EM Chapter 3 Lifting and Moving Patients
Which of the following is a patient who could be transported on a stair chair?
A patient who is having difficulty breathing
You have been dispatched to a home where, upon entering, you note that there is smoke in the rear of the building. The patient is unconscious on the living room couch. You have about two to three minutes to get the patient out the front door. What type of move will this require?
An emergency move will be the most appropriate in this case. Because of the severity of the situation, you have a moment to decide how to get the patient out of the house. By the time you go back to the ambulance to get a stair chair, it may be too late. Consider an emergency move involving one of the drags to get the patient out of this hostile environment.
Where should you position the weight of the object being lifted?
As close to the body as possible
To avoid injuries while lifting and moving an obese patient over a long distance, what must always be present among team members?
Communication For team members to work together effectively, they need to communicate throughout all lifting and moving tasks. Use commands that are easy for team members to understand. Verbally coordinate each lift from beginning to end.
Which of the following factors should be considered before lifting any patient?
Communications The weight of the patient Your physical limitations All of the above
Which of the choices is a CORRECT statement when transferring a patient from his or her bed to the stair chair?
Do not use the device for unresponsive patients. Contraindications for the stair chair include unresponsive patients and patients with possible spinal injury.
What is the MOST important thing you can do to prevent an injury to yourself when moving patients?
Know your limitations. Many times, EMS providers get themselves into trouble when they overestimate how much they can lift and carry. This contributes greatly to accidental injury. Know your own physical abilities and limitations. Do not overestimate yourself or other rescuers.
Moving patients onto carrying devices
Patient with suspected spine injury: immobilize head, neck, and spine before move; perform manual stabilization, place rigid cervical collar; maintain manual stabilization until patient is immobilized to spine board Patient with no suspected spine injury: extremity lift (used to carry patient to stretcher or stair chair from ground or sitting position); or direct ground lift - from ground to stretcher - methods: draw-sheet method and direct-carry method
Any patient who is unresponsive and has no spinal injury should be placed on the cot in which position?
Recovery
Urgent Moves
Situations: required treatment can be performed only if patient is moved; factors at scene cause patient decline provided when patient must be moved quickly but there is time to provide quick, temporary consideration toward preventing/aggravating spinal injury Moving a patient onto a long spine board: used if immediate threat to life and suspicion of spine injury; log-roll, supine position, lift onto stretcher, secure Rapid Extrication: when taking time to immobilize with short backboard or vest before moving may cause deadly delay; stabilize spine manually when moving onto long spine board
Emergency Moves
Situations: scene is hazardous; life-threatening conditions requires repositioning; must reach other patients may aggravate spine injuries - only reserved for life-threatening situations Options: clothes drag, incline drag (always head first), firefighter's drag, blanket drag, one-rescuer assist, two-rescuer assist
Which of the following is a situation in which urgent moves are necessary?
The patient's airway is compromised. Urgent moves are required when a patient must be moved quickly for treatment of an immediate threat to life, such as an airway compromise, major bleeding, or altered mental status. Calls holding are not a reason to rush the care of the patient.
Which of the following statements regarding body mechanics is true?
Use your legs to lift.
Which of the following is an indication for an emergency move?
You are unable to gain access to other patients who need lifesaving care. Indications for an emergency move include (1) immediate environmental danger to the patient or rescuer, (2) inability to gain access to other patients who need lifesaving care, and (3) inability to provide lifesaving care because of the patient's location or position.
An ambulance that is specially equipped to handle obese patients is called:
a bariatric ambulance.
direct carry
a method of transferring a patient from bed to stretcher, during which two or more rescuers curl the patient to their chests then reverse the process to lower the patient to the stretcher
You are confronted with a situation in which your BEST option to move the patient will be to quickly use a blanket drag, shirt drag, or armpit-forearm drag. These maneuvers are referred to as
emergency moves Emergency moves consist of the blanket drag, shirt drag, and the armpit-forearm drag.
power grip
gripping with as much hand surface as possible in contact with the object being lifted, all fingers bent at the same angle, and hands at least 10in apart
bariatric
having to do with patients who are significantly over-weight or obese
power lift
lift from a squatting position with weight to be lifted close to the body, feet apart and flat on the ground, body weight on or just behind the balls of the feet, and back locked in; upper body is raised before the hips; also called squat-lift position
To minimize or prevent aggravation of a spinal injury during an emergency move, the EMT should move the patient in the direction of the:
long axis of the body. To minimize aggravation of a spinal injury, move the patient in the direction of the long axis of the body when possible.
extremity lift
method of lifting and carrying a patient during which one rescuer slips hands under the patient's armpits and grasps the wrists, while another rescuer grasps the patient's knees
direct ground lift
method of lifting and carrying a patient from ground level to a stretcher in which two or more rescuers kneel, curl the patient to their chests, stand, then reverse the process to lower the patient to the stretcher
draw-sheet method
method of transferring a patient from bed to stretcher by grasping and pulling the loosened bottom sheet of the bed
An important key to preventing injury while lifting or moving is:
not compensating when lifting with one hand. To prevent injury while lifting or moving a patient or heavy equipment, avoid leaning to either side, and keep your back straight and locked.
Recovery position
patient on side
Non-urgent Moves
patient stable; no immediate life threat; can be assessed, treated, and moved in normal way; take precautions to not aggravate conditions normal ways to move patient after performing a complete on-scene assessment and any spinal stabilization and immobilization
An emergency move would be permitted in order to change a patient's position so that you could:
perform CPR
body mechanics
proper use of the body to facilitate lifting and moving and prevent injury
Body Mechanics
proper use to prevent injury; consider the object, your limitations, and communication keep chair as close as possible to body; use stair chair whenever possible; position feet properly, don't twist or turn; do not compensate when lifting with one hand push rather than pull; back locked; avoid overhead
Patient carrying Devices
stretcher (or any device) designed to carry patient safety to ambulance or hospital wheeled stretchers: power, manual, bariatric stair chairs spine board: long (with neck or spine injury suspected) or short Stretchers: portable, scoop, basket, flexible, vacuum
Shock positioning
supine position; do not lower head nor raise legs
Techniques for moving a patient experiencing an immediate life threat are called:
urgent moves Urgent moves are required when the patient must be moved quickly for treatment of a serious injury.
