Spinal Precautions & Log Rolling

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Outline

Overview

  1. Purpose
    1. Patients in spinal precautions should be kept flat (0 degrees at the hips) at all times to prevent twisting, bending, or turning the spine
    2. C-spine precautions should be held during any movements or turning
    3. Log-Rolling is used to turn patients to the side while stabilizing their spine
      1. True log-rolling with c-spine precautions requires 3 people to turn and one person to wash or change linens, etc.

Nursing Points

General

  1. Supplies needed
    1. Cervical collar in place if needed
    2. 3-4 team members
    3. Draw sheet

Nursing Concepts

    1. Steps and Nursing Considerations for Log Rolling (without cervical-spine precautions)
      1. Perform hand hygiene
      2. Explain procedure to patient
      3. Have the patient cross their arms across their chest, if not contraindicated
      4. Prep – Staff member #1
        1. Stand next to patient’s shoulder
        2. Place one hand one patient’s shoulder on the opposite side
        3. Place other hand on patient’s upper thigh on the opposite side
      5. Prep – Staff member #2
        1. Stand next to patient’s hip
        2. Place one hand on the patient’s upper hip bone on the opposite side
        3. Place other hand behind patient’s knee on the opposite side
        4. **Arm should cross over Staff member #1’s arm
      6. Designate one person to be in charge – usually person #1.
      7. Person #1 counts to 3
      8. On 3 – both staff members lift/pull patient towards them together, maintaining alignment in spine
      9. Staff member #3 can then perform back/skin/perineal care or linen change
      10. When it’s time to lay the patient back, Staff Member #1 counts to 3 again, and both lower the patient back to flat together
      11. Repeat on opposite side if necessary to complete a linen change or other procedure
  1. With Cervical Spine precautions
    1. Staff Member #1 holds C-spine and is in charge of counting/controlling the movements
    2. Staff Member #2 and #3 log roll as above
    3. Staff Member #4 does the patient care

Patient Education

  1. Importance of holding still and letting the staff members do all the work so that they don’t twist/turn at the spine

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Transcript

In this video we’re going to talk about some mobility when it comes to patients in spinal precautions. Remember they can’t bend, twist, or turn, so we HAVE to be so careful when we’re moving them. If they’re also in c-spine precautions, make sure you also have someone holding c-spine.

Now, if you check out our positioning lesson in Fundamentals, we talk about reverse trendelenburg. Reverse trendelenburg is a great position for patients in spinal precautions to get their head up without bending them at the waist.
Now, let’s say you need to roll this patient who is just in spinal precautions, maybe to wash their back or change their sheets. You’ll lay them back flat and raise the bed to a working height. Then, you will need THREE staff members. Two to do the log roll turn and one to do the patient care.
One staff member stands next to patient’s shoulder and places one hand on patient’s shoulder on the opposite side, then places their other hand on patient’s upper thigh on the opposite side.
Then, another staff member stands next to the patient’s hip and places one hand on the patient’s upper hip bone on the opposite side and places their other hand behind patient’s knee on the opposite side. You’ll see that the staff members arms should cross over each other.
Have the patient cross their arms over their chest if they can. Then, the staff member closest to the head will be the one in charge of the turn. So they’ll count to 3. On 3, both staff members will gently turn the patient towards themselves together. The whole goal here is to prevent twisting and turning in the back. So you don’t just pull as hard as you can!
Then the third staff member can wash the back or change the sheets or whatever needs to happen. Then, when it’s time to roll back, the staff member in charge is going to count to 3 again.
On 3, both staff members will gently turn the patient back down onto the bed at the same time, without twisting or turning the patient.

Then, of course, if you need to you can repeat this on the other side.
If the patient is in c-spine precautions, you’d also have someone holding c-spine and THEY would be the one in charge of counting.

We hope that was helpful, remember to NOT twist or turn the patient. Be gentle!

Now, go out and be your best selves today. And, as always, happy nursing!

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Nursing Clinical 360

With the rapid expansion of the COVID-19 pandemic many schools, instructors and students are left wondering what just happened?Students can’t access the tools and onsite clinical help they desperately need and instructors are trying to piece together online learning that prepares their students for success.It is because of this uncertainty and abrupt change that we have developed the Nursing Clinical 360 Course.Featuring:38 Highly Detailed Nursing Skills Video Lessons18 Health Assessment Lessons26 IV Skills Videos42 Case Studies30+ Care PlansWe want to give students the practical knowledge they need to feel confident going into a clinical or practical situation, as well as give instructors a concise library of online resources to handle the sudden demand for distance learning.

