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Operations: Lifting and Moving Patients

Level 4

Lifting and Moving Patients EMT Refresher Course EMSNeeds.com Continuing Education

Overview | Assessment | Treatment | Roles

Objectives

Lifting and Moving Patients EMT Refresher Course

In this Lifting and Moving course you will earn 1 CE hour. This course is accredited for all levels since all EMS personnel are technically First Responders.

At the end of this course you will be able to:

  • Define body mechanics.
  • Discuss the guidelines and safety precautions that need to be followed when lifting a patient.
  • Describe the indications for an emergency move.
  • Describe the indications for assisting in non-emergency moves.
  • Discuss the various devices associated with moving a patient in the out-of-hospital arena.
  • Explain the rationale for properly lifting and moving patients.
  • Explain the rationale for an emergency move.

References for content used by permission are on the left side under "EMS Resources."

There are four sections: Overview, Assessment, Treatment, and Roles. Take the section tests in order by clicking the Take Test button. Your results are saved if you are interrupted. Then do the next section—no lost time or effort with mini-test sections!

EMS Course Levels

Overview

Many First Responders are injured every year because they attempt to lift or move patients improperly. When to move a patient is determined by both the patient's condition and the environment in which they ares found. The determination of how to move the patient is made by considering the complaint, the severity of the condition and the location.

 

Definitions

  • Anterior - front
  • Posterior - back
  • Portable stretcher - a board or cloth with handles used to carry patients.
  • Stair chair - a folding chair used to move patients who can sit upright.
Emergency Stop
Assessment

Principles of Moving Patients

In general, a patient should be moved immediately (emergency move) only when there is an immediate danger to the patient if not moved:

  • Fire or danger of fire;
  • Explosives or danger of explosion;
  • Inability to protect the patient from other hazards at the scene;
  • Inability to gain access to other patients in a vehicle who need life-saving care; or
  • Life-saving care cannot be given because of the patient's location or position, e.g., a cardiac arrest patient sitting in a chair or lying on a bed.

If there is no threat to life, the patient, when ready for transportation, should be moved by the EMS crew.

lifting
Treatment

Body Mechanics/Lifting Techniques Safety Precautions Guidelines for Lifting

Body mechanics refer to what is the best way to use your body to move or lift a patient. Lift with your legs, not your back. Keep weight as close to body as possible.

  • Consider the weight of a patient and the need for help.
  • Know your own physical ability and limitations.
  • Lift without twisting.
  • Have your feet positioned properly.
  • Communicate clearly and frequently with partner and other EMS providers.

Emergency Moves

  • The greatest danger in moving a patient quickly is the possibility of aggravating a spine injury.
  • In an emergency, every effort should be made to pull the patient in the direction of the long axis of the body to provide as much protection to the spine as possible.
  • It is impossible to remove a patient from a vehicle quickly and at the same time provide much protection to the spine.
  • If the patient is on the floor or ground, he can be moved by:
    • Pulling on the patient's clothing in the neck and shoulder area.
    • Putting the patient on a blanket and dragging the blanket.
    • Putting the First Responder's hands under the patient's armpits (from the back), grasping the patient's forearms and dragging the patient.
  • Never pull the patient's head away from the neck and shoulders.
  • Non-urgent moves are performed with other responders.

Direct Ground Lift (No Suspected Spine Injury)

  • Two or three rescuers line up on one side of the patient.
  • Rescuers kneel on one knee (preferably the same for all rescuers).
  • The patient's arms are placed on his/her chest if possible.
  • The rescuer at the head places one arm under the patient's neck and shoulder and cradles the patient's head. The rescuer places his/her other arm under the patient's lower back.
  • The second rescuer places one arm under the patient's knees and one arm above the buttocks.
  • If a third rescuer is available, he should place both arms under the waist and the other two-rescuers slide their arms either up to the mid-back or down to the buttocks as appropriate.
  • On signal, the rescuers lift the patient to their knees and roll the patient in toward their chests.
  • On signal, the rescuers stand and move the patient to the stretcher.
  • To lower the patient, the steps are reversed.

Extremity Lift (No Suspected Extremity Injuries)

  • One-rescuer kneels at the patient's head and one kneels at the patient's side by the knees.
  • The rescuer at the head places one hand under each of the patient's shoulders while the rescuer at the foot grasps the patient's wrists.
  • The rescuer at the head slips his/her hands under the patient's arms and grasps the patient's wrists.
  • The rescuer at the patient's foot slips his/her hands under the patient's knees.
  • Both rescuers move up to a crouching position.
  • The rescuers stand up simultaneously and move with the patient to a stretcher.

Transfer of Supine Patient from Bed to Stretcher or Direct Carry

  • Position cot perpendicular to bed with head end of cot at foot of bed.
  • Prepare cot by unbuckling straps and removing other items.
  • Both rescuers stand between bed and stretcher, facing patient.
  • First rescuer slides arm under patient's neck and cups patient's shoulder.
  • Second rescuer slides hand under hip and lifts slightly.
  • First rescuer slides other arm under patient's back.
  • Second rescuer places arms underneath hips and calves.
  • Rescuers slide patient to edge of bed.
  • Lift/curl the patient toward the rescuers' chests.
  • Rescuers rotate and place patient gently onto cot.

Draw Sheet Method

  • Loosen bottom sheet of bed.
  • Position cot next to bed.
  • Prepare cot: Adjust height, lower rails, unbuckle straps.
  • Reach across cot and grasp sheet firmly at patient's head, chest, hips and knees.
  • Slide patient gently onto cot.

Patient Positioning

  • An unresponsive patient without trauma should be moved into the recovery position by rolling the patient onto his/her side (preferably the left).
  • A patient with trauma should not be moved until additional EMS resources can evaluate and stabilize the patient.
  • A patient experiencing pain or discomfort or difficulty breathing should be allowed to assume a position of comfort.
  • A patient who is nauseated or vomiting should be allowed to remain in a position of comfort; however, the First Responder should be positioned appropriately to manage the airway.

Lift into Ambulance

 

Lifting on a portable stretcher


Roles and Responsibilities

With common back injuries to EMS, remember to lift with your legs, not your back. Move patients that are in immediate danger. Position patients to prevent further injury.

Assist other EMS responders in lifting and moving. Communicate clearly and frequently with other First Responders.




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