While the casualty is on his side, the back should be assessed for step off's,
deformities, contusions, abrasions, punctures penetrations, burns,
lacerations, and swelling (DCAP-BLS) and for tenderness, instability, and
crepitation (TIC) as well as for rectal bleeding.
f. Slide Board Into Position.
If a fourth assistant is available, have him slip the spine board under the
(2) If a fourth assistant is not available, have the middle (second) assistant
release his hold on the casualty's hip, grasp the closest edge of the spine board, and
slide it against the casualty. Then have him release the board, reach across the board,
grasp the far edge, and hold the board in place so it will not slip as the casualty is
placed on the board.
If needed, all three assistants can release one of their holds on the casualty
to help move the spine board beneath the casualty. If this is done, the first
and third assistants return to supporting the casualty with both hands while
the second assistant uses one hand to prevent the spine board from slipping.
g. Position Casualty on Board. Have the assistants slowly lower the casualty
in unison, allowing the casualty's back to rest on the spine board. As they lower the
casualty, turn his head slightly to keep it in alignment with his spine. Position the
casualty with his body in the middle of the spine board.
h. Place Padding Beneath the Casualty. Have the assistants slip padding
(folded towels, jackets, and so forth) at the natural curves beneath the small of the
casualty's back, beneath his knees, and beneath his ankles. Have an assistant place
additional padding beneath the casualty's neck.
i. Secure Casualty to Board. Have the assistants secure the casualty to the
long spine board using patient securing straps and cravats as shown in figure 2-6.
(1) Secure the casualty's chest (and upper arms if straps are long enough),
hips, thighs, and lower legs to the spine board using the patient securing straps.
Cravats or strips of cloth can be used if securing straps are not available.
(2) Secure the casualty's head to the spine board with a cravat. Folded
material or socks filled with sand may be placed at each side of the casualty's head
before the cravat is applied to provide additional stability.
The head is secured last to allow it to remain in-line with the body through-out
the securing process.