EMT-B, Ch 8: Lifting & Moving

Skill Drill: What are the three steps of performing the direct ground lift?

1) Line up on one side of the patient, with one provider at the head, one at the waist, and one at the patient's knees. All providers should be kneeling. Place the patient's arms on his or her chest, if possible. 2) On command, lift the patient to knee level. 3) On command, roll the patient toward your chest, and then stand and carry the patient to the stretcher.

Skill Drill: What are the two steps of moving a patient on stairs with a stretcher?

1) Strap the patient securely. Make sure one strap is tight across the upper torso, under the arms, and secured to the handles to prevent the patient from sliding. 2) Carry a patient downstairs with the foot end first, always keeping the head elevated.

Skill Drill: What are the eight steps of performing the rapid extrication technique?

1) The first provider provides in-line manual support of the head and cervical spine. 2) The second provider gives commands, applies a cervical collar, and performs the primary assessment. 3) The second provider supports the torso. The third provider frees the patient's legs from the pedals and moves the legs together, without moving the pelvis or spine. 4) The second provider and the third provider rotate the patient as a unit in several short, coordinated moves. The first provider (relieved by the fourth provider as needed) supports the patient's head and neck during rotation (and later steps). 5) The first (or fourth) provider places the backboard on the seat against the patient's buttocks. (Use of a backboard may depend on local protocols.) 6) The third provider moves to an effective position for sliding the patient. The second and the third providers slide the patient along the backboard in coordinated 8-to-12-inch (20-to-30-cm) moves until the patient's hips rest on the backboard. 7) The third provider exits the vehicle, moves to the backboard opposite the second provider, and they continue to slide the patient until the patient is fully on the backboard. 8) The first (or fourth) provider continues to stabilize the head and neck while the second and third providers carry the patient away from the vehicle and onto the prepared stretcher.

Skill Drill: What are the three steps of performing the extremity lift?

1) The patient's hands are crossed over the chest. Grasp the patient's wrists or forearms and pull the patient to a sitting position. 2) Your partner moves to a position between the patient's legs, facing in the same direction as the patient, and places his or her hands under the knees. 3) Rise to a crouching position. On command, lift and begin to move.

Skill Drill: What are the four steps of moving loading a wheeled stretcher into an ambulance?

1) Tilt the head of the stretcher upward, and place it into the patient compartment with the wheels on the floor and the safety bar latched on the hook. 2) The second EMT on the side of the stretcher releases the undercarriage lock and lifts the undercarriage. 3) Roll the stretcher into the back of the ambulance. 4) Secure the stretcher to the clamps mounted in the ambulance.

If an injured patient needs to be moved but is not in immediate danger from fire or building collapse, you should first: A. order the equipment you need for extrication. B. check the patient's airway, breathing, and circulation. C. remove the patient with the rapid extrication technique. D. determine the number of people you will need to move the patient.

B. check the patient's airway, breathing, and circulation. --> The only time your attention should be directed away from the primary assessment of the patient is when the patient's life or your life is in immediate danger.

When lifting a stretcher using the power lift, you should: A. bend at the hips, knees, back, and arms. B. bend at the waist and keep your back straight. C. place your hands palms up on the litter handle. D. place your hands palms down on the litter's side bars.

C. place your hands palms up on the litter handle. --> When lifting any heavy object, your hands should be facing palms up; this provides better lifting power and is not as stressful on the wrists.

When two EMTs are lifting a patient on a long backboard, they should: A. lift the patient from the sides of the board. B. make every attempt to lift with their backs. C. position the strongest EMT at the foot of the board. D. position the strongest EMT at the head of the board.

D. position the strongest EMT at the head of the board. --> Since more than half of the patient's weight is distributed to the head end of a backboard or stretcher, you should always ensure that the strongest EMT is at that position. This will reduce the risk of injury to less strong personnel as well as the risk of dropping the patient.

Proper guidelines for correct reaching include all of the following, EXCEPT: A. avoiding twisting your back. B. avoiding hyperextension of your back. C. keeping the back in a locked-in position. D. reaching no more than 30 inches in front of your body.

D. reaching no more than 30 inches in front of your body. --> When reaching, you should keep your back in a locked-in position, and avoid twisting or hyperextending your back. Do not reach more than 15-20 inches in front of your body.

The rapid extrication technique is a: A. nonurgent move to remove a patient from a vehicle. B. technique used to transfer a patient from a bed to a stretcher. C. technique used to lift a patient with no suspected spinal injury onto a stretcher. D. technique used to quickly remove a patient from a vehicle and onto a backboard.

D. technique used to quickly remove a patient from a vehicle and onto a backboard. --> With the rapid extrication technique, a seriously injured patient can be moved from a sitting position in a vehicle to a supine position on a backboard while protecting the spine at the same time.

