Lifting And Moving Patients - 6

Front 1

What is the first concern of any job?

Back 1

SAFETY

Front 2

Whose safety are we concerned
about?

Back 2

1. You
2. Your partner
3. Your patient

Front 3

Injury Prevention

Back 3

1 Physical fitness--Making our bodies more resilient. – flexibility & strength
2 Body mechanics--The way we move.

Front 4

Flexibility

Back 4

Daily stretches improve resilience and make us more resistant to injury.

Front 5

Strength Training

Back 5

Building muscles takes the load off bones, tendons, and ligaments.

Front 6

Weight Training

Back 6

• Circuit training at a gym
– lift with good body mechanics
• Basic,simple exercises to do at home

Front 7

Strengthening Exercises

Back 7

Pushups
Pull-ups
Crunches
Squats
• Work quadriceps and gluteus.
• Most lifting should be performed with these
muscles.
Toe-Raises
• Work the calves.
• Help to strengthen the legs.

Front 8

On the Job Prevention

Back 8

Can we work on flexibility while on the job?
Yes-- Don’t sit still for more than 45 minutes. Do stretches
Can we work on strength while on the job?
No-- Not in a controlled sense.

Front 9

Body Mechanics

Back 9

The proper use of the body to facilitate lifting and moving and to prevent injury.

Shoulder girdle should be aligned over the pelvis.
Lifting should be done with legs.
Weight should be kept close to the body.
Grasp should be made with palms up.

Front 10

Rules of Lifting & Moving

Back 10

• Keep feet shoulder width apart
• Bend knees
• Lock back
• Push, don’t pull
• Hold weight close to body
• and...Avoid Twisting

Front 11

Anaerobic exercise

Back 11

Exercise during which the energy required is provided without utilization of inspired oxygen. This type of exercise is limited to short bursts of vigorous activity.

Front 12

Moving and Positioning the Patient

Back 12

• Take care to avoid injury whenever a patient is moved.
• Practice using equipment.
• Know that certain patient conditions call for special techniques.

Front 13

Performing the Power Lift

Back 13

• Tighten your back in normal upright position.
• Spread your legs apart about 5".
• Grasp with arms extended down side of body.
• Adjust your orientation and position.
• Reposition feet.
• Lift by straightening legs.
• A power grip gets the maximum force from your hands
• Arms and hands face palm up.
• Hands should be at least 10" apart.
• Each hand goes under the handle with the palm facing up and the thumb extended upward.
• Curl fingers and thumb tightly over the top of the handle.
• Never grasp a litter or backboard with the hands placed palms- down over the handle.

Front 14

Weight and Distribution

Back 14

• Patient will be heavier on head end.
• Patients on a backboard or stretcher should be diamond carried.

Front 15

Diamond Carry

Back 15

A carrying technique in which one EMT is located at the head end, one at the end foot, and one at each side of the patient. Each of the sides use one hand to support the stretcher so they are all able to face forward as they walk.

• Four EMT-Bs lift device while facing patient.
• EMT-B at foot end turns around to face forward.
• EMT-Bs at sides turn.
• Four EMT-Bs face same direction when walking.

Front 16

One-Hand Carrying

Back 16

• Face each other and use both hands.
• Lift the backboard to carrying height.
• Turn in the direction you will walk and switch to using one hand.

Front 17

Carrying Backboard or Cot on Stairs

Back 17

• Strap patient securely to the backboard.
• Carry patient down stairs foot end first, head end elevated.
• Carry patient up stairs head end first.

Front 18

Directions and Commands

Back 18

Anticipate and understand every move.
Moves must be coordinated.
Orders should be given in two parts.

Front 19

Additional Guidelines

Back 19

• Find out how much the patient weighs.
• Know how much you can safely lift.
• Communicate with your partners.
• Do not attempt to lift a patient who weighs over
250 lbs with fewer than four rescuers.
• Avoid unnecessary lifting or carrying.

Front 20

Using a Stair Chair

Back 20

• Secure patient to stair chair with straps.
• Rescuers take their places: one at head, one at
foot.
• Rescuer at the head gives directions.
• Third rescuer precedes.

Front 21

Principles of Safe Reaching and Pulling

Back 21

• Back should always be locked and straight. • Avoid any twisting of the back. • Avoid hyperextending the back.
• When pulling a patient on the ground, kneel to minimize the distance.
• Use a sheet or blanket if you must drag a patient across a bed.
• Unless on a backboard, transfer patient from the cot to a bed with a body drag.
• Kneel as close as possible to patient when performing a log roll.
- Elevate wheeled ambulance cot or stretcher before moving.
- Never push an object with your elbows locked.
- Do not push or pull from an overhead position.

Front 22

Emergency Moves

Back 22

a move in which the patient is dragged or pulled from a dangerous scene before initial assessment and care are provided.

• Performed if there is some potential danger for you or the patient
• Performed if necessary to reach another patient who needs lifesaving care
• Performed if unable to properly assess patient due to location

Front 23

Urgent Moves

Back 23

• Used to move a patient who has potentially unstable injuries
• Use the rapid extrication technique to move patients seated in a vehicle.

Front 24

When to Use Rapid Extrication Technique

Back 24

• Vehicle or scene is unsafe.
• Patient cannot be properly assessed.
• Patient requires immediate care.
• Patient’s condition requires immediate transport.
• Patient is blocking access to another seriously injured patient.

Front 25

Rapid Extrication

Back 25

• Provide in-line support and apply cervical collar.
• Rotate patient as a unit.
• Lower patient to the backboard.

