Lifting and Moving Patients

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 patient’s 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 Don’t 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 patient’s head holds the head in line with the body as two or three additional rescuers take position with hands at the patient’s lower and upper leg, hip and torso, and shoulder2. 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 Don’t 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, patient’s condition, and situation

22. One-Rescuer Emergency Drags Clothing Drag Blanket Drag Shoulder Drag Firefighter’s 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 patient’s 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 Don’t 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 patient’s weight with your arms under the patient’s thighs If able, have the patient clasp hands and lean forward; if not able, grasp the patient’s hands with yours to keep patient from falling back

28. Firefighter’s Carry Support the patient’s weight on your shoulders while holding the patient’s 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 patient’s legs under the knees while the rear rescuer reaches under patient’s armpits from behind to grasp the patient’s forearms

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