True/False: Backboards are commonly used for patients who are found lying down.

True: Backboards are commonly used for patients who are found lying down.

True/False: Whenever you grasp a stretcher or backboard, your hands should be at least 10 inches (25 cm) apart.

True: Whenever you grasp a stretcher or backboard, your hands should be at least 10 inches (25 cm) apart.

Which of the following statements regarding patient weight distribution is correct? a. The majority of a horizontal patient's weight is in the torso. b. Most of the patient's weight rests on the foot end of the stretcher. c. A semi-sitting patient's weight is equally distributed on both ends. d. The EMT at the patient's head will bear the least amount of weight.

a. The majority of a horizontal patient's weight is in the torso.

In a ________ carry, one provider must walk backward. a. Two-person b. One-handed c. Firefighter d. Diamond

a. Two-person --> In a two-person carry, one of the providers must walk backward.

You are dispatched to a house where an 80-year-old woman has fallen in an upstairs bathroom and hit her head on the sink. When you arrive she is unconscious. Which is the best equipment to use to move her to the ambulance? a. Stair chair b. Backboard c. Stretcher d. Stokes litter

b. Backboard --> Because the patient is unconscious and must be moved down a flight of stairs, a backboard is the best equipment to move her.

When lifting a backboard, you should use which of the following? a. Lateral lift b. Diamond carry c. Dead lift d. Power lift

b. Diamond carry --> A patient on a backboard or stretcher can be lifted and carried by four providers in a diamond carry, with one provider at the head end of the device, one at the foot end, and one at each side of the patient's torso.

You are called to a scene where a 40-year-old man was clearing trees in a remote area and was struck by a falling tree. When you arrive, he is conscious but the tree is laying across his lower legs. How should you remove the victim once the tree is removed? a. Extremity lift b. Direct lift c. Power lift d. Clothes drag

b. Direct lift --> You should use a direct lift for patients with no suspected spinal injury who are lying supine and need to be carried some distance to be placed on a stretcher.

You are transporting a 50-year-old patient who reports respiratory distress but has no other indications of other injury or illness. What is the best position in which to place this patient? a. Immobilized b. Fowler/semi-Fowler c. Supine d. Recovery

b. Fowler/semi-Fowler --> The best placement for this patient is a Fowler or semi-Fowler position.

To minimize risk of injuring yourself when lifting or moving a patient, you should: a. Flex at the waist instead of the hips. b. Keep the weight as close to your body as possible. c. Use a direct carry whenever possible. d. Avoid the use of log rolls or body drags.

b. Keep the weight as close to your body as possible.

The proper technique for using the power grip is to: a. Rotate your palms down. b. Lift with your palms up. c. Position your hands about 6" apart. d. Hold the handle with your fingers.

b. Lift with your palms up.

You are attending to a 26-year-old female who is 34 weeks pregnant with her first child. Your patient has been having lower abdominal pains and cramping for the past two hours. In placing your patient on the stretcher and preparing for transport, you should place her: a. Supine with her legs elevated. b. On her left side. c. In the Fowler position. d. In a position of comfort.

b. On her left side.

Which of the following is an example of an urgent move? a. Extremity lift b. Rapid extrication technique c. Clothes drag d. One-person walking assist

b. Rapid extrication technique --> A rapid extrication technique is an urgent move.

The _________________ is both the mechanical weight-bearing base of the spinal column and the fused central posterior section of the pelvic girdle. a. Coccyx b. Sacrum c. Thorax d. Ischium

b. Sacrum

Which of the following conditions or situations presents the MOST unique challenge to the EMT when immobilizing an elderly patient on a long backboard? a. Patient disorientation. b. Naturally deformed bones. c. Abnormal spinal curvature. d. Joint flexibility.

c. Abnormal spinal curvature.

Which of the following statements regarding an emergency patient move is correct? a. The spine must be fully immobilized prior to performing an emergency move. b. It is not possible to perform an emergency move without injuring the patient. c. An emergency move is performed before the primary assessment and treatment. d. The patient is dragged against the body's long axis during an emergency move.

c. An emergency move is performed before the primary assessment and treatment.

It is essential that you _________________ your equipment to prevent the spread of disease. a. Properly store b. Incinerate c. Decontaminate d. Throw out

c. Decontaminate

You are responding to an accident where a 25-year-old female fell 15 feet while rock climbing. The terrain is steep and there is not much space to work. Which device should you use? a. Scoop stretcher b. Vacuum mattress c. Flexible stretcher d. Kendrick Extrication Device (KED)

c. Flexible stretcher --> A flexible stretcher can be used if the patient must be belayed or rappelled by ropes or is in a confined space.

