THE LATERAL TRAUMA POSITION

Transporting unconscious or obtunded victims supine can be dangerous as it may result in mechanical obstruction of the airway or fluid aspiration unless the airway is secured. Traditionally, EMS have used the recovery position with the victim lying on his/her side ,  maintaining airway patency. The recovery position is less useful in trauma victims as it generates unacceptable spinal movement, contradicting the principles of spinal immobilisation in trauma victims.

The lateral trauma position (LTP) is a variation of the established recovery position. It starts with a modified two-person log-roll with manual cervical spine control. Eventually, the patients will be lying on their sides with blankets and a rigid collar immobilising the cervical spine in a neutral position. The log-roll, too, may generate spinal motion. In this group of patients, this potential harm is offset by the beneficial effects of gaining airway patency and clearance. Several Norwegian EMS have implemented the LTP into their trauma protocols.

Thanks to Dr PK Hyldmo for sharing this video. Him and his coworkers at the Norwegian Air Ambulance and Kristiansand EMS are demonstrating the technique. The video is in Norwegian. Let us know if there is a version that is subtitled or with english narrative.

Read more about the LTP:

Cliff Reid wrote about it here.

Per Kristians Hyldmo´s papers here, here and here.

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6 Responses to THE LATERAL TRAUMA POSITION

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  2. Delamarre Louis says:

    Hello. I’m a medical resident in anesthesia and intensive care medicine in France.
    Thanks for your very interesting posts. Inspiring.

    I’ve a question regarding trauma, which doesn’t perfectly relate to this particular post.
    When you perform a body scan at the arrival of a multiple-trauma patient, do you perform systematically an angiographic sequence of the supra-aortic vessels, looking for carotid arteries dissection?

    • Hi, we use a biphasic contrast protocol which highlights both arterial and venous systems at the same time, from circle of willis to proximal femur. One pass to reduce radiation dose, but still answer the big questions about haemorrhage and chest injury. (Plain head and c-spine first).

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