Log Rolling
Log rolling is a patient turning technique that moves the entire body as a single unit (like a log) without twisting the spine. It is used for patients with spinal injuries, after spinal surgery, or for patients with hip fractures to prevent further injury during repositioning.
Exam Tip
Log rolling: entire body moves as ONE UNIT (no twisting). Minimum 2 staff members. Pillow between knees. Used for spinal injuries and hip fractures. Keep spine in neutral alignment. Roll toward the staff on a coordinated count.
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. It typically requires two or more staff members.
When to Use Log Rolling
| Indication | Reason |
|---|---|
| Spinal cord injury | Prevent further spinal damage |
| After spinal surgery | Maintain surgical alignment |
| Hip fracture/surgery | Prevent displacement |
| Severe back pain/injury | Reduce pain and prevent worsening |
| Any suspected spinal injury | Protect until cleared by physician |
Steps for Log Rolling (Two-Person Technique)
- Explain the procedure to the patient
- Place a pillow between the patient's knees to maintain hip alignment
- Cross patient's arms over chest (or have them hold their own arms)
- Staff member 1: Stands at the patient's head and shoulders
- Staff member 2: Stands at the patient's hips and legs
- On a count of three: Both staff members roll the patient toward them simultaneously, keeping the spine straight and aligned
- Support the patient in the side-lying position with pillows behind the back and between the legs
- Never allow the patient to twist, flex, or extend the spine during the turn
Key Safety Points
- Minimum 2 staff members required (some facilities require 3)
- 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, minimum 2 staff members, pillow between the knees, keep the spine straight. Used for spinal injuries and hip fractures. The patient should NEVER twist during the turn.
Study This Term In
Related Terms
Body Mechanics
Body mechanics refers to the coordinated use of body position, movement, and alignment to prevent injury during patient care activities such as lifting, transferring, and repositioning. Proper body mechanics protect both the nurse and the patient from musculoskeletal injury.
Fowler's Position
Fowler's position is a standard patient positioning in which the head of the bed is elevated to a 45-90 degree angle while the patient sits semi-upright or upright. Variations include low Fowler's (15-30 degrees), semi-Fowler's (30-45 degrees), standard Fowler's (45-60 degrees), and high Fowler's (60-90 degrees).
Supine Position
The supine position is a body position in which the patient lies flat on their back, face up. It is one of the most common positions in healthcare, used for physical assessments, CPR, many medical procedures, and sleep. CNAs must know proper supine positioning, including pressure point protection and when this position is contraindicated.
Prone Position
The prone position is a body position in which a patient lies face down on their stomach with their head turned to one side. In healthcare, prone positioning is used for back care, certain respiratory conditions, and specific procedures, though it is less commonly used than supine or lateral positions.
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