Course Lessons

1 - Head to Toe and Health Assessment
Intro to Health Assessment
Barriers to Health Assessment
The 5-Minute Assessment (Physical assessment)
Adult Vital Signs (VS)
Pediatric Vital Signs (VS)
General Assessment (Physical assessment)
Integumentary (Skin) Assessment
Neuro Assessment
Head/Neck Assessment
EENT Assessment
Heart (Cardiac) and Great Vessels Assessment
Thorax and Lungs Assessment
Abdomen (Abdominal) Assessment
Lymphatic Assessment
Peripheral Vascular Assessment
Musculoskeletal Assessment
Genitourinary (GU) Assessment
2 - IV Insertion
Supplies Needed
Using Aseptic Technique
Selecting THE vein
Tips & Tricks
IV Catheter Selection (gauge, color)
IV Insertion Angle
How to Secure an IV (chevron, transparent dressing)
Drawing Blood from the IV
Maintenance of the IV
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
Needle Safety
IV Drip Therapy – Medications Used for Drips
IV Drip Administration & Safety Checks
Understanding All The IV Set Ports
Giving Medication Through An IV Set Port
How to Remove (discontinue) an IV
IV Placement Start To Finish (How to Start an IV)
Bariatric: IV Insertion
Dark Skin: IV Insertion
Tattoos IV Insertion
Geriatric: IV Insertion
Combative: IV Insertion
Tips & Advice for Newborns (Neonatal IV Insertion)
Tips & Advice for Pediatric IV
3- Nursing Skills
Nursing Skills (Clinical) Safety Video
Bed Bath
Linen Change
PPE Donning & Doffing
Sterile Gloves
Mobility & Assistive Devices
Spinal Precautions & Log Rolling
Restraints
Starting an IV
Drawing Blood
Blood Cultures
Central Line Dressing Change
Inserting a Foley (Urinary Catheter) – Female
Inserting a Foley (Urinary Catheter) – Male
Trach Suctioning
Trach Care
Inserting an NG (Nasogastric) Tube
NG (Nasogastric)Tube Management
NG Tube Med Administration (Nasogastric)
Stoma Care (Colostomy bag)
Wound Care – Assessment
Wound Care – Selecting a Dressing
Wound Care – Dressing Change
Wound Care – Wound Drains
Pill Crushing & Cutting
EENT Medications
Topical Medications
Drawing Up Meds
Medications in Ampules
Insulin Mixing
SubQ Injections
IM Injections
IV Push Medications
Spiking & Priming IV Bags
Hanging an IV Piggyback
Chest Tube Management
Pressure Line Management
4- Nursing Care Plans
Purpose of Nursing Care Plans
How to Write a Nursing Care Plan
Using Nursing Care Plans in Clinicals
Nursing Care Plan (NCP) for Abdominal Pain
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Alcohol Withdrawal Syndrome / Delirium Tremens
Nursing Care Plan (NCP) for Alzheimer’s Disease
Nursing Care Plan (NCP) for Angina
Nursing Care Plan (NCP) for Aortic Aneurysm
Nursing Care Plan (NCP) for Appendicitis
Nursing Care Plan (NCP) for Arterial Disorders
Nursing Care Plan (NCP) for Asthma
Nursing Care Plan (NCP) for Atrial Fibrillation (AFib)
Nursing Care Plan (NCP) for Benign Prostatic Hyperplasia (BPH)
Nursing Care Plan (NCP) for Cardiogenic Shock
Nursing Care Plan (NCP) for Cardiomyopathy
Nursing Care Plan (NCP) for Cholecystitis
Nursing Care Plan for Cirrhosis (Liver)
Nursing Care Plan (NCP) for Congestive Heart Failure (CHF)
Nursing Care Plan (NCP) for Constipation / Encopresis
Nursing Care Plan (NCP) for Diverticulosis / Diverticulitis
Nursing Care Plan (NCP) for Eating Disorders (Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder)
Nursing Care Plan (NCP) for Endocarditis
Nursing Care Plan (NCP) for Dehydration & Fever
Nursing Care Plan (NCP) for Gestational Hypertension, Preeclampsia, Eclampsia
Nursing Care Plan (NCP) for GI (Gastrointestinal) Bleed
Nursing Care Plan (NCP) for Heart Valve Disorders
Nursing Care Plan (NCP) & Interventions for Increased Intracranial Pressure (ICP)
Nursing Care Plan (NCP) for Inflammatory Bowel Disease (Ulcerative Colitis / Crohn’s Disease)
Nursing Care Plan (NCP) for Leukemia
Nursing Care Plan (NCP) for Mood Disorders (Major Depressive Disorder, Bipolar Disorder)
Nursing Care Plan (NCP) for Myocardial Infarction (MI)
Nursing Care Plan (NCP) for Neutropenia
Nursing Care Plan (NCP) for Pancreatitis
Nursing Care Plan (NCP) for Parkinson’s Disease
Nursing Care Plan (NCP) for Peptic Ulcer Disease (PUD)
Nursing Care Plan (NCP) for Schizophrenia
Nursing Care Plan (NCP) for Seizures
Nursing Care Plan (NCP) for Spinal Cord Injury
Nursing Care Plan (NCP) for Systemic Lupus Erythematosus (SLE)
Nursing Care Plan (NCP) for Vomiting / Diarrhea
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Osteoporosis
Nursing Care Plan (NCP) for Congenital Heart Defects
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care Plan (NCP) for Rheumatoid Arthritis (RA)
Nursing Care Plan (NCP) for Disseminated Intravascular Coagulation (DIC)
Nursing Care Plan (NCP) for Diabetes Insipidus
Nursing Care Plan (NCP) for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care Plan (NCP) for Lymphoma (Hodgkin’s, Non-Hodgkin’s)
Nursing Care Plan (NCP) for Thrombocytopenia
Nursing Care Plan (NCP) for Sickle Cell Anemia
Nursing Care Plan (NCP) for Bronchiolitis / Respiratory Syncytial Virus (RSV)
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Post-Traumatic Stress Disorder (PTSD)
Nursing Care Plan (NCP) for Glomerulonephritis
Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia
Nursing Care Plan (NCP) for Renal Calculi
5- Nursing Concept Maps
Concept Map Course Introduction
Coronary Artery Disease Concept Map
COPD Concept Map
Asthma Concept Map
Pneumonia Concept Map
Bowel Obstruction Concept Map
Gastrointestinal (GI) Bleed Concept Map
Congestive Heart Failure Concept Map
Hypertension (HTN) Concept Map
Breast Cancer Concept Map
Amputation Concept Map
Sepsis Concept Map
Stroke Concept Map
Depression Concept Map