1. PATIENTLIFTING PATIENT LIFTING

2. OBJECTIVE n Identify the procedures for safely lifting a patient

3. PATIENT LIFTING n Principles of Safe Lifting n Principles of Safe Carrying Patients n Patient Handling and Equipment

4. Principles of Safe Lifting n Use Longest and Strongest muscle groups n Keep arms and legs close to your body n Use legs, not back, to lift n Evaluate every situation n Plan in advance and assemble resources

5. Guidelines for Safe Lifting n Consider weight of patient and need for additional help n Know physical ability and limitations n Lift without twisting n Communicate clearly and frequently with partner(s)

6. Guidelines for Safe Lifting (cont) n LIFTING COTS AND STRETCHERS Know or find out weight to be liftedKnow or find out weight to be lifted Use at least two peopleUse at least two people Use even # of people; maintain balanceUse even # of people; maintain balance –Know weight limitation of equipment –What if patient exceeds weight limit?

7. Lift Positions n Power Lift Position Weak knees and thighsWeak knees and thighs Procedures:Procedures: –Spread feet –Straddle cot/backboard; feet flat –Distribute weight on balls of feet –Stand; back locked and upper body up before hips

8. Lift Positions (cont) n Power Grip Maximum force from handsMaximum force from hands Palm and fingers in complete contact with objectPalm and fingers in complete contact with object –All fingers are bent at same angles –Hands should be at least 10” apart

9. Principles of Safe Carrying n Guidelines for Safe Carrying: Know weight to be liftedKnow weight to be lifted Know crew’s abilities Know crew’s abilities Coordinate & communicate with partners Coordinate & communicate with partners Keep wt. close to body Keep wt. close to body Keep back “locked-in”; do not twistKeep back “locked-in”; do not twist

10. Principles of Safe Carrying(cont) n Guidelines (cont) Flex at the hips; bend at the kneesFlex at the hips; bend at the knees Do not hyperextend back Do not hyperextend back

11. Principles of Safe Carrying(cont) n Carrying a Stretcher Partner of similar strength/heightPartner of similar strength/height 4 or more EMT-B’s4 or more EMT-B’s –Lift “face on” with both hands –Once lifted to carrying height, turn in proper direction and switch to using one hand

12. Patient Handling Equipment n Wheeled Stretchers n Portable Stretchers n Scoop Stretcher n Basket Stretcher (Stokes Litter) n Flexible Stretcher n Backboards n Litter

13. Wheeled Stretcher n Two Rescuer Used in narrow spaces; requires more strengthUsed in narrow spaces; requires more strength Rescuers should face each otherRescuers should face each other Easily unbalancedEasily unbalanced

14. Wheeled Stretcher (cont) n Four Rescuer One at each cornerOne at each corner More stability; less strength requiredMore stability; less strength required Safer over rough terrainSafer over rough terrain n Scoop stretcher - interim device Place scoop around patientPlace scoop around patient Lock scoop stretcher and transfer patientLock scoop stretcher and transfer patient Unlock and remove scoop stretcherUnlock and remove scoop stretcher

15. Portable Stretchers n Used when wheeled stretcher cannot be used n Weighs less than wheeled stretcher n Patient and equipment must be supported by EMT’s

16. Scoop Stretcher n Splits into two or four pieces n Fitted around patient lying on ground or flat surface n Requires both sides of pt. accessible n Not adequate when used alone for spinal injury

17. Basket Stretcher (Stokes Litter) n Used in technical and water rescues n Holes in bottom to allow water to drain n Line bottom with waterproof material

18. Flexible Stretcher n Excellent support and immobilization n Uncomfortable n May be folded or rolled n Can be lowered by rope or slid down a flight of stairs

19. Backboards n Used primarily for suspected spinal injuries n Long Backboards 6-7 feet long6-7 feet long Commonly for patients found lying downCommonly for patients found lying down

20. Backboards (cont) n Short Backboards 3-4 feet long3-4 feet long Used for patients found in sitting positionUsed for patients found in sitting position Designed to immobilize head and torsoDesigned to immobilize head and torso

21. Litter n 3-person lift and carry onto litter Place litter next to victimPlace litter next to victim All kneel on same side of victim (knee towards head is up)All kneel on same side of victim (knee towards head is up) Hand positionsHand positions –Head - one under neck; one under shoulders –Middle - one under lower back; one below buttocks –Feet - one under ankles; one under knees

22. Litter (cont) n n 3-person (cont) Lifting victim onto litter – –Rescuer at head gives commands – –Lift victim onto knee, towards you – –Move forward to litter – –Lower victim onto litter(may need to slide victim- positioning)

23. Litter (cont) n 4th Rescuer Available Stays on side of litter opposite victimStays on side of litter opposite victim Slides litter into positionSlides litter into position Steadies litter while victim is loweredSteadies litter while victim is lowered

24. Litter (cont) n Carrying the Litter Apply at least 2 litter straps(3 preferred), before lifting litterApply at least 2 litter straps(3 preferred), before lifting litter 2 rescuers at head, one at foot; if 4th rescuer available, 2 at head, 2 at feet2 rescuers at head, one at foot; if 4th rescuer available, 2 at head, 2 at feet

25. Litter (cont) n Carrying the Litter (cont) Rescuer at victim’s right shoulder gives commandsRescuer at victim’s right shoulder gives commands –Lift on command –Wait for command to move; carry feet first –Procedures reversed for stopping and lowering

26. Litter (cont) n On-loading victims into ambulance Load head firstLoad head first –As approach ambulance, bear around so head is facing rear of ambulance –Lower litter (using commands) –Positioning One rescuer at feet (tallest, strongest)One rescuer at feet (tallest, strongest) Other two on either side, about midwayOther two on either side, about midway

27. Litter(cont) n On-Loading Victims (cont) Command from rescuer at feet, lift so handles rest on seatCommand from rescuer at feet, lift so handles rest on seat Rescuers on sides go into ambulanceRescuers on sides go into ambulance –One at head –One near middle All slide litter into ambulanceAll slide litter into ambulance

28. Litter (cont) n On-loading Victims (cont) Litters loaded in specific orderLitters loaded in specific order –Upper right –Lower right –Upper left –Lower left

29. Litter (cont) n On-Loading Victims (cont) Loading litter into top positionLoading litter into top position –Rescuers stay in position –On command, litter lifted and inside position hooked first and inform other EMTs Never mix deceased and live victimsNever mix deceased and live victims

30. Litter (cont) n Off-loading patients Reverse entire procedureReverse entire procedure Most seriously injured last so off-loaded firstMost seriously injured last so off-loaded first

31. SUMMARY n Principles of Safe Lifting Guidelines for Safe LiftingGuidelines for Safe Lifting Lift PositionsLift Positions n Principles of Safe Carrying Guidelines for Safe CarryingGuidelines for Safe Carrying Carrying a StretcherCarrying a Stretcher

32. SUMMARY (cont) n Patient Handling Equipment Wheeled StretcherWheeled Stretcher Portable StretcherPortable Stretcher Scoop StretcherScoop Stretcher Basket StretcherBasket Stretcher Flexible StretcherFlexible Stretcher BackboardsBackboards LitterLitter

33. NOW, LET’S PRACTICE…