UNIVERSITI KUALA LUMPUR

ROYAL COLLEGE OF MEDICINE PERAK

Course code and Name:
RFB20403 PHYSIOTHERAPEUTIC SKILL 2
Title: THREE-MAN LIFTING

Student Name (Matric Number):

1) ILHAM AMNI AMANINA BINTI ISMAIL (59219121634)
2) LEE MICHELLE KEYZA (59219121647)
3) LUQMAN ARIF BIN AMIRRUDIN (59219121590)
4) MASTURA BINTI RAZALI (59219121624)
5) NURUL FILZA NASUHA BINTI SALMAN (59219121626)

Lecturer:
MADAM NURHANISAH BINTI SEJARI
MADAM ZAIDATUL HUSNA BINTI ABDUL RAHMAN

Submission Date:
21/12/2022
Academic Session:
SEMESTER SEPTEMBER 2022
TABLE OF CONTENT

NO. CONTENTS PAGES

1. Introduction of Technique

2. Purpose of technique

3. Indication of Technique

4. Contraindication of Technique

5. Procedure of Technique

6. Conclusion
 7. References

INTRODUCTION TECHNIQUE

When there is some emergency that happen to some place, a physiotherapist should
help the person who is in a dangerous condition. So what physiotherapist should do is lifting
and transfer the patient to other safe place. In certain case, there is some patients which have
overweight like more 100 kg, thus the therapist cannot do lifting alone. So there is the way to
lift the overweight patient. The name of the technique is three men lifting.

This is used to transfer a patient over short distances or into a bed or stretcher. On the
knee that is closest to the victim’s feet, each participant kneels. This technique happens when
there is an emergency. The therapist will bring the victim to their knees and place them there
at the person at the head’s direction. This method is frequently used to treat a gravely hurt
casualty. This technique contains hammock carry and three-person carry or stretcher lift. But
rescuers have to be careful because it can affect their back pain. The pressure on the lumbar
spine is increased by the rigorous activity that physiotherapists regularly perform, including
lifting patients and maintaining fixed postures throughout sessions. The benefits of this
technique is it can easily bring the patient to the safe place when there’s some emergency.
PURPOSE OF TECHNIQUE

The idea that "Patient Safety" should be the top priority at hospitals may lessen the
emphasis placed on the general safety and health of physiotherapists. Despite having a strong
understanding of musculoskeletal injuries and how to prevent them, physiotherapists still
sustain injuries while lifting patients in various settings during their profession. The goal of
this study was to compare and assess the physiotherapists' real and perceived expertise of
patient lifting procedures. Although the majority of physiotherapists were aware of correct
lifting techniques, very few of them were really using it in their work. The analysis revealed
that while 96% of physiotherapists claimed to be aware of safer patient lifting techniques, the
actual number was lower. Lifting a patient is a critical task for physiotherapists. Lifting a
patient is dangerous because they are attached to many leads, IV lines, catheters, etc. A
physiotherapist or patient may suffer an injury when lifting for a variety of reasons.
Numerous studies have revealed an increase in the prevalence of work-related injuries among
physiotherapists, and adequate preventive and management techniques should be advised to
reduce work-related injuries in the physiotherapy setting. As physiotherapists, you have to
bear in mind while moving patients that you must observe correct body mechanics for your
patients as well as for yourself.
INDICATION OF THE TECHNIQUE

Three man lifting is a manual lifting technique that is done by 3 people, which is
usually performed when a patient is lying on a surface and needs to be transferred to another
surface in a lying position. This includes transferring a patient from bed to stretcher or
stretcher to bed. After knowing the technique, it is best that we know when it is necessary to
perform this technique.
Before we start any lifting or transferring of patients, it is recommended that the
healthcare worker calculate the lifting index before performing the technique to avoid
musculoskeletal disorder caused by manual lifting, such as lower back pain, and also to know
whether they need assistance from another person or an apparatus. Lower back pain is one of
the risk factors of this technique as the patient’s movement during a lift can create loads
within the lifter’s spine. To calculate the lifting index, first you need to calculate the
recommended weight limit (RWL), with the equation shown below.
RWL = LC x HM x VM x DM x AM x FM x CM
- LC : load constant, is the maximum weight anyone should lift under ideal
condition (51 lbs.)
- HM : horizontal multiplier, is the horizontal distance of the object from a
point between the ankles of the person performing the lift and the load,
measured along the floor
- VM : vertical multiplier, is the vertical height of the lift
- DM : distance multiplier, is the distance the object is lifted or lowered
vertically
 - AM : asymmetric multiplier, is the distance the object is displaced, in degrees
from the front of the body
- FM : frequency multiplier, is how often the lifts are made in a 15-minute
period
- CM : coupling multiplier, quality of hand-to-object connection (for lifting legs
and arms, the coupling would in most cases be rated “good”, since you can
get your hand around them; for other body parts or for the entire body,
however, the coupling would likely be rated “poor”)

After calculating the recommended weight limit (RWL), now you can calculate the
lifting index by using the equation shown below.

LI = Load weight (L) / Recommended Weight Limit (RWL)

If the lifting index calculated out is greater than 1.0, it means that there will be an
increased risk of lifting-related low back pain, and many workers will be at elevated risk if
the lifting index exceeds 3.0. Other indications that it is safe to do this lifting technique is that
the patient is able to follow directions and is not combative. Patients' behavior can be
unpredictable, they might experience sudden muscle spasm, be combative, or resist, and it is
best that the lifters know beforehand the patient’s behavior to ensure the safety of the lifters
and patient.

