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Lifting and Moving Patients

Lifting and Moving Patients

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Lifting and Moving Patients

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    1. Lifting and Moving Patients Lesson 5

    3. Back injury is hazard for First Responders To minimize risks, use good body mechanics Body mechanics are principles of using your body safely Body Mechanics

    4. Body Mechanics and Lifting Techniques Know your physical ability and limitations Plan the lift Ensure you have a good grip Test the load Position your feet properly before starting lift Lift with your legs, not with your back Keep patients weight close to your body Avoid twisting your back during the lift Communicate clearly with your partner and other EMS providers

    5. Patient Positioning Reposition a patient only when necessary Reposition a breathing, unresponsive, non-trauma patient in the recovery position Dont move or reposition a trauma patient unless necessary to treat life-threatening condition Allow responsive patient to assume comfortable position

    6. Recovery Position Helps keep airway open Allows fluid to drain from mouth Prevents aspiration If possible, put victim onto left side Continue to monitor breathing

    7. Recovery Position for Unresponsive Breathing Infant Hold infant facedown over your arm with head slightly lower than body Support the head and neck with your hand, and keep nose and mouth clear

    8. Skill: Recovery Position (Modified HAINES)

    16. Log Roll Use log roll to move patient from prone to supine Three to five rescuers are needed to safely roll patient For trauma patient with spinal injury, stabilize head in line with body

    17. Log Roll continued 1. The rescuer at the patients head holds the head in line with the body as two or three additional rescuers take position with hands at the patients lower and upper leg, hip and torso, and shoulder 2. At the direction of the responder at the head, the rescuers in unison roll the patient toward them, with the head held in line and the spine straight 3. The rescuers complete the log roll, positioning the patient on the back with head and neck still in line with the body

    18. Emergency Moves Use only if: Patient faces an immediate danger You cannot give lifesaving care because of location or position

    19. Risk of Spinal Injury Moving patient quickly risks aggravating a spinal injury Keep head and neck in line with spine It is impossible to protect spine while removing patient from a vehicle quickly

    20. Extrication from Vehicles First Responders may be trained in rapid extrication using cervical collar and inline stabilization of head/neck Follow local protocol Wait for EMTs trained in special extrication techniques

    21. One-Rescuer Emergency Drags Pull/drag patient in direction of long axis of body Dont drag patient sideways, and avoid twisting neck/trunk Never pull head away from neck/shoulders Risk of spinal injury can be minimized by using a blanket, rug, board, etc Choice of move depends on materials at hand, patients condition, and situation

    22. One-Rescuer Emergency Drags Clothing Drag Blanket Drag Shoulder Drag Firefighters Drag Upper Extremity Drag Upper Extremity Drag for Rapid Extrication

    23. Emergency Carries Used when patient must be moved immediately One or more rescuers may carry patient Method used depends on patients size, condition and situation: Walking assist Cradle carry Multiple-rescuer techniques are safer/less stressful

    24. With All Emergency Carries Use good body mechanics/lifting techniques Dont try to lift/carry person before checking for injuries

    25. Moving Victims If Alone Unresponsive victim who cannot safely be dragged Pack-strap carry

    26. Moving Victims If Alone Lighter victim or child Cradle carry (responsive or unresponsive victims) Piggyback carry (responsive victim)

    27. Piggyback Carry Support the patients weight with your arms under the patients thighs If able, have the patient clasp hands and lean forward; if not able, grasp the patients hands with yours to keep patient from falling back

    28. Firefighters Carry Support the patients weight on your shoulders while holding the patients thigh and arm

    29. Moving Victims If Alone Responsive victim who can walk with help One-person walking assist

    30. Moving Victims With Help Responsive victim: Two-person walking assist Two-handed seat carry

    31. Two-Rescuer Extremity Carry To carry a patient down steps, the forward rescuer grasps patients legs under the knees while the rear rescuer reaches under patients armpits from behind to grasp the patients forearms

    32. Two-Rescuer Assist Both rescuers position the patients arms over their shoulders Each rescuer grasps the patients wrist, with the other arm around the patients waist

