Minimal patient handling: a Faculty of Pre-Hospital Care consensus statement

BackgroundSpinal immobilisation is a common intervention for the pre-hospital patient following trauma. Most commonly the patient is log-rolled on to a rigid long spinal board. Once on the long spinal board, the patient, with a cervical collar applied, will be immobilised using head blocks and straps and secured to the board for transportation to definitive care.Once at definitive care, the patient may again be log-rolled to facilitate removal of the spinal board, removal of clothing and examination of the back and spinal columns. Further movement of the patient will usually occur again during transfer for CT imaging.Spinal immobilisation using these techniques is not without negative sequelae (Abram and Bulstrode, 2010). There is the potential for harm to be caused by the log-rolling used to place and remove the patient on the spinal board and by the immobilisation on the spinal board. Consequently, a number of pre-hospital clinicians are using alternative techniques to provide spinal immobilisation and to package patients either using a scoop stretcher or a vacuum mattress.This consensus statement will outline emerging best practice when packaging the pre-hospital trauma patient and providing spinal immobilisation. The best practice described is based on the recommendations of a consensus meeting held in the West Midlands in April 2012, where the opinion of experienced practitioners from across the pre-hospital and emergency care community considered the currently available evidence and reviewed current clinical practice.The indications for spinal immobilisation are not considered in this statement as they are addressed in other consensus statements.

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