6: Lifting and Moving Patients

Cognitive Objectives (1 of 4)
1-6.1 Define body mechanics. 1-6.2 Discuss the guidelines and safety precautions that need to be followed when lifting a patient. 1-6.3 Describe the safe lifting of cots and stretchers. 1-6.4 Describe the guidelines and safety precautions for carrying patients and/or equipment.

Cognitive Objectives (2 of 4)
1-6.5 Discuss one-handed carrying techniques. 1-6.6 Describe correct and safe carrying procedures on stairs. 1-6.7 State the guidelines for reaching and their application. 1-6.8 Describe correct reaching for log rolls.

Cognitive Objectives (3 of 4)
1-6.9 State the guidelines for pushing and pulling. 1-6.10 Discuss the general considerations of moving patients. 1-6.11 State three situations that may require the use of an emergency move.

Cognitive Objectives (4 of 4)
1-6.12 Identify the following patient-carrying devices: Wheeled ambulance stretcher Portable ambulance stretcher Stair chair Scoop stretcher Long spine board Basket stretcher Flexible stretcher

Affective Objectives
1-6.13 Explain the rationale for properly lifting and moving patients.

Psychomotor Objectives (1 of 2)
1-6.14 Working with a partner, prepare each of the following devices for use, transfer a patient to the device, properly position the patient on the device, move the device to the ambulance, and load the patient into the ambulance: Wheeled ambulance stretcher Portable ambulance stretcher Stair chair Scoop stretcher Long spine board Basket stretcher Flexible stretcher

Psychomotor Objectives (2 of 2)
1-6.15 Working with a partner, the EMT-B will demonstrate techniques for the transfer of a patient from an ambulance stretcher to a hospital stretcher.

Moving and Positioning the Patient

Take care to avoid injury whenever a patient is moved.

Practice using equipment.

Know that certain patient conditions call for special techniques.

Body Mechanics
Shoulder girdle should be aligned over the pelvis. Lifting should be done with legs. Weight should be kept close to the body. Grasp should be made with palms up.

Proper Lifting

Performing the Power Lift (1 of 3)

Tighten your back in normal upright position. Spread your legs apart about 5". Grasp with arms extended down side of body. Adjust your orientation and position. Reposition feet. Lift by straightening legs.

Performing the Power Lift (2 of 3)

A power grip gets the maximum force from your hands Arms and hands face palm up. Hands should be at least 10" apart. Each hand goes under the handle with the palm facing up and the thumb extended upward.

Performing the Power Lift (3 of 3)

Curl fingers and thumb tightly over the top of the handle. Never grasp a litter or backboard with the hands placed palmsdown over the handle.

Weight and Distribution

Patient will be heavier on head end. Patients on a backboard or stretcher should be diamond carried.

Diamond Carry
Four EMT-Bs lift device while facing patient.

EMT-B at foot end turns around to face forward.

EMT-Bs at sides turn. Four EMT-Bs face same direction when walking.

One-Handed Carrying
Face each other and use both hands. Lift the backboard to carrying height. Turn in the direction you will walk and switch to using one hand.

Carrying Backboard or Cot on Stairs

Strap patient securely to the backboard. Carry patient down stairs foot end first, head end elevated. Carry patient up stairs head end first.

Wheeled Ambulance Stretcher or Cot

Stair Chair

Backboard

Directions and Commands

Anticipate and understand every move. Moves must be coordinated. Orders should be given in two parts.

Additional Guidelines
Find out how much the patient weighs. Know how much you can safely lift. Communicate with your partners. Do not attempt to lift a patient who weighs over 250 lbs with fewer than four rescuers. Avoid unnecessary lifting or carrying.

Using a Stair Chair

Secure patient to stair chair with straps. Rescuers take their places: one at head, one at foot. Rescuer at the head gives directions. Third rescuer precedes.

Principles of Safe Reaching and Pulling (1 of 3)

Back should always be locked and straight. Avoid any twisting of the back. Avoid hyperextending the back. When pulling a patient on the ground, kneel to minimize the distance.

Principles of Safe Reaching and Pulling (2 of 3)

Use a sheet or blanket if you must drag a patient across a bed. Unless on a backboard, transfer patient from the cot to a bed with a body drag. Kneel as close as possible to patient when performing a log roll.

Principles of Safe Reaching and Pulling (3 of 3)

Elevate wheeled ambulance cot or stretcher before moving.

Never push an object with your elbows locked.

Do not push or pull from an overhead position.

General Considerations
Plan the move. Look for options that cause the least strain.

Emergency Moves
Performed if there is some potential danger for you or the patient

Performed if necessary to reach another patient who needs lifesaving care

Performed if unable to properly assess patient due to location

Emergency Drags (1 of 2)
Clothes Drag

Blanket Drag

Emergency Drags (2 of 2)
Arm-to-Arm Drag

Arm Drag

One-Person Rapid Extrication

One-Rescuer Drags, Carries, and Lifts (1 of 3)

Front cradle

Fire fighters drag

One-Rescuer Drags, Carries, and Lifts (2 of 3)

One-person walking assist

Fire fighters carry

One-Rescuer Drags, Carries, and Lifts (3 of 3)

Pack strap

Urgent Moves
Used to move a patient who has potentially unstable injuries

Use the rapid extrication technique to move patients seated in a vehicle.

When to Use Rapid Extrication Technique

Vehicle or scene is unsafe. Patient cannot be properly assessed. Patient requires immediate care. Patients condition requires immediate transport. Patient is blocking access to another seriously injured patient.

Rapid Extrication (1 of 3)
Provide in-line support and apply cervical collar.

Rapid Extrication (2 of 3)
Rotate patient as a unit.

Rapid Extrication (3 of 3)
Lower patient to the backboard.

Nonurgent Moves (1 of 2)
Direct ground lift

Nonurgent Moves (2 of 2)
Extremity lift

Transfer Moves
Direct carry

Draw sheet method

Scoop Stretcher
Adjust stretcher length. Lift patient slightly and slide stretcher into place, one side at a time. Lock stretcher ends together. Secure patient and transfer to the cot.

Geriatrics
Emotional concerns Fear Skeletal concerns Osteoporosis Rigidity Kyphosis Spondylosis Pressure sores Use special immobilizing techniques. Be compassionate.

Bariatrics
Care of the obese Increase in back injuries among EMTs Manufacturing of higher capacity equipment Use proper lifting techniques.

Wheeled Ambulance Stretcher

Most commonly used device Has specific head and foot ends Has a folding undercarriage EMT-B must be familiar to specific features of cots used in the ambulance.

Loading the Wheeled Ambulance Cot

Tilt the head of the cot upward. Place it into the patient compartment. Release the undercarriage lock and lift. Roll the cot into ambulance. Secure the cot to ambulance clamps.

Patient-Moving Equipment (1 of 3)

Portable stretcher

Flexible stretcher

Patient-Moving Equipment (2 of 3)

Backboard

Basket stretcher

Patient-Moving Equipment (3 of 3)

Scoop stretcher

Stair chair