1. Lifting and Moving Patients
CHAPTER 5
Lifting and Moving Patients

2. Safety Precautions for Lifting
Use your legs to lift, not your back. Back injuries are a leading cause of long-term disability for EMTs.
Keep weight as close to the body as possible

3. Lifting Considerations
Consider the weight of object/ patient and the need for additional help.
Know your physical ability and limitations.
Lift without twisting or turning.
Have feet positioned properly.
Communicate clearly and frequently with partner.
Have a plan.
Do not compensate when lifting with one hand.
Use a stair chair when on stairs.

4. Use legs, not back, to lift.

5. Keep weight close to your body.

6. Safe Lifting of Cots and Stretchers
Know or find out the weight to be lifted.
Use at least two people (should be an even number – maintains balance)
Ensure enough help is available
Know or find out the weight limitations of equipment
Know what to do with patients who exceed weight limitations of equipment.
Lift while keeping back in locked-in position.
When lowering cot or stretcher, reverse steps
Avoid bending at the waist.

7. Power-Lift Position
Using the power-lift or squat-lift position, keep back locked into normal curvature. The power-lift position is useful for individuals with weak knees or thighs. The feet are a comfortable distance apart. The back is tight and the abdominal muscles lock the back in a slight inward curve. Straddle the object. Keep feet flat. Distribute weight to balls of feet or just behind them. Stand by making sure the back is locked in and the upper body comes up before the hips.

8. Power-Grip
Use power grip to get maximum force from hands. The palm and fingers come into complete contact with the object and all fingers are bent at the same angles. The power grip should always be used in lifting. This allows force to be developed. Hands should be at least 10 inches apart.

9. Carrying
Whenever possible, transport patients on devices that can be rolled
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 – even numbers
Keep the weight as close to the body as possible
Keep back in a locked-in position and refrain from twisting
Flex at the hips, not the waist; bend at the knees (lift with the knees)
Do not hyperextend the back (do not lean back from the waist)

10. Carrying cont’d… Correct carrying procedure
Use correct lifting techniques to lift the stretcher
Partners should have similar strength and height
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
Correct 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
Have someone guiding the person who is going backwards

11. Safe Reaching Techniques
Guidelines for reaching
Keep your back locked in.
Avoid twisting the back while reaching.
When reaching overhead, avoid hyperextension of the back
Application of reaching techniques
Avoid reaching more than inches in front of your body.
Avoid situations where prolonged (more than a minute) strenuous effort is need in order to avoid injury
Correct reaching for log rolls
Keep back straight while leaning over patient
Lean from the hips
Use shoulder muscles to help with roll

12. Safe Pushing and Pulling
Push, rather than pull.
Keep your back locked in (whenever possible).
Keep line of pull through center of body by bending knees
Keep weight close to your body.
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

13. Types of Moves

14. Emergency Moves
In general, a patient should be moved immediately (emergency move) only when:
Scene is hazardous – immediate danger to the patient.
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 life-saving care
Life-saving care cannot be given because of the patient’s location or position (e.g. a cardiac arrest patient sitting in a chair or lying on a bed).

15. Emergency Moves cont’d…
The greatest danger in moving a patient quickly is the possibility of aggravating a spine injury
In an emergency, every effort should be made to pull the patient in the direction of the long axis of the body to provide as much protection to the spine as possible
It is impossible to remove a patient from a vehicle quickly and at the same time provide as much protection to the spine as can be accomplished with an interim immobilization device.
If the patient is on the floor or ground, he can be moved by:
Pulling on the patient’s clothing in the neck and shoulder area
Putting the patient on a blanket and dragging the blanket
Putting the EMT-B’s hands under the patient’s armpits (from the back), grasping the patient’s forearms and dragging the patient
Straddle slide to a long board

16. Emergency Move: Clothes Drag

17. Emergency Move: Incline Drag (Head-First)

18. Emergency Move: Firefighter’s Drag

19. Emergency Move:
Firefighter’s Carry

20. Emergency Move: One-Rescuer Assist

21. Emergency Move: Two-Rescuer Assist

22. Urgent Moves Scene factors cause a decline in patient condition.
Treatment of patient’s condition requires a move.

23. Urgent Move with Spinal Precautions

24. Non-Urgent Moves Use when there is no threat to life.
Use when patient’s condition allows for assessment and care.
Typically utilize a carrying device.

25. Non-Urgent Move: Extremity Carry

26. Patient-Carrying Devices

27. Wheeled Ambulance Stretcher
Most commonly used device
Rolling
Restricted to smooth terrain – designs are getting much better though
Foot end should be pulled
One person must guide the stretcher at the head

28. Portable Stretcher

29. Stair Chair
Should use whenever possible, if stairs are in the path to be taken
Transports patient in the sitting position until stretcher is reached
DO NOT USE if back/neck/spine injury is suspected.

30. Long Spine Board
Traditionally, these were wooden, but with advances in technology they are now x-ray translucent and water safe

31. Patient Immobilized on Long Spine Board

32. Again, these were traditionally a wooden device.
Short Spine Board
Again, these were traditionally a wooden device.
Not commonly used in the field any longer, due to the invention of the K.E.D.

33. Vest-Type Extrication Device (K.E.D.)

34. Patient Immobilized in Vest-Type Extrication Device

35. Scoop (Orthopedic) Stretcher
This device comes apart at the head and foot. It is commonly used for patients who have fallen in tight spaces (e.g. bathrooms, between a bed and a wall).
It does not ensure spine stabilization.

36. Basket (Stokes) Stretcher

37. Flexible (Reeves) Stretcher

38. Moving Patients to Carrying Devices

39. Carrying Device Choice
What is the patient’s position?
Is there a suspected spinal cord injury?

40. Patient Positioning Part of patient care plan
Must not cause harm to patient
Must be safe

41. Recovery Position
An unresponsive patient without suspected spine injury should be moved into the recovery position by rolling the patient onto his/her side (preferably left) without twisting the body.

42. Position of Comfort (Fowler’s)
A patient with chest pain or discomfort or difficulty breathing should sit in a position of comfort as long as hypotension is not present.

43. Shock Position Patient without Spinal Injury
A patient in shock (hypoperfusion) should have his legs elevated 8 – 12 inches. This position is known as the Trendelenberg position.

44. Transferring the Patient to a
Hospital Stretcher

45. Position stretcher.

46. Pull sheet under patient taut.

47. Slide patient to hospital stretcher.

48. Be sure patient is centered. Raise side rail.