Which of the following is the MOST appropriate device to use when immobilizing a patient with a suspected spinal injury? a. Wheeled stretcher b. Portable stretcher c. Long backboard d. Scoop stretcher

c. Long backboard

An EMT may injure his or her back, even if it is straight, if the: a. Hands are held too close to the legs. b. Shoulder is aligned over the pelvis. c. Force is exerted straight down the spine. d. Back is bent forward at the hips.

d. Back is bent forward at the hips.

Upon arriving at the scene of a motor vehicle crash, you find a single patient still seated in his car. There are no scene hazards. As you approach the vehicle, you note that the patient is semiconscious and has a large laceration to his forehead. You should: a. Apply a cervical collar and quickly remove the patient with a clothes drag. b. Slide a long backboard under his buttocks and lay him sideways on the board. c. Apply a vest-style extrication device before attempting to move the patient. d. Direct your partner to apply manual in-line support of the patient's head.

d. Direct your partner to apply manual in-line support of the patient's head.

When carrying a patient down a flight of stairs on a backboard, which person should be at the head end of the backboard? a. Jerry, who is 6'2" and strong b. Tina, who is 5'4" and is the most flexible of the team c. Tom, who is 5'10" and has average upper body strength and superior lower body strength d. Doug, who is 5'8" and a weightlifter

d. Doug, who is 5'8" and a weightlifter --> Doug should be at the head of the backboard because he is strong and is shorter than Jerry, the other strong team member.

You are attending to a 34-year-old male patient who requires transport to the hospital for assessment of his chronic back pain. The patient weighs over 750 pounds. Your bariatric stretcher has a wider surface area to allow for: a. Increased stability and leverage when lifting with more than two providers. b. Increased lifting capacity and patient weight load. c. Better stability when moving the patient on uneven ground. d. Increased patient comfort and dignity.

d. Increased patient comfort and dignity.

In contrast to typical wheeled ambulance stretchers, features of a bariatric stretcher include: a. A collapsible undercarriage. b. Weight capacity of up to 650 lb. c. Two safety rails on both sides of the stretcher. d. Increased stability from a wider wheelbase.

d. Increased stability from a wider wheelbase.

To facilitate a safe and coordinated move, the team leader should: a. Speak softly but clearly to avoid startling the patient. b. Never become involved in the move, only direct the move. c. Be positioned at the feet so the team can hear. d. Use preparatory commands to initiate any moves.

d. Use preparatory commands to initiate any moves.

It is impractical to apply a vest-type extrication device on a critically injured patient to remove him or her from a wrecked vehicle because it: A. takes too long to correctly apply. B. does not fully immobilize the spine. C. cannot be used on patients who are in their car. D. does not provide adequate stabilization.

A. takes too long to correctly apply. --> It takes several minutes to correctly apply a vest-type extrication device. This is too much time to waste when treating a critically injured patient. A long backboard would be more appropriate. Vest-type immobilization devices, when applied correctly, provide adequate spinal stabilization and are ideal to use in stable patients who need to be removed from their vehicle.

To extract a patient from the basement of a building, you must transport the patient up a flight of stairs. In doing this, you must ensure that: A. the elevated head of the backboard goes first. B. the backboard with the elevated foot end goes first. C. the backboard is slightly tilted to the left to distribute weight. D. the patient's feet are higher than his or her head, whichever end is carried first.

A. the elevated head of the backboard goes first. --> When you carry a patient upstairs or up an incline, you must ensure that the elevated head of the backboard or stretcher goes first. This will help to equally distribute the weight.

What is the first rule of lifting? A. Twist slowly when you lift. B. Keep your back in a straight position. C. Bend at the waist to pick something up. D. Use your arms to do most of the lifting.

B. Keep your back in a straight position. --> The first rule of lifting is to always keep your back in a straight, upright, position and use the powerful muscles of your thighs. Never twist while lifting.

An injured hang glider is trapped at the top of a large mountain and must be evacuated to the ground. The terrain is very rough and uneven. Which of the following devices would be the safest and most appropriate to use? A. Stair chair B. Stokes basket C. Scoop stretcher D. Long backboard

B. Stokes basket --> A basket stretcher, also called a Stokes basket, should be used to carry patients over rough or uneven terrain that is inaccessible by ambulance. Its closed-ended sides protect the patient from falling out of the device.

Skill Drill: What are the four steps of using the scoop stretcher?

1) Adjust the length of the stretcher. 2) Lift the patient slightly and slide the stretcher into place, one side at a time. 3) Lock the stretcher ends together, and avoid pinching both the patient and your fingers. 4) Secure the patient to the scoop stretcher, and transfer it to the stretcher.

Skill Drill: What are the three steps of performing the one-handed carry?

1) Face each other and use both hands. 2) Lift the backboard to carrying height. 3) Turn in the direction you will walk, and switch to using one hand.

Skill Drill: What are the two steps of performing the power lift?

