IMMOBILIZATION AND

MOVEMENT

Emergency Medical Interventions

for Mass Casualty Situations

Objectives

 Discuss the need for appropriate

immobilization of injuries
 Discuss the types of immobilization
 Discuss the methods for
immobilization
 Discuss methods for emergency
movement of patients

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Need For Injury Immobilization

Common injuries that occur during

small or mass casualty incidents
include:
 Fractures
 Sprains
 Strains

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Selecting The Appropriate

Splinting Device
Basic immobilization
 Areas above and below the injured
site are being held stable

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Selecting The Appropriate Splinting
Device
In mass casualty situations:
 Responder may be required to make
use of items available at the scene to
assemble improvised splints
 Responder will have to determine the
speed and type of splint necessary

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Selecting The Appropriate Splinting

Device
Four types of immobilization devices:
 Slings and swathes
 Moldable splints
 Ladder splints
 Long backboard

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 Slings

A sling is a simple device that can be

applied quickly to support a damaged
shoulder of arm. Slings can be made
from:
 Cloth
 Paper
 Any material that is easily tied
 Supports the weight of the arm

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Applying The Sling

 Fold the cloth in half to finish with two

triangles
 Wrap the cloth around the injured arm
 Rest the arm in the fold and tie the
ends around the neck
 A small knot at the elbow end will
keep the arm from sliding out of the
sling

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 Applying The Sling

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Swathes

A swathe is a device used to bind the

arm sling to the body and uses a rolled
cloth strip. Substitutes are:
 Rope
 Electrical wire
 Duct tape
 Anything long enough to be wrapped
around the patients body

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 Swathes

The purpose of the swathe:

 To prevent the arm sling from
swinging forward
 Stabilizes the injured shoulder

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Swathes

Applying the swath:

 Slide the swath under the arm slip
 Continue to wrap around the torso
 Tie swathe in the back

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 Swathes

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Moldable Splints

Moldable splints can be applied to legs,

ankles or arms.

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 Moldable Splints

To apply the moldable splint:

 Measure arm or leg
 Measure splint above or below injury
 Once the splint is unrolled:
 Bend at the uppermost portion of the arm
and bend at the lowermost portion of the
hand
 Fold splint where bend in elbow occurs

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Moldable Splints

To apply the moldable splint

(continued):
 Secure the arm to the splint with
rolled gauze bandage or similar item
 Wrap arm from hand to elbow
 Check for pulses to insure area is not
wrapped to tightly

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Moldable Splints

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Moldable Splints

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 Ladder Splint

A ladder splint is metal and needs

padding. Without padding, it is
uncomfortable and can cause further
injury to the patient.

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Ladder Splint

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 Ladder Splint

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Ladder Splint

To apply a ladder splint:

 Measure ladder splint along the leg,
bending it at the ankle joint
 Use rolled gauze bandage to secure
leg, ankle and foot

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 Full spinal Immobilization

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Full Spinal Immobilization

Spinal cord injury symptoms:

 Numbness and tingling in lower
extremities
 No feeling in arms or legs
 Complaint of severe midline spinal
pain
 Multiple systemic fractures

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Approaching The Neck/back Injured
Patient
After identifying a patient has a
suspected neck or back injury:
 Decide how to handle them safely,
reducing further injury

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Approaching The Neck/back Injured

Patient
After identifying a patient has a
suspected neck or back injury
(continued):
 The best position for the patient is on
his back, face up. To bring a patient
into this position:
 Immobilize or support neck, head,
shoulders and spine

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Approaching The Neck/back Injured
Patient
The person at the patients head
provides cervical support and is the
ONLY person to give commands for
movement. Once you apply support
you cannot let go.

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Approaching The Neck/back Injured

Patient

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Equipment For Spinal Immobilization

 Backboard
 Backboard straps
 Tape
 Rolled blanket
 Cervical Collar

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Equipment For Spinal Immobilization

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Aligning The Head, Shoulders, Hip And
Feet
The head, shoulders, hips and legs
need to be aligned in order to
immobilize the spine. If the process of
aligning the patient causes undue pain,
or if you have to force alignment,
transport patient in the position in
which they were found.

