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 – Scoop stretcher

stretcher – Long spine board
– Portable ambulance – Basket stretcher
stretcher – Flexible stretcher
– Stair chair
 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 • Adjust your
normal upright position. orientation and
• Spread your legs apart position.
about 5". • Reposition feet.
• Grasp with arms extended • Lift by
down side of body. 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 palms-
down 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 fighter’s drag

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

Fire fighter’s 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.
• Patient’s 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