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© 2011 National Safety Council 23-1 LIFTING AND MOVING PATIENTS LESSON 23
© 2011 National Safety Council 23-2 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 23-3 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 23-4 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 patients weight close to your body
© 2011 National Safety Council 23-5 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 23-6 Patient Positioning Reposition patient only when necessary Reposition breathing, unresponsive, non-trauma patient in recovery position Dont move or reposition trauma patient unless necessary to treat life-threatening condition Allow responsive patient to assume comfortable position
© 2011 National Safety Council 23-7 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 23-8 Skill: Log Roll 1.Rescuer at patients head holds head in line with body as 2 or 3 additional rescuers take position with hands at patients 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 23-9 Emergency Moves Use only if: Patient faces immediate danger You cannot give lifesaving care because of location or position
© 2011 National Safety Council 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 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 Rescuer Emergency Drags Pull or drag patient in direction of long axis of body Dont 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, patients condition and situation
© 2011 National Safety Council Rescuer Emergency Drags (continued) Clothing drag Blanket drag Shoulder drag Firefighters drag Upper extremity drag Upper extremity drag for rapid extrication
© 2011 National Safety Council Emergency Carries Used when patient must be moved immediately 1 or more rescuers may carry patient Method used depends on patients size and condition and the situation
© 2011 National Safety Council With All Emergency Carries Use good body mechanics and lifting techniques Dont try to lift or carry person before checking for injuries
© 2011 National Safety Council Moving Patients – If Alone Unresponsive patient who cannot safely be dragged – Packstrap carry
© 2011 National Safety Council Moving Patients – If Alone (continued) Lighter patient or child Cradle carry (responsive or unresponsive patients) Piggyback carry (responsive patient)
© 2011 National Safety Council Piggyback Carry Support patients weight with your arms under patients thighs If able, have patient clasp hands and lean forward; if not able, grasp patients hands with yours to keep patient from falling back
© 2011 National Safety Council Firefighters Carry Support patients weight on your shoulders while holding patients thigh and arm
© 2011 National Safety Council Moving Patients – If Alone (continued) Responsive patient who can walk with help – 1-rescuer walking assist
© 2011 National Safety Council Moving Patients – With Help Responsive patient: 2-rescuer walking assist 2-rescuer cradle carry 2-rescuer extremity carry
© 2011 National Safety Council Rescuer Cradle Carry Both rescuers clasp arms behind patients back and under the legs
© 2011 National Safety Council Rescuer Extremity Carry To carry patient down steps: Forward rescuer grasps patients legs under the knees Rear rescuer reaches under patients armpits from behind to grasp patients forearms
© 2011 National Safety Council Rescuer Walking Assist Both rescuers position patients arms over their shoulders Each rescuer grasps patients wrist, with the other arm around patients waist
© 2011 National Safety Council 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 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 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 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 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 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 Skill: Extremity Lift 1.The first rescuer kneels at the patients head and the second rescuer kneels by the patients feet. The rescuer at the head places 1 arm under each of the patients shoulders while the rescuer at the feet positions the patients arms. 2.The rescuer at the head then slips his or her hands under the patients armpits and grasps the patients wrists and crosses them on the patients chest. The rescuer at the feet turns around and reaches his or her hands back and under the patients knees.
© 2011 National Safety Council 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 Extremity Lift – Alternative Position Previous technique is preferred if rescuers must move some distance or over inclined surface Alternatively, rescuer at patients feet may face patient and other rescuer Can be used to move patient to side or short distance
© 2011 National Safety Council 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 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 Skill: Direct Carry (continued) 2.The rescuer at the head slides 1 arm under the patients neck and cups the patients farther shoulder. The second rescuer slides 1 arm under the patients hips and lifts slightly. The rescuer at the head slides his or her other arm under the patients back, and the second rescuer places his or her other arm underneath the patients thighs near the knees. Together, both rescuers slide the patient to the edge of the bed.
© 2011 National Safety Council 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 Draw Sheet Transfer
© 2011 National Safety Council 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 patients head, chest, hips and knees 3.Slide patient gently onto stretcher
© 2011 National Safety Council 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 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 Typical Equipment for Packaging and Moving Patients Long backboard Kendrick Extrication Device (KED) Standard stretcher Portable stretcher Orthopedic stretcher Basket stretcher Stair chair
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