In addition, it is safe to proceed with the technique when the amount of weight the
lifters handle can be estimated, and also the “geometry” of the lift - the body and hand
positions in relation to the object being lifted - and the amount of weight lifted are not subject
to change. Even though many researches indicate that manual lifting can put the healthcare
worker at risk of musculoskeletal disorder and are recommending healthcare workers to do
mechanical lifting, sometimes in healthcare settings it is unavoidable to do manual lifting
when there is no mechanical apparatus available to be used immediately. These indications
are a greenlight to show that the healthcare workers are safe to lift and transfer the patient,
and the patient is safe to be lifted and transferred too.
CONTRAINDICATION PRECAUTION/LIMITATION OF THE TECHNIQUE

Before the therapist performs three-men lifting techniques there are certain
precautions that they need to be aware of to ensure safeness for the therapist and patient.
Study that was conducted in the United States reported that healthcare staff experience back
injury. We can minimize this injury if the therapist knows how to handle the patient while
transferring and lifting in the correct way. First of all, therapists should know clearly about
procedures and the policies of handling patients. For three-men lifting transfer, this technique
probably needs three people to carry the patient and one of them needs to give cues so that all
of them are ready and can carry the patient at the same time. Make sure the carer’s back is
straight and stomach muscles contracted when lifting and transferring.

Next, all therapists need to be aware there is no harm around the area that they want to
transfer the patient. They should wear suitable shoes so that they will not slip on during
lifting the patient from bed to bed. The shoes must have a wide base and level to ensure the
safety of patients and carers. Plus, they should avoid wearing socks only without shoes and
the surface of the floor should be smooth and flat. In addition, therapists should wear
appropriate clothing. For example, they should wear loose and comfortable cloth so that they
can facilitate the movement and to prevent unnecessary falls while bringing the patient. Then,
during the three-men lifting it is compulsory for the therapist to make sure that both feet open
slightly in broad base while kneeling or standing to provide stability. Therapists also need to
bend slightly their knees and stand close to the patient every time when lifting and
transferring the patient.

PROCEDURE OF THE TECHNIQUE

Hammock carry:
1) Make the patient's hands cross on their body.
2) The team leader must instruct the team members to count and ask for the correct position.
3) Instruct the team member not to wear any accessories on their hands that could impede or
inflict additional injuries on the patient.
4) Practice interlocking and unlocking before inserting hands under the patient and grasping
one wrist on the opposing member.
5) Only one wrist on the opposite member can be grasped by the member on the ends.
6) The member with only one wrist grasped will support the patient's head and feet with their
free hand.
7) Lift the patient on the leader's command and transfer the patient. Always use proper lifting
techniques.
8) Carefully transfer the patient to the other bed
 Three-person carry:
1) Arrange three therapists on one side of the casualty, with the tallest person at the
shoulders, another at the hips, and the third at the knees.
2) The therapist at the shoulders works both hands under the victim's neck and shoulders, the
therapist at the hips works both hands under the pelvis and the hips, and the therapist at the
knees lifts the knees and ankles.
3) The crew gently lifts the patient at the command lift, which is usually given by the
therapist at the shoulders.
4) At a second command, they gradually turn the victim toward them, until the casualty is
resting in the bends of their elbows.
5) At the third command, the entire crew rises to their feet.
6) The therapist will rotate the patient so that the patient's back is against the therapist's
chests.
7) When walking, all therapists will start on the same foot and walk in a straight line.
8) Carefully transfer the patient to the other bed and adjust the patient position to ensure the
patient's comfort.

HAMMOCK CARRY

THREE-PERSON CARRY
CONCLUSION

● It is important to stay alert to all the precaution and contraindication before perform
lifting and transferring the patient for the sake of therapist and patient safety.
(ILHAM)
● A physiotherapist needs to be well-versed in a variety of safe patient lifting
procedures in order to move a patient. Physiotherapists occasionally need assistance
from others since they are unable to move a patient on their own. Patient lifting
techniques and skills are only learned in day-to-day practise by observing others do it
or by using the trial-and-error method. There is a need to analyse how many
physiotherapists have knowledge about safer lifting technique in order to prevent
problems for physiotherapists while handling a patient because their skill-based
 knowledge is not provided in the curriculum of physiotherapy and their proper
techniques are not being practised. (MAS)
● A procedure in three man lifting is the written set of step-by-step instructions for how
a specific activity is to be conducted to make sure the victim is safe and avoid the
others injuries when the therapist lifts them.Also for therapist, incorrect manual
handling is one of the most common causes of injury at work, accounting for over a
third of all workplace injuries.

REFERENCE
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https://testbook.com/question-answer/three-man-carry-is-also-known-as--
6209ff9a1ef171c9ddc35d46
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physiotherapy students. Physiotherapy, 79(5), 323–326. https://doi.org/10.1016/s0031-
9406(10)62095-0
3. Horodyski, M., Conrad, B. P., Del Rossi, G., DiPaola, C. P., & Rechtine, G. R. (2011).
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https://www.academia.edu/43985795/Knowledge_on_Safer_Patient_Lifting_Techniques_am
ong_Physiotherapists
5. Tuyl, L. J., Mackney, J. H., & Johnston, C. L. (2012). Management of sternal precautions
following median sternotomy by physical therapists in Australia: a web-based
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