Logrolling: How to Move an Accident Victim | The Survival Doctor

U.S. soldiers practice rescuing during medical training at Fort Hood, Texas, in 2011. The soldiers are assigned to the 1st Brigade Combat Team, 1st Cavalry Division.

by James Hubbard, MD, MPH

You’re driving down a highway when the car in front of you swerves to avoid something. You swerve too—right off the road.

You are able to stop on the grass, but the other car can’t. It flips and the driver is ejected. You find him lying on the ground, bleeding, groaning, but otherwise not responding.

At this point, what’s the number-one thing you’ll avoid doing if possible, even though it might be tempting?

Answer: moving him—unless you do it the right way.

In my last post I discussed the initial steps I’d suggest if you found someone unconscious. One of them is not to move the person unless you have to for safety. That’s a big deal.

But if you do have to move the person, there is a safe(r) way to do it. It’s called a logroll.

Why Not Move the Person?

If you find someone unconscious, you must assume they could have a spinal injury unless you know for sure they don’t. Moving the person could make the injury worse or even cause paralysis.

The only way I know to be sure there’s no spinal injury is to know exactly what happened and that it didn’t involve:

  1. An injury to the head, neck, or back
  2. A fall from even a few feet
  3. Something like a car accident where the sheer force could have resulted in injury

There are exceptions when you may have to make a judgment call on moving the person, such as if they’re in imminent danger. A fire is an example. Or they’re choking on their own fluids. Or you have to get them in position for chest compressions. But in general, there is a specific way to move with the least risk of further spine injury: by using the logroll.

How to Logroll

The point of logrolling is to keep the neck and back as straight and still as possible.

You might need to logroll, for example, if fluids are draining down someone’s windpipe and causing trouble breathing; you could logroll them onto their side. Or you can logroll to get someone onto a backboard.

In the scenario I began with, you’d be starting with the person face-up. But whether face-up or face-down, the concept is still the same. Keep the neck and back from moving.

To prepare for the logroll, first, stabilize the neck and the rest of the spine:

  1. Keep the head still using your hands or kneeling with the head between your knees. Ideally, you’ll continue doing this while someone else does step 2.
  2. If you have a neck brace, have someone put it on the victim without moving the head. Otherwise, have your helper pack soft items around the neck and head into every nook and cranny. Remember the head can nod back and forth, so pack the front also. Have the helper tape or wrap the packing in place. Just be sure it’s not choking the person or restricting the airway in any fashion.

Now you can logroll the person. This is best done with several people.

You’ll be the leader, so first, you kneel and hold the head. (Even with a neck brace, you must do this.) Then, direct your helpers to get into place. They should kneel along one side of the person where they can grab these areas:

Helper 2: Shoulder and hip
Helper 3: Hip and knee
Helper 4 (if available; not absolutely necessary): Near the backboard if one is being used

Tell helpers 2 and 3 to grab the opposite side of the victim’s body at the designated spots. All three of you will be rolling the victim toward these helpers—all at the same time. No twisting; it’s as if the victim were stuck to a board.

Now it’s time to roll. The leader makes sure everyone goes in unison. For instance, move on the count of three. “As I say three, move.”

Once the victim is rolled onto their side, you can stuff materials around the back and neck to keep the person in that position. Or, if you need to move the victim from that spot, have person 4 scoot the backboard up to the victim’s back. Then have the group logroll the victim back onto the board.

More on how to get the backboard ready ahead of time later. (You’ll need to put ties in certain positions so you can secure the person to it.)

What about you? Have you ever done a logroll? Ever heard of one?

 

U.S. Army photo by Sgt. Christine Rosa [public domain], via Wikimedia Commons.