Solo Roll onto Tarp and Pad
If you need to help someone who’s injured in the backcountry, the solo roll onto tarp and pad is a great technique to have in your back pocket.
If somebody is injured or unconscious, and can’t move on their own — laying directly on the ground and not being protected from the weather isn’t good, and can make their situation, and overall outcome, much worse.
So, we generally want to get the patient protected from the environment as soon as possible.
The roll onto tarp and pad is a great way to take care of this problem.
When should this be used?
You should usually do this move after you’ve completed your scene assessment and primary assessment, but before you move into your secondary assessment, and any further treatments.
- Scene assessment.
- Primary assessment
- Move and protect patient
- Secondary Assessment
- Make a problem list
- Evacuation (if needed)
In your scene assessment, you’re doing things like checking for dangers to yourself, your partners, the public and the patient. You’re accounting for everybody and getting your general idea of what happened.
In your primary assessment, you’re finding and fixing life threatening problems, like severe external bleeds or airway and breathing issues— You don’t want to spend much time moving the person or doing anything else before doing your primary assessment.
Move and protect patient
Before you get into your secondary assessment or treatment phases, you should get the patient protected, warm, and in a comfortable position. This is where rolling the patient onto the tarp and pad will come into play.
Now, after your patient is protected, you should move into your secondary assessment/treatment phase— doing things like monitoring vital signs, getting the full patient history, and doing a thorough physical exam. This process might take 10-15 minutes, so having your patient protected with the tarp and pad is setting you up for success.
Make a problem list
It’s important that after you finish your secondary assessment, you take note of the problems you’ve found with your patient. This allows you to have documents of the incident, observe trends over time, and allows another rescuer to quickly catch up on what is going on for the patient.
After documenting your patients state, you can move into the treatment phase. Uncovering parts of the body as you need them, and covering them back up to keep the patient warm and protected.
Evacuation (if needed)
In the case that your patient needs an evacuation, and they’re unable to walk out on their own, being already protected from the environment within the tarp and pad, they’re in a good position to be transported into a litter.
Steps: How to roll a patient onto a tarp
1) Roll the tarp up half way and place it on the opposite side of your patient.
2) Roll them towards you. To do the most “spine frienly roll”, place one hand on their cheek and the other under their opposite shoulder — with your elbow at their hip. This way, you control the three weight centres of their head, shoulders, and hips. With a heavier patient, you’ll need to position your hand further down their torso or even at their hip or knee.
3) Next, roll them towards you, leaning the person on your legs. Getting them past 90° is important for two reasons: 1 – It will allow you to let go of them to reach across for the tarp without them flopping back over, and 2 – It will allow you to get the tarp further underneath them and in a better position for later.
4) Reach across and tuck the rolled side of the tarp underneath them as much as possible.
5) Lay them back down. Then, reach underneath and pull the tarp out from under them. You can now cover them up.
6) We’ll repeat the same process with a foam pad or a camping mattress.
What if they have a spine injury?
Whether they have a spine injury or not, getting the person protected from the environment should be a priority. This patient will need to be moved in the future anyways, so rather do it earlier rather than later— so they can be more comfortable and warm throughout the treatment process.
This roll onto the tarp and pad is a spine friendly movement, if done attentively. You’ll need to move the patient carefully, correctly placing your hands to stabilize their head/neck to avoid movement during the roll.
Getting your patient straight into a recovery position
If you anticipate wanting them on their side in a recovery position right away, you can alternatively not put the foam pad as far underneath, and then lay them back onto it so they are now off centre on the pad. Then roll them onto their opposite side into a recovery position. Place a pillow under their head that is the right size so their head, neck, and back are in line.
Advantages for putting the foam pad under the tarp
You could do the opposite and have the pad inside, but doing it this way you can now use the tarp to move the patient. Eventually it can also become the inside vapour barrier if you’re making a double vapour barrier hypothermia wrap system, with this tarp right around their body to prevent evaporative cooling and another tarp around the outside of everything to protect from the wind and weather, with your insulation layers in between.
As always — There can be tons of variations of this technique and you should adapt it based on the situation.