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Aligning The Head, Shoulders, Hip And

Feet
Once head, shoulders, hips and feet
have been aligned, it is important to
maintain alignment.

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Making A Blanket Roll

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Making A Blanket Roll

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Securing The Patient To The Backboard

 Roll blanket lengthwise to make a

head block
 Bend the blanket around the head
and secure to board, splinting the
uppermost portion of the spine
 Secure patient to backboard

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Securing The Patient To The Backboard

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Securing the Patient to the Backboard

Secure chest to backboard:

 Thread strap through handles on
board
 Start at armpits and thread down to
the hips
 Return to chest, snapping the buckle
 Check tightness of straps across
chest

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Securing The Patient To The Backboard

Strap/secure legs to backboard:

 Thread strap through handles on the
board
 Move up along edges, up to hips
 Continue to thread across to other
side
 Return to original starting point

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Securing The Patient To The Backboard

Strap/secure legs to backboard

(continued):
 Snap the buckle
 Take out slack
 Strap should be tight enough to hold
legs in place without them moving but
not so tight as to cut off circulation

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Securing The Patient To The Backboard

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Securing The Patient To The Backboard

Securing the head:

 Wrap blanket roll around the head to
pad and maintain stabilization
 Tape blanket to sides of the board,
making sure to tape across the
patients forehead

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Movement Of Patients

There are four categories of moving patients:

 Rolling
 2-person
 4-person
 Carries
 Lifting
 Horizontal
 Vertical

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 Movement Of Patients

There are four categories of moving

patients (continued):
 Drags
 Clothing
 Sling
 Blanket

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Movement Of Patients

There are four categories of moving

patients (continued):
 Stretcher Carries
 2-person
 4-person

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 Movement Of Patients

The log roll maneuver:

 One responder will maintain patient’s head to
maintain in-line stabilization
 One responder holds the head
 The next responder will grasp the body at the hip
and chest
 Cross arms, left hand on hip, right hand holding
clothing on chest
 All movement commands are given by the person
holding the patients head

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The 4-person Log Roll

 Four people coordinate their efforts

to roll the patient
 Inspect injured patients back
 Place the backboard behind the
patient
 Return to the ground for strapping

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 Movement Of Patients

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Movement Of Patients

In a coordinated effort:
 Roll patient towards you onto his side
 The bottom most arm should be
extended above the head, keeping the
spine in alignment
 Feel for abnormalities
 Evaluate spine area for the presence
of injury

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 Movement Of Patients

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Movement Of Patients

 Redness along the spine is a sign of

possible injury

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 Movement Of Patients

Once you have inspected the injured

persons back:
 Place backboard to contact patients
back
 While holding the backboard and
injured patient, lower both to the
ground:
 Hold the handles and grasp the
patient

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Movement Of Patients

 Hold the handles and grasp the

patient
 Roll both back to the ground, away
from you

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Sliding The Injured Person Into Position

Sliding a patient into the correct

position on the backboard allows the
responder to center them on the
splinting device without causing further
injury.

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Sliding The Injured Person Into Position

 Coordinate with the other rescuer at the

head
 Together, slide your patient up and
down in small increments until patients
body is centered on the backboard
 Strap patient to backboard

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 One-person Carries

One-person carries are relatively

unstable and expose both the
responder and patient to possible
injury from falls.

