board or moved directly with the scoop stretcher.
Key Point: The scoop stretcher is not a long-term solution for spinal immobilisation, but it’s incredibly effective for initial transfers and moving a casualty without rolling them.
3. Extrication Devices
When to Use: Extrication devices, like the Kendrick Extrication Device (KED), are designed for tight spaces, such as removing a casualty from a vehicle. This device stabilises the head, neck, and torso while the casualty is extricated from the scene.
How to Use:
- The KED is wrapped around the casualty’s torso and fastened with straps.
- Their head is secured to the device, which allows you to carefully transfer them onto a spinal board for further transportation.
Key Point: The KED or similar extrication devices should only be used in situations where it’s vital to move the casualty before full spinal immobilisation.
The Principles of Log Rolling
Log rolling is a technique that allows rescuers to turn a casualty with minimal movement of their spine. It’s typically used when placing a casualty onto a spinal board.
Here’s how to do it:
- Prepare the Team: Log rolling requires at least three rescuers (preferably four), with one person assigned to stabilise the head and neck, and the others to handle the body.
- Head Support: The person at the head is in charge. They keep the head aligned and direct the team.
- Body Position: The other rescuers position themselves along the casualty’s side—one at the shoulders and hips, the other at the knees.
- Roll in Sync: On the head-supporting person’s count, the team rolls the casualty onto their side while keeping the body, head, and neck aligned. The movement should be slow and controlled.
- Slide the Spinal Board: While the casualty is on their side, the spinal board is slid underneath. Once the board is in place, the casualty is carefully rolled back onto it (on the lead’s command), maintaining the neutral position.
- Secure the Casualty: Straps are fastened across the torso, pelvis, and legs to keep the casualty immobilised, and the head is supported with blocks or manual stabilisation.
Key Point: Clear communication is essential during a log roll. The person controlling the head must lead the process, ensuring the casualty’s spine remains stable.
Movement and Airway Prioritisation
It’s vital to reiterate that airway management takes priority over any suspected spinal injury. If the casualty is unresponsive and not breathing, you’ll need to carefully roll them onto their back and start CPR. When you’re faced with the decision to move a casualty, remember that spinal stabilisation is important, but not at the cost of life-threatening issues like blocked airways.
Final Thoughts: When in Doubt, Don’t Move
First aiders should always remember the golden rule: only move a casualty if it’s absolutely necessary. Whether you’re using a spinal board, scoop stretcher, or extrication device, ensure that movement is done with precision and minimal disruption to the casualty’s spine. And when it comes to airway management, it’s your top priority—spinal precautions come second to saving a life.
By learning and practising these techniques, you’re ensuring that you can confidently handle a spinal injury situation, keeping both the casualty and yourself safe.
Learn Advanced First Aid with My First Aid Course Brisbane
If you’re looking to deepen your understanding and gain practical experience in handling spinal injuries, consider enrolling in HLTAID014 Provide Advanced First Aid with My First Aid Course Brisbane. Our experienced professionals offer nationally recognised training, ensuring that you’re equipped with the knowledge and skills to manage emergencies confidently and safely. At My First Aid Course, we pride ourselves on being the highest-reviewed first aid training provider in Brisbane. Our advanced courses go beyond the basics, covering essential topics such as spinal immobilisation, advanced airway management, and trauma care. Whether you’re a first aider or work in a high-risk environment, our courses will prepare you to handle critical situations with confidence.
