Log-roll in the trauma bay

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No. Absolutely and definitely no log roll. 

He could well have a fracture pelvis. These unstable patients can die if
you log roll them (movement of pelvic bones disrupts clot, increases
bleeding, patient arrests). Have learnt this through observation the
hard way (thought I guess harder for my patients than for me!).

I always practice and teach minimum patient handling to preserve clot.
Log roll in the type of patient you describe is usually of little
benefit and carries a high risk - so don't.

Tim. Coats.
Professor of Emergency Medicine.
Leicester University.

-----Original Message-----
From: Jacob Scholtz [mailto:jacob.scholz at gmail.com] 
Sent: 07 March 2007 18:13
To: trauma-list at trauma.org
Subject: Log-roll in the trauma bay

A patient is brought into your trauma-bay after a from a building. He
has a neck-collar, but the rest of his spine has not been immobilised.
He is in respiratory distress. The airway is clear. Breath-sounds are
present bilaterally. Saturation 99% with 10 L O2. Blood pressure 65/-.
His abdomen is tender. He has no obvious open injuries to the thorax,
abdomen or extremities. Fluids are given, but the blood pressure does
not improve significantly. The surgeon wants the patient brought to the
OR for a laparotomy. The patient is complaining of pain from the lower
back, the abdomen and his legs bilaterally. Would you log-roll the
patient before bringing him to the OR?

Jacob



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