Emergency Care (Chapter 5) Lifting And Moving Patients

Front 1

Body Mechanics

Back 1

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

Front 2

What should you consider before lifting any patients?

Back 2

THE OBJECT: weight, will you require additional help?

YOUR LIMITATIONS: EMT's of similar strength and height can life and carry together more easily.

COMMUNICATION: continue to communicate with your partner to make the lift more comfortable.

Front 3

Proper Lifting Technique

Back 3

- Position your feet propertly
- Use your legs
- Never turn or twist
- Do not compensate when lifting with one hand (keep your back straight)
- Keep the weight as close to your body as possible
- Use a stair chair when carrying a patient on stairs whenever possible.

Front 4

Power Lift

Back 4

A lift from a squating position with weight to be lifted close to the body, feet apart and flat on the ground, body weight on or just behind balls of feet, back locked in. The upper body is raised before the hips.

Also called the Squat-Lift Position

Front 5

Power Grip

Back 5

Griping with as much hand surface as possible in contact with the object being lifted, all fingures bent at the same angle, hands at least 10 inches apart.

Front 6

When reaching you should...

Back 6

- Keep your backin a locked-in position
- Avoid twisting while reaching
- Avoid reaching more than 15 to 20 inches in front of your body
- Avoid prolonged reaching when strenous effort is required

Front 7

When pushing or pulling you should...

Back 7

- Push, rather than pull, whenever possible
- Keep your back locked-in
- Keep the line of pull through the center of your body by bending your knees
- Keep the weight close to your body
- If the weight is below your waist level, push or pull from a kneeling position
- Avoid pushing or pulling overhead
- Keep your elbows bent and arms close to your sides

Front 8

Emergency Moves

Back 8

- The scene is hazardous
- Care of life-threatening conditions require repositioning
- You must reach other patients

*To minimize or prevent aggravation of the injury, move the patient in the direction of the LONG AXIS of the body when possible

**NOT ABLE TO PRECAUTION FOR SPINAL INJURY

Front 9

Urgent Moves

Back 9

- Patients must be moved quickly but unlike emergency moves, urgant moves are preformed with precautions for spinal injuries.
- The required treatment can only be preformed if the patient is moved.
- Factors at the scene cause patient decline.

Front 10

One-Rescuer Drags

Back 10

- Clothes drag
- Incline drag (always head first)
- Shoulder drag
- Foot drag
- Firefighters drag
- Blanket drag

Front 11

One Rescuer
(assist/lifts)

Back 11

- One rescuer assist
- Craddle Carry
- Pack strap carry
- Firefighters carry
- Piggy bank carry

Front 12

One-Rescuer Assist

Back 12

- Place patients arm around your neck, grasping her hand in yours.
- Place your other arm around the patients waist.
- Help patient walk to safety.
- Be prepared to chance movement technique if level of danger increases.
- Be sure to comunicate with patient about obstacles, uneven terrain, and so on.

Front 13

Cradle Carry

Back 13

- Place one arm across patients back with your hand under her arm.
- Place your other arm under her knees and lift.
- If patient is conscious, have her place her near arm over your shoulder.
- NOTE: This carry places a lot of weight on the carriers back. It is ususally appropriate only for very light patients.

Front 14

Pack Strap Carry

Back 14

- Have patient stand.
- Turn your back to her, bringing her arms over your shoulders to cross your chest.
- Keep her arms as straight as possible, her armpits over your shoulders.
- Hold patients wrists, bend, and pull her onto your back.

Front 15

Firefighters Carry

Back 15

- Place your feet against patients feet and pull him towards you.
- Bend at waist and flex knees.
- Duck and pull him across your shoulder, keep holding one of his wrists.
- Use your free arm to reach between his legs and grasp his thigh.
- Weight of patient falls onto your shoulders.
- Stand up.
- Transfer your grip on thigh to patients wrists.

Front 16

Piggy Bank Carry

Back 16

- Assist the patient to stand.
- Place her arms over your shoulder so they cross your chest.
- Bend over and lift patient.
- While she holds on with her arms, crouch and grasp each leg.
- Use a lifting motion to move her onto your back.
- Pass your forearms under her knees and grasp her wrists.

Front 17

Two Rescuers
(assist/lifts)

Back 17

- Two-Rescuer Assist
- Firefighters Carry with Assist

Front 18

Non-Urgent Moves

Back 18

Moved only when ready for transportation using all precautions.