    33. Non-emergency Moves Used to move patient when no threat to life Performed by multiple rescuers Not used if patient has suspected spinal injury, internal bleeding, or uncontrolled external bleeding Stabilize patients before moving them Minimize any chance of aggravating illness or injury These moves are usually performed by responding EMS personnel

    34. Before Using a Non-emergency Move Complete primary/secondary assessment Correct any life-threatening problems Immobilize all suspected fractures/dislocations Ensure there are no signs/symptoms of neck/spinal injury

    35. Direct Ground Lift Non-emergency move for patients without suspected neck or spinal injuries Used to lift/carry supine patient from ground to stretcher

    36. Direct Ground Lift Rescuers kneel on one side of the patient Rescuer at head places one arm under the patient's neck and shoulder and cradles the patient's head Rescuers lift patient to their knees and roll the patient in toward their chests Rescuers stand and move patient to stretcher

    37. Extremity Lift Two-rescuer technique used for patients without suspected injury to neck, spine, or extremities May be used with responsive/unresponsive patient May be used to carry patient a short distance or move patient from chair to stretcher May be used to carry a patient through a tight space

    38. Extremity Lift 1. The first rescuer kneels at the patient's head and the second rescuer kneels by the patient's feet. The rescuer at the head places one arm under each of the patient's shoulders while the rescuer at the feet positions the patient's arms. 2. The rescuer at the head then slips his or her hands under the patient's armpits and grasps the patient's wrists and crosses them on the patients chest. The rescuer at the feet turns around and reaches his or her hands back and under the patient's knees.

    39. Extremity Lift continued Both rescuers move to a crouching position and assess their grip on the patient On a signal from the rescuer at the head, the rescuers stand up simultaneously and move forward with the patient

    40. Extremity Lift Alternative Position Preferred if rescuers must move some distance or over inclined surface Rescuer at patients feet may face patient and other rescuer Can be used to move patient to side or short distance Transfer from Bed to Stretcher Assist EMS personnel transferring patient from bed to stretcher Use either direct carry or draw sheet technique Not used with patient with suspected spinal injury

    41. Direct Carry 1. Position the stretcher at a right angle to the bed, ideally, with the head end of the stretcher at the foot of the bed. The stretcher should be at the same height as the bed. Unbuckle the straps and remove other items from the stretcher. Both rescuers stand between the bed and the stretcher, facing the patient.

    42. Direct Carry continued 2. The rescuer at the head slides one arm under the patient's neck and cups the patient's farther shoulder. The second rescuer slides one arm under the patients hips and lifts slightly. The rescuer at the head slides his or her other arm under the patient's back, and the second rescuer places his or her other arm underneath the patients thighs near the knees. Together, both rescuers slide the patient to the edge of the bed.

    43. Direct Carry continued 3. On a signal of the rescuer at the head, the rescuers lift and curl the patient toward their chests 4. The rescuers step back, rotate toward the stretcher, and place the patient gently on the stretcher

    44. Draw Sheet Transfer

    45. Draw Sheet Transfer 1.Loosen bottom bed sheet and roll its edge on the side where you will place stretcher 2. Position stretcher alongside bed. Prepare stretcher: Adjust height, lower rails, and unbuckle straps Both responders reach across stretcher and grasp rolled sheet edge firmly at level of patient's head, chest, hips, and knees 3. Slide patient gently onto stretcher

    46. Draw Sheet Transfer Alternative Method Rescuers first roll patient onto one side, and one rescuer holds the patient in that position. Second rescuer positions a sheet with rolled edge beneath patient The patient is rolled back into original position, now on the sheet The rescuers together pull on sheet to slide patient onto stretcher

    47. EMS Equipment for Moving Patients First Responders often assist EMTs with packaging and moving patients A wide range of commercial devices are used Learn devices you are likely to encounter in your area

    48. Typical Equipment for Packaging and Moving Patients Long Backboard Short Backboard Vest Extrication Device Standard Stretcher Portable Stretcher Orthopedic Stretcher Basket Stretcher Stair Chair