Log Rolling

What Is Log Rolling?

Log rolling is a specialized turning technique where the patient's head, shoulders, trunk, hips, and legs are moved simultaneously as one unit, keeping the spine in alignment. This technique prevents any twisting or flexion of the spine that could cause further damage. Staffing and technique depend on the spinal precautions, equipment and individual care plan.

When to Use Log Rolling

Planned Team Log Roll

1. Explain the procedure to the patient
2. Place a pillow between the patient's knees to maintain hip alignment
3. Cross patient's arms over chest (or have them hold their own arms)
4. Staff member 1: Stands at the patient's head and shoulders
5. Staff member 2: Stands at the patient's hips and legs
6. On a count of three: Both staff members roll the patient toward them simultaneously, keeping the spine straight and aligned
7. Support the patient in the side-lying position with pillows behind the back and between the legs
8. Never allow the patient to twist, flex, or extend the spine during the turn

Key Safety Points

• Use the staffing specified by the nurse and handling plan; suspected spinal injury may need additional trained staff and head/neck stabilization
• Keep the spine in neutral alignment at all times
• Use a draw/turn sheet under the patient for easier, smoother turning
• Pillow between knees prevents hip adduction and maintains alignment
• Count together ("On three: one, two, three, turn") for coordinated movement
• Roll toward the staff, not away from them, for better control

CNA Role

• Assist with log rolling when directed by the nurse
• NEVER turn a patient with a suspected spinal injury using regular turning techniques
• Check the care plan for specific positioning orders
• Report any complaints of numbness, tingling, or increased pain during or after the procedure

Exam Alert

Log rolling is tested on the CNA exam as part of patient safety and positioning. Key points: the entire body moves as ONE UNIT, the specified trained team, pillow between the knees, keep the spine straight. Used for spinal injuries and hip fractures. The patient should NEVER twist during the turn.

Do not initiate an improvised two-person roll for an unstable suspected spinal injury. Summon the trained team and follow stabilization instructions; hip-surgery precautions vary by approach. Official guidance.