Front 19

Wheeled Stretcher

Back 19

(Stretcher, Cot, or Litter)
- Usually in a reclining position
- Beneficial to patients NOT suspected with neck or spinal injuries
- Safest level is closest to the ground when moving the patient
- Secure patient to stretcher befor lifting or moving
- Secure stretcher to ambulance

Front 20

Short and Long Backboards/Spineboards

Back 20

SHORT: used primarily for removing patients from vehicles when a neck or spine injury is suspected.

LONG: used for most other cases.

Front 21

Portable Stretcher
(aka: Folding Stretcher)

Back 21

- May be beneficial in multiple-casualty incidents
- May be canvus, aluminum, or heavy plastic and usually fold or collapse.

Front 22

Scoop Stretcher
(or Orthopedic Stretcher)

Back 22

- Splits into two pieces vertically, allowing the patients to be "scooped" by pushing the halves together under the patient
- Does NOT offer any support directly under the spine, so it is not recommended for patients with suspected spinal injury.

Front 23

Basket Stretcher
(or Stokes Stretcher)

Back 23

- Can be used to move a patient from one level to another or over rough terrain
- The basket should be lined with a blanket before positioning the patient

Front 24

Flexible Stretcher
(or Reeves Stretcher)

Back 24

- Is made of canvas or rubberized or other flexible material, often with wooden slats sewn into pockets and three carring handles on each side.
- Because of its flexibility, it can be useful in restricted areas or narrow hallways.

Front 25

Vacuum Mattress

Back 25

- The patient is placed on the device and air is withdrawn by means of a pump. The mattress then becomes rigid and conforming, padding voids naturally for greater comfort.
- Many services now use it.

Front 26

Moving a patient with suspected spine injury:

Back 26

- MUST have his head, neck and spine immobilized before being moved.
- IF the patient is in a vehicle you will perform manual stabilization, place a rigid cervical collar and maintain manual stabilization while immobilizeing him with a short spine board or vest until you may safely put him on a long spine board.
- IF tghe patient is lying down or standing, move him directly to a long spine board.
- IMMOBILITION IS MANDATORY WITH POSSIBLE SPINE INJURY

Front 27

Moving a patient with no suspected spine injury:

Back 27

Use any of the following lifts if it suits the cicrumstances:

- Extremity Lift
- Direct Ground Lift
- Draw-Sheet Method
- Direct Carry

Front 28

Extremity Lift

Back 28

One resuer slips hands under ther patients armpits and grasps the wrists, while the other rescuer grasps the patients knees.

Front 29

Direct Ground Lift

Back 29

- From ground level to stretcher.
- Two or more rescuers kneel, curl the patient to their chests, stand, then reverse the process to lower the patient to the stretcher.

Front 30

Draw-Sheet Method

Back 30

- From bed to stretcher.
- Grasp and pull the loosened bottom sheet of the bed.

Front 31

Direct Carry

Back 31

- From bed to stretcher.
- Two or more rescuers curl the patient to their chests, then reverse the process to lower the patient to the stretcher.

Front 32

How would you place a unresponsive patient?

Back 32

- With NO suspected spine injury should be placed in the recovery position (on his side) to aid dranage from his mouth and, if he vomits, to help prevent his breathing the vomit into his lungs.
- AVOID transporting the unresponsive patient in a chair-type device since the airway cannot be properly maintained.

Front 33

How would you place a patient who was not suspected of spine injury?

Back 33

- May be transported in a position of comfort.
- Use cautiously, in case the patient vomits
- Always monitor the patients airway and level of responsiveness.
- Remember that breathing is aided by raising the back of the stretcher.

Front 34

How would you place a patient who was suspected of a spine injury?

Back 34

- MUST be placed on a long backboard.

Front 35

How would you place a patient who was in shock?

Back 35

- Elevate patients legs 8 to 12 inches if no suspect of neck or spine injury.
- Elevate the foot end of the backboard 8 to 12 inches so that the patients entire body is inclined if you suspect neck or spine injury.

Front 36

Trendelenburg Position

Back 36

For a patient in shock with suspected neck or spinal injury. Lift backboard at bottom 8 to 12 inches so the entire body of the patient is inclined witht he head 8 to 12 inches lower than the feet.

Front 37

How would you (probably) transfer a patient to a hospital stretcher?

Back 37

By using a motified draw-sheet method