Lesson 5 Lifting and Moving PatientsIn most cases wait for professional help
May have to move victim to protect from danger at scene
May have to move victim to flat surface to provide CPR
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Body mechanics are principles of using your body safely
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Know your physical ability and limitations
Plan the lift
Test the load
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
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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
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Prevents aspiration
Continue to monitor breathing
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
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Skill:
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Extend victim’s arm farther from you above victim’s head
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Put forearm nearer victim’s head under victim’s nearer shoulder with hand under hollow of neck
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Roll victim away from you by pushing on victim’s flexed knee and lifting with forearm while hand stabilizes head and neck
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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
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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 shoulder
2. 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
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You cannot give lifesaving care because of location or position
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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
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Extrication from Vehicles
First Responders may be trained in rapid extrication using cervical collar and inline stabilization of head/neck
Follow local protocol
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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
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Method used depends on patient’s size, condition and situation:
Walking assist
Cradle carry
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Don’t try to lift/carry person before checking for injuries
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Pack-strap carry
Piggyback carry (responsive victim)
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
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Firefighter’s Carry
Support the patient’s weight on your shoulders while holding the patient’s thigh and arm
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One-person walking assist
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
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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
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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
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Complete primary/secondary assessment
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Non-emergency move for patients without suspected neck or spinal injuries
Used to lift/carry supine patient from ground to stretcher
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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
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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
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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.
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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
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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
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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.
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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.
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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
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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
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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
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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
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Long Backboard
Short Backboard