1) Lock your back in a slight curve. Spread and bend your legs. Grasp the backboard, palms up and just in front of you. Balance and center the weight between your arms. 2) Position your feet, straddle the object, and distribute your weight evenly. Lift by straightening your legs, keeping your back locked in.

Skill Drill: What are the two steps of moving a patient with a stair chair?

1) Position and secure the patient on the chair with straps. Take your places at the head and foot of the chair. 2) Lower the chair to roll on landings and for transfer to the stretcher.

Skill Drill: What are the four steps of performing the direct carry?

1) Position the stretcher parallel to the bed. Secure the stretcher to prevent movement. Face the patient while standing between the bed and the stretcher. Position your arms under the patient's neck and shoulders. Your partner should keep his hands under the patient's knees. 2) Lift the patient from the bed in a smooth, coordinated fashion. 3) Slowly carry the patient to the stretcher. 4) Gently lower the patient onto the stretcher and secure with straps.

Skill Drill: What are the three steps of performing the diamond carry?

1) Position yourselves facing the patient. 2) The providers at each side turn the head-end hand palm down and release the other hand. 3) The providers at each side turn toward the foot end. The provider at the foot end turns to face forward.

7.Which of the following techniques is considered to be an emergency move? A. Extremity lift B. Supine transfer C. Firefighter's drag D. Direct ground lift

C. Firefighter's drag --> The firefighter's drag is a one-person technique that is used when a patient must be removed from a life-threatening situation immediately.

True/False: A power grip involves grasping a stretcher or backboard with the hand placed palm down over the handle.

False: A power grip involves inserting each hand under the handle with the palm facing up and the thumb extended upward. You should never grasp a stretcher or backboard with the hand placed palm down over the handle.

True/False: Lifting by extending the properly placed flexed legs is the most powerful way to lift and is called an emergency move.

False: Lifting by extending the properly placed flexed legs is the most powerful way to lift and is called a power lift.

When pulling a patient, you should extend your arms no more than _________________ in front of your torso. a. 15 to 20 inches b. 5 to 10 inches c. 10 to 15 inches d. 20 to 30 inches

a. 15 to 20 inches

To avoid the strain of unnecessary lifting and carrying, which of the following should you use when moving a patient from the ground onto a stretcher? a. Draw sheet method b. Direct carry c. Extremity lift d. Stair chair

a. Draw sheet method --> Using the draw sheet method can help you avoid the strain of unnecessary lifting and carrying.

When lifting the patient, it is imperative to use which proper body mechanics? a. Hold your back in an upright position. b. Keep your feet close together. c. Bend as far forward at the hips as possible. d. Extend your arms out as far as possible.

a. Hold your back in an upright position. --> You should keep your spine aligned and upright.

The MOST serious consequence of a poorly planned or rushed patient move is: a. Injury to your or your patient. b. Causing patient anxiety of fear. c. Confusion among team members. d. Unnecessarily waisting time.

a. Injury to your or your patient.

To protect a restrained patient and prevent him from using leverage to break free, the EMT should secure _________________ . a. One arm above the head. b. Only the patient's torso. c. Both arms at the patient's sides. d. Both arms above the head.

a. One arm above the head.

The scoop stretcher is also known as what? a. Orthopedic stretcher b. Flexible litter c. Basket litter d. Ambulance stretcher

a. Orthopedic stretcher --> A scoop stretcher is also called an orthopedic stretcher.

When moving a conscious, weak patient down a flight of stairs, you should: a. Place the wheeled stretcher at the bottom of the stairs and carry the patient down the stairs with a stair chair. b. Secure the patient to a scoop stretcher and carry them headfirst down the stairs to the awaiting stretcher. c. Collapse the undercarriage of the wheeled stretcher and carefully carry the patient down the stairs on the stretcher. d. Assist the patient in walking down the stairs and place them on the wheeled stretcher at the bottom of the stairs.

a. Place the wheeled stretcher at the bottom of the stairs and carry the patient down the stairs with a stair chair.

You are attending to a 22-year-old female patient who has overdosed. The patient is unresponsive in an upstairs bedroom. The most appropriate way to bring the patient downstairs is: a. Secured to a fracture board with the strongest provider at the head end. b. Secured to a stair chair with the strongest provider at the head end. c. Secured to a fracture board with the strongest provider at the foot end. d. Secured to a stair chair with the strongest provider at the foot end.

a. Secured to a fracture board with the strongest provider at the head end.

As you and your partner are carrying a stable patient down a flight of stairs in a stair chair, you feel a sudden, sharp pain in your lower back. You should: a. Stop the move and request additional lifting assistance. b. Stop the move and have the patient walk down the stairs. c. Guide your partner while moving the chair backwards. d. Reposition your hands and continue to move the patient.

a. Stop the move and request additional lifting assistance.