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One-person Carries

One-person carries include:

 Support
 Saddleback
 Fireman’s carry

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 One-person Carries

Support Carry
 Uses the combined effort of the
responder and the patient
 Help the patient to a standing position
 Place patient’s arm over your
shoulder
 Grasp wrist tightly and pull down with
your hand

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One-person Carries

Support Carry (continued)

 Wrap your opposite hand around
patient’s back
 Help stabilize him as he walks

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 One-person Carries

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One-person Carries

Saddleback carry:
 Squat down while patient straddles
your hips
 Grasp each of the patient’s legs, just
above the knees
 Lock your hands across your
stomach

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 One-person Carries

Saddleback carry (continued):

 Have patient lean forward and wrap
his arms around your neck and
shoulders
 Rise to full standing position

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One-person Carries

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 One-person Carries

Fireman's Carry:
 Move patient into upright, standing
position
 Position yourself facing patient
 Grasp patient’s left arm and place
your head under their armpit

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One-person Carries

Fireman's Carry (continued):

 Drop to one knee and allow the
patient to bend at the waist, coming
to rest across your shoulders
 Bring patient’s left hand down to your
waist
 Reach around patient’s left leg and
grasp patient’s left wrist

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 One-person Carries

Fireman's Carry (continued):

 Rise to a full standing position
 Walk, carrying the patient

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One-person Carries

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Two-person Support Carries

Two-person support carries supports a

patient without carrying their weight.
 Bring patient to a standing position
 Two responders place the patients
arms over their shoulders
 Each responder grasps patient wrist
tightly and pull down

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Two-person Support Carries

Two-person support carries (continued):

 Both responders wrap their free arms
around patients back to stabilize
them as they walk

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Two-person Support Carries

The front and back carry is simple and

effective technique to move a patient
short distances:
 Position patient on his back, have
one responder approach from the
head and squat behind them
 Move patient to semi-seated position

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Two-person Support Carries

The front and back carry (continued)

 Place responder’s hands under the
patient’s arm, locking them across
the chest
 The second responder stands
between patient’s feet, facing away
 The responder squats down and
grasps the patient’s leg just above
the knees

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Two-person Support Carries

The front and back carry (continued)

 Both responders stand up
 Avoid swinging patient from side to
side

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Two-person Support Carries

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 Drags

Drags are techniques used to quickly

extract a patient from danger.

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Drags

Clothing drags:
 Position the patient on his back with
arms and legs aligned
 Position yourself squatting at patient’s
head
 Grasp the clothing of your patient, either
shirt or jacket, at the shoulder and upper
back on each side of the head and neck

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 Drags

Clothing drags (continued):

 Cradle head and neck between your
hands and forearms
 Pull strongly and smoothly
 Assure clothing does not place pressure
on patient’s neck
 Keep patient’s head and neck as close to
the ground as you can

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Drags

Sling drags use a short length of wide

diameter rope (two belts looped together
or a fabric loop may be used), to move a
patient:
 Place patient on back with their hands
secured over their stomach
 Place loop across patient’s chest, under
their arms, coming out under the head

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 Drags

Sling drags (continued):

 Tie rope, belt or fabric behind patient’s
neck
 Grasp ends of rope and pull, or put hour
head and arm through the loop and
crawl, dragging patient

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Drags

Blanket drags:
 Roll patient on their back on blanket or
cloth

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 Stretcher Carries

The stretcher is a very important and

useful movement and evacuation device.
Stretcher carries use:
 Stretcher
 Backboard
 Other devices that can be used as a
platform

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Stretcher Carries

Two-person stretcher carry:

 Load patient on stretcher
 Place one responder at the head, one at
the foot, facing to move patient feet first
 Responders squat, grasp the stretcher
handles
 Both responders lift

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 Stretcher Carries

Four-person stretcher carry:

 Load patient on stretcher
 Place one responder on either side of the
stretcher at the foot and head
 Responders squat, grasp stretcher
handle with the inside hand
 Rise to a full standing position

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Summary

Topics of this lesson were:

 Applying sling and swathes
 Splinting
 Securing patient to a backboard
 Rolling the spinal compromised patient
 The emergent tasks of drags and carries
 Stretcher carries

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 Summary

 We discussed the need for

appropriate immobilization of
injuries.
· Discussed the types of
immobilization.
· Discussed methods for
immobilization.
· Explained methods for emergency
movement of patients.

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Questions

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