1. Slide 1 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Chapter 6 Lifting and Moving Patients

2. Slide 2 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Overview  Body Mechanics  Lifting  Carrying  Reaching  Pushing and Pulling  Principles of Moving Patients  Emergency Moves  Urgent Moves  Nonurgent Moves  Equipment

3. Slide 3 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Body Mechanics  The principles of effective movement used in lifting and moving patients Use of proper body mechanics reduces the EMS provider’s chances of being injured.

4. Slide 4 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Lifting Techniques  Safety precautions  Use legs, not back, to lift  Keep weight as close to body as possible  Consider weight of patient and need for additional help  Know physical ability and limitations  Lift without twisting  Have feet positioned properly  Communicate clearly and frequently with partner

5. Slide 5 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Improper Lifting Technique  Improper lifting technique with back twisted

6. Slide 6 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Proper Lifting Technique

7. Slide 7 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Proper Lifting Technique Know the weight limitations of the devices!

8. Slide 8 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Guidelines for Stretchers  When possible use a stair chair instead of a stretcher, if medically appropriate

9. Slide 9 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Guidelines for Stretchers  Know or find out the weight to be lifted  Use at least two people  Ensure enough help available  Use an even number of people to lift so that balance is maintained  Know or find out the weight limitations of equipment being used

10. Slide 10 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Guidelines for Stretchers  Using power-lift or squat-lift position  Use power grip to get maximum force from hands  Lift while keeping back in locked-in position  When lowering cot or stretcher, reverse steps  Avoid bending at the waist

11. Slide 11 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Video Clip: The Squat Lift for Lifting a Stretcher Video Clip: The Squat Lift for Lifting a Stretcher

12. Slide 12 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Carrying  Precautions for carrying—whenever possible, transport patients on devices that can be rolled It is always best to let the equipment perform the work.

13. Slide 13 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Guidelines for Carrying  Know or find out the weight to be lifted  Know limitations of the crew’s abilities  Work in a coordinated manner and communicate with partners  Keep the weight as close to the body as possible

14. Slide 14 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Guidelines for Carrying  Keep back in a locked-in position and refrain from twisting  Flex at the hips, not the waist; bend at the knees  Do not hyperextend the back (do not lean back from the waist)

15. Slide 15 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Correct Carrying Procedure  Use correct lifting techniques to lift the stretcher  Partners should have similar strength and height

16. Slide 16 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. One-Handed Carrying Technique  Pick up and carry with the back in the locked- in position  Avoid leaning to either side to compensate for the imbalance

17. Slide 17 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Carrying Procedure on Stairs  When possible, use a stair chair instead of a stretcher  Keep back in locked-in position  Flex at the hips, not the waist; bend at the knees  Keep weight and arms as close to the body as possible

18. Slide 18 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Carrying Procedure on Stairs   A stair chair provides more flexibility for handling and transporting patients in narrow or steep areas.

19. Slide 19 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Reaching Guidelines  Keep back in locked-in position  When reaching overhead, avoid hyperextended position  Avoid twisting the back while reaching

20. Slide 20 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Reaching Techniques  Avoid reaching more than 15–20 inches in front of the body  Avoid situations where prolonged (more than 1 minute) strenuous effort is needed to avoid injury

21. Slide 21 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Correct Reaching for Log Rolls  Keep back straight while leaning over patient  Lean from the hips  Use shoulder muscles to help with roll

22. Slide 22 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Pushing and Pulling Guidelines  Push, rather than pull, whenever possible  Keep back locked-in  Keep line of pull through center of body by bending knees  Keep weight close to the body

23. Slide 23 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Pushing and Pulling  Push from the area between the waist and shoulder  If weight is below waist level, use kneeling position  Avoid pushing or pulling from an overhead position if possible  Keep elbows bent with arms close to the sides

24. Slide 24 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Principles of Moving Patients  Emergency moves  Urgent moves  Nonurgent moves

25. Slide 25 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Emergency Moves  There is an immediate danger to the patient if not moved  Fire or danger of fire  Explosives or other hazardous materials  Inability to protect the patient from other hazards at the scene  Inability to gain access to other patients in a vehicle who need lifesaving care  Lifesaving care cannot be given because of the patient’s location or position

26. Slide 26 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Video Clip: Rapid Extrication of a Patient from a Vehicle Video Clip: Rapid Extrication of a Patient from a Vehicle

27. Slide 27 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Urgent Moves  Altered mental status  Inadequate breathing  Shock (hypoperfusion)

28. Slide 28 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Nonurgent Moves  If there is no threat to life, the patient should be moved when ready for transportation (nonurgent move)

29. Slide 29 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Emergency Moves  Clothes drag

30. Slide 30 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Emergency Moves  Blanket drag

31. Slide 31 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Emergency Moves  Pulling the patient under the arms

32. Slide 32 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Nonurgent Moves  Direct ground lift

33. Slide 33 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Video Clip: Direct Ground Lift (No Suspected Spine Injury) Video Clip: Direct Ground Lift (No Suspected Spine Injury)

34. Slide 34 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Nonurgent Moves  Extremity lift

35. Slide 35 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Video Clip: Extremity Lift (No Suspected Spine Injury) Video Clip: Extremity Lift (No Suspected Spine Injury)

36. Slide 36 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Nonurgent Moves  Stretcher to bed transfer

37. Slide 37 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Video Clip: Transfer of Supine Patient from the Stretcher to the Bed by the Direct Carry Method Video Clip: Transfer of Supine Patient from the Stretcher to the Bed by the Direct Carry Method

38. Slide 38 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Video Clip: Transfer of a Supine Patient from the Stretcher to the Bed by the Draw Sheet Method Video Clip: Transfer of a Supine Patient from the Stretcher to the Bed by the Draw Sheet Method

39. Slide 39 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Equipment Stretchers and Cots

40. Slide 40 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Wheeled Stretcher

41. Slide 41 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Portable Stretcher

42. Slide 42 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Scoop Stretcher

43. Slide 43 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Flexible Stretcher

44. Slide 44 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Basket Stretcher

45. Slide 45 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Stair Chair

46. Slide 46 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Long Backboard

47. Slide 47 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Seated Spinal Devices

48. Slide 48 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Patient Positioning  Supine

49. Slide 49 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Patient Positioning  Fowler’s

50. Slide 50 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Patient Positioning  Recovery

51. Slide 51 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Patient Positioning  Pregnant patient

52. Slide 52 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Patient Positioning  Children should be secured in car seats for transport

53. Slide 53 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Summary  Body Mechanics  Lifting  Carrying  Reaching  Pushing and Pulling  Principles of Moving Patients  Emergency Moves  Urgent Moves  Nonurgent Moves  Equipment