Transcript *************f****2***********2**************`2**(2**)2***2**+2**,2**

LESSON 23
LIFTING AND
MOVING PATIENTS
© 2011 National Safety Council
23-1
Introduction
• Moving injured patient likely to cause further injury
• In most cases wait for professional help
• May have to move patient to protect from danger at
scene
• May need to assist other EMS personnel
© 2011 National Safety Council
23-2
Body Mechanics
• Back injury is hazard for EMRs
• To minimize risks, use good body
mechanics
• Body mechanics are principles of
using your body safely
© 2011 National Safety Council
23-3
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 (power lift)
• Keep patient’s weight close to your body
© 2011 National Safety Council
23-4
Body Mechanics and
Lifting Techniques (continued)
• Lift straight up, maintain good posture
• Avoid twisting your back during lift
• Use good technique when reaching
• When possible, push rather than pull
• Communicate clearly with your partner and other
EMS providers
© 2011 National Safety Council
23-5
Patient Positioning
• Reposition patient only when necessary
• Reposition breathing, unresponsive, non-trauma
patient in recovery position
• Don’t move or reposition trauma patient unless
necessary to treat life-threatening condition
• Allow responsive patient to assume comfortable
position
© 2011 National Safety Council
23-6
Log Roll
• Use log roll to move patient from prone to supine
• 3-5 rescuers are needed to safely roll patient
• For trauma patient with spinal injury, stabilize head in
line with body during move
© 2011 National Safety Council
23-7
Skill: Log Roll
1. Rescuer at patient’s head holds head in line with
body as 2 or 3 additional rescuers take position with
hands at patient’s lower and upper leg, hip and
torso, and shoulder
2. On the count of responder at the head, rescuers in
unison roll patient toward them, with head held in
line and spine straight
3. Rescuers complete log roll, positioning patient on
back with head and neck still in line with body
© 2011 National Safety Council
23-8
Emergency Moves
Use only if:
• Patient faces immediate
danger
• You cannot give
lifesaving care because
of location or position
© 2011 National Safety Council
23-9
Risk of Spinal Injury
• Moving patient quickly risks aggravating a spinal injury
• Keep head and neck in line with spine
• It is impossible to completely protect spine while
removing patient from a vehicle quickly
© 2011 National Safety Council
23-10
Extrication from Vehicles
• EMRs 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
© 2011 National Safety Council
23-11
1-Rescuer Emergency Drags
• Pull or drag patient in direction of long axis of body
• Don’t drag patient sideways
• Avoid twisting neck and trunk
• Never pull head away from neck and shoulders
• Risk of spinal injury can be minimized by using
blanket, rug, board, etc.
• Choice of move depends on materials at hand,
patient’s condition and situation
© 2011 National Safety Council
23-12
1-Rescuer Emergency Drags
(continued)
• Clothing drag
• Blanket drag
• Shoulder drag
• Firefighter’s drag
• Upper extremity drag
• Upper extremity drag for rapid extrication
© 2011 National Safety Council
23-13
Emergency Carries
• Used when patient must be moved immediately
• 1 or more rescuers may carry patient
• Method used depends on patient’s size and condition
and the situation
© 2011 National Safety Council
23-14
With All Emergency Carries
• Use good body mechanics and lifting techniques
• Don’t try to lift or carry person before checking for injuries
© 2011 National Safety Council
23-15
Moving Patients – If Alone
• Unresponsive patient who
cannot safely be dragged –
Packstrap carry
© 2011 National Safety Council
23-16
Moving Patients – If Alone
• Lighter patient or child
 Cradle carry (responsive
or unresponsive patients)
 Piggyback carry
(responsive patient)
© 2011 National Safety Council
23-17
(continued)
Piggyback Carry
• Support patient’s weight
with your arms under
patient’s thighs
• If able, have patient clasp
hands and lean forward;
if not able, grasp
patient’s hands with
yours to keep patient
from falling back
© 2011 National Safety Council
23-18
Firefighter’s Carry
• Support patient’s weight
on your shoulders while
holding patient’s thigh
and arm
© 2011 National Safety Council
23-19
Moving Patients – If Alone
• Responsive patient who
can walk with help –
1-rescuer walking assist
© 2011 National Safety Council
23-20
(continued)
Moving Patients – With Help
Responsive patient:
• 2-rescuer walking assist
• 2-rescuer cradle carry
• 2-rescuer extremity carry
© 2011 National Safety Council
23-21
2-Rescuer Cradle Carry