Front 26

Emergency Moves - One person

Back 26

One-Rescuer Drags, Carries, and Lifts (Pack Strap)
One-Rescuer Drags, Carries, and Lifts (One-person walking assist, Fire Fighter's Carry)
One-Rescuer Drags, Carries, and Lifts (Front Cradle, Fire Fighter's Drag)
One-Person Rapid Extrication

Front 27

Emergency Moves - multiple people

Back 27

Arm Drag
Arm - Arm Drag
Clothes Drag
Blanket Drag

Front 28

Transfer Moves

Back 28

Direct Carry
Drawsheet Method

Front 29

Scoop Stretcher

Back 29

• Adjust stretcher length.
• Lift patient slightly and slide stretcher into place, one side at a time.
• Lock stretcher ends together.
• Secure patient and transfer to the cot.

Front 30

Geriatrics

Back 30

• Emotional concerns – Fear
• Skeletal concerns – Osteoporosis – Rigidity – Kyphosis – Spondylosis
• Pressure sores
• Use special immobilizing techniques.
• Be compassionate.

Front 31

Bariatrics

Back 31

• “Care of the obese”
• Increase in back injuries among EMT's
• Manufacturing of higher capacity equipment
• Use proper lifting techniques.

Front 32

Wheeled Ambulance Stretcher

Back 32

• Most commonly used device
• Has specific head and foot ends
• Has a folding undercarriage
• EMT-B must be familiar to specific features of cots used in the ambulance.

Front 33

Loading the Wheeled Ambulance Cot

Back 33

Tilt the head of the cot upward.
– Place it into the patient compartment.
Release the undercarriage lock and lift.
Roll the cot into ambulance.
Secure the cot to ambulance clamps.

Front 34

Patient-Moving Equipment

Back 34

Stair Chair
Scoop Stretcher
Backboard
Basket Stretcher
Flexible stretcher
Portable Stretcher

Front 35

Non-Urgent Moves

Back 35

Direct Ground Lift
Extremity Lift

Front 36

wheeled ambulance stretcher

Back 36

a specially designed stretcher that can be rolled along the ground and has a collapsible carriage that allows it to be loaded into the ambulance. (also called the cot or the ambulance cot)

Front 37

stair chair

Back 37

a lightweight folding device that is used to carry a conscious, seated patient up or down the stairs.

Front 38

scoop stretcher

Back 38

designed to be split into two or four sections that can be fitted around a patient who is lying on the ground or other relatively flat surfaces.

Front 39

what is the rapid extrication technique?

Back 39

to move a patient from a sitting position inside a vehicle to supine on a backboard in less than one minute when conditions do not allow for standard immobilization.

Front 40

power lift

Back 40

a lifting technique in which the EMT's back is held upright, with legs bent, and the patient is lifted when the EMT straightens the legs to raise the upper body and arms.

Front 41

power grip

Back 41

a technique in which the litter or backboard is gripped by inserting each hand under with the palm facing up and the thumb extended, fully supporting the underside of the handle on the curved palm with the fingers and the thumb.

Front 42

portable stretcher

Back 42

a stretcher with a strong rectangular tubular metal frame and rigid fabric stretched across it

Front 43

flexible stretcher

Back 43

a stretcher that is a rigid carrying device when secured around a patient but can be folded up or rolled when not in use.

Front 44

basket stretcher

Back 44

rigid stretcher commonly used in technical and water rescues that surrounds and supports the patient yet allows water to drain through holes in the bottom. also called a Stokes litter.

Front 45

backboard

Back 45

device used to provide support to a patient who is suspected of having a hip, pelvic, spinal, or lower extremity injury. also called a spine board, trauma board, or long board.

Front 46

Direct Ground Lift

Back 46

used for patients who are found lying supine on the ground with no suspected spinal injury.

Front 47

Extremity Lift

Back 47

used for patients who are found lying supine or in a sitting position with no suspected spinal or extremity injuries.

Front 48

Review and evaluate your call:

Back 48

- procedures that need more practice
- equipment that needs to be cleaned or repaired
- skills that you need to review or acquire

Front 49

Which conditions call for special lifting and moving techniques?

Back 49

head injuries
shock
spinal injury
pregnancy

Front 50

lifting - chest pain or difficulty breathing

Back 50

sit in position of comfort, as long as not hypotensive

Front 51

lifting - spinal injuries

Back 51

should be immobilized in supine position on a backboard

Front 52

lifting - shock

Back 52

packaged and moved in a Trendelenburg position with legs elevated 6" to 12"

Front 53

lifting - pregnant and hypotensive

Back 53

positioned and transported on left sides

Front 54

lifting - unresponsive patients with suspected spinal injury

Back 54

position into recovery position by rolling patient onto side without twisting body

Front 55

lifting/transporting - nauseated/vomiting patient

Back 55

position in position of comfort but be able to manage airway

Front 56

when is the only time you can grasp a cot or backboard with the hand placed palm down over the handle?

Back 56

when you are standing at the front end with your back to the cot, such as in the diamond carry.

Front 57

Where is the weight on a patient?

Back 57

if in supine position or lying in a semi-sitting position then between 68% and 78% of the body weight is in the torso. therefore more of the patient's weight rests on the head half. (note a stronger person should also carry the head)

Front 58

patients should be carried in which direction?

Back 58

feet first so the person in the front has less weight since they have to walk forward, grip the handles with their back to the device. this also allows the patient to see where they are going. (except when going up stairs - then carry head first).

Front 59

orders that initiate lifting should

Back 59

be given in two parts: a preparatory command and a command of execution. example: all ready to stop. stop!

Front 60

when using a countdown

Back 60

specify if you are going to lift on three or after three

Front 61

you should not attempt to lift a patient 250 lbs or more without

Back 61

four rescuers. special equipment and techniques could be required for patients over 300 lbs.