If someone’s been severely hurt, your first concern should be to get him ready for evacuation. This is particularly true if he’s sustained a neck or back injury, which makes moving him tricky. Your goal is to get him onto a backboard, which can support his body while you’re moving him. To do this, the first step is to get him into what’s called a neutral anatomical position. It’s highly unlikely that you will re-create the damaging forces it took to injure the victim in the first place simply by moving him into a better position for transport, except in cases of falling from a significant height or being hit by something substantial, but take care to move deliberately and at a slow enough pace that current injuries are not worsened by jerky motions or unnatural rotations. In cases of falls from heights greater than 15′ or impacts by large objects such as ATVs and trees, do not move the patient unless absolutely necessary until EMS arrives.
important concern at this point is to make sure that his airway doesn’t have any blockages. You have already checked for this in your initial examination, but take a moment to confirm it. See Figure 3.1.
A recovery position can be used when the victim isn’t seriously injured. She should be placed on her side, with her head resting on her arm. She can bend her legs a bit to keep balanced. If she shows a tendency to vomit or cough blood and sputum, this is a good position, since the vomit and other excreta won’t be able to block her airway. See Figure 3.2.
If you determine the injured person absolutely needs to be rolled on her side in order to be moved or to prevent choking, seek assistance if possible. The more people assisting, the better, because more hands can stabilize the injured person and prevent unwanted spinal motion. If you don’t have help, you had better have a good reason to proceed with the log roll instead of waiting for EMS to arrive— such as an immediate life threat.
Generally at least two are needed for a safe log roll, one to stabilize the head and neck and one to stabilize the lower spine and pelvis. The person stabilizing the head and neck is the person in control, and he is the one who dictates when the roll occurs so that there is no confusion between parties resulting in an alternate twisting of the body.
The person at the head (#1) cradles the head and neck by placing hands at the ears and fingers under the neck while the second person (#2) positions her knees perpendicular to the patient allowing for the patient to be rolled toward her lap. Person #2 places her hands at the shoulder and hip of the patient and at the command of Person #1, pulls the patient in coordinated effort toward her lap, at which time a back assessment for bleeding and deformities is done. Then a backboard, blanket, or tarp is placed under the injured person before she is
If the site of the injury is hazardous, you’ll need to get the victim (and you) away from it as quickly as possible. You may also need to move the injured person if he’s incapable of walking out on his own, either to carry him out or get him to a rescue vehicle. Your key goal here is to be fast, efficient, and above all, not to further injure the patient. It’s also a situation in which we can’t emphasize enough the importance of remaining calm. It’s possible to hurry without seeming hurried. See “Moving Techniques” later in this chapter for specifics on how to move an injured person. If hazardous conditions prevail, you’re going to have to very quickly make a decision about whether to move the person—probably before you’ve even examined him. The methods we’ll discuss here are easily mastered ways of accomplishing this.
The following techniques are some of the most common methods of moving an injured person out of harm’s way.
The Clothes Drag
The great advantage of this technique is that it isn’t going to wear you out. The one thing it does need is a clear path between the victim’s body and your destination. Clearly you can’t have the patient bumping over rocks and sticks while being moved.
Pull the victim by his collar, hauling him in the direction you want. You can do a modified version of this technique, called the blanket roll, by gently maneuvering the patient onto a blanket and then dragging the blanket. See Figure 3.4.
One-Person Walk Assist
The Front Cradle
If the victim is small—especially if she is a child—use this technique to get her out. Keep in mind that it will wear you out quicker than some other techniques. The patient slips her arm around the back of the rescuer’s neck while the rescuer lifts the patient under the lap, carrying her to the desired safe spot. See Figure 3.6.