• Both rescuers clasp
arms behind patient’s
back and under the legs
© 2011 National Safety Council
23-22
2-Rescuer Extremity Carry
To carry patient down steps:
• Forward rescuer grasps
patient’s legs under the
knees
• Rear rescuer reaches
under patient’s armpits
from behind to grasp
patient’s forearms
© 2011 National Safety Council
23-23
2-Rescuer Walking Assist
• Both rescuers position patient’s
arms over their shoulders
• Each rescuer grasps patient’s
wrist, with the other arm around
patient’s waist
© 2011 National Safety Council
23-24
Urgent Moves
• Used when patient must be moved urgently and
quickly, but situation allows a little more time to ensure
patient safety
• An urgent move may be needed for:
- Patients with altered mental status
- Patients with inadequate breathing
- Patients in shock
- Other situations involving potential danger to patient
© 2011 National Safety Council
23-25
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
• Generally used to prepare patient for transport
• Stabilize patient before moving
• Minimize any chance of aggravating illness or injury
• These moves are usually performed by responding
EMS personnel
© 2011 National Safety Council
23-26
Before Using a
Non-Emergency Move
• Complete primary and
secondary assessments
• Correct any life-threatening
problems
• Immobilize all suspected
fractures and dislocations
• Ensure there are no signs
and symptoms of neck or
spinal injury
© 2011 National Safety Council
23-27
Direct Ground Lift
• Non-emergency move for patients without suspected
neck or spinal injuries
• Used to lift and carry supine patient from ground to
stretcher
© 2011 National Safety Council
23-28
Skill: Direct Ground Lift
1. Rescuers kneel on one side of the patient
2. Rescuers position their hands on the patient
3. Rescuers lift patient to their knees and roll the
patient in toward their chests
4. Rescuers stand and move patient to stretcher, and
reverse steps to lower patient
© 2011 National Safety Council
23-29
Extremity Lift
• 2-rescuer technique used for patients without
suspected injury to neck, spine or extremities
• May be used with responsive or unresponsive patient
• May be used to carry patient a short distance or move
patient from chair to stretcher
• May be used to carry patient through a tight space
© 2011 National Safety Council
23-30
Skill: 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 1 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.
© 2011 National Safety Council
23-31
Skill: Extremity Lift
(continued)
3. Both rescuers move to a crouching position and
assess their grip on the patient.
4. On a signal from the rescuer at the head, the
rescuers stand up simultaneously and move forward
with the patient.
© 2011 National Safety Council
23-32
Extremity Lift – Alternative Position
• Previous technique is preferred if rescuers must move
some distance or over inclined surface
• Alternatively, rescuer at patient’s feet may face patient
and other rescuer
• Can be used to move patient to side or short distance
© 2011 National Safety Council
23-33
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
© 2011 National Safety Council
23-34
Skill: 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.
© 2011 National Safety Council
23-35
Skill: Direct Carry
(continued)
2. The rescuer at the head slides 1 arm under the
patient’s neck and cups the patient’s farther shoulder.
The second rescuer slides 1 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.
© 2011 National Safety Council
23-36
Skill: 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.
© 2011 National Safety Council
23-37
Draw Sheet Transfer
© 2011 National Safety Council
23-38
Skill: 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
© 2011 National Safety Council
23-39
Draw Sheet Transfer –
Alternative Method
1. Rescuers first roll patient onto one
side, and 1 rescuer holds the
patient in that position; second
rescuer positions a sheet with
rolled edge beneath patient
2. The patient is rolled back into
original position, now on the sheet
3. The rescuers together pull on
sheet to slide patient onto stretcher
© 2011 National Safety Council
23-40
EMS Equipment for
Moving Patients
• EMRs often assist EMTs with
packaging and moving patients
• Wide range of commercial
devices is used
• Learn devices you are likely to
encounter in your area
© 2011 National Safety Council
23-41
Typical Equipment for Packaging
and Moving Patients
• Long backboard
• Kendrick Extrication
Device (KED)
• Standard stretcher
• Portable stretcher
• Orthopedic stretcher
• Basket stretcher
• Stair chair
© 2011 National Safety Council
23-42