EMS Chapter 3

Flexible stretcher

(Reeves) Useful in restricted areas, or narrow hallways.

Wheeled Stretcher

(Stretcher, cot, litter) In all ambulances. Purpose: to safely transport patient from one place to another, usually in a reclining position. Level surfaces, this is ideal. Don't use odd numbers of EMTs. When the stretcher is lifted, two EMTs should lift at opposite ends of the stretcher (head and foot)

Power Lift

A lift from the squatting position with weight to be lifted close to the body, feet apart, and the back locked in. The upper body is raised before the hips. (square-lift position).

Extremity Lift

A method of lifting an 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

Manual stretchers

Are lifted by the EMTs

Portable and Basket Stretcher

Can be carried by 4 EMTs. Useful over rough terrain. Can be used for long distances because there are 4 and not 2. portable: (folding) useful when there are multiple casualty incidents basket: (stokes) used when moving a patient from one level to another, or over rough terrain

Emergency moves, One rescuer Drags

Clothes drag (using shirt over shoulders) Incline drag (always head first, go down stairs) Shoulder drag Foot drag (watch head) Firefighter's crawl (patient on back, hands tied together. Straddle and pass hands over your head. raise your body and crawl with patient) Blanket Drag

Stair Chair

Excellent for stairs. Transport in sitting position. Rolled. 2 rescuers need, and a 3rd spotter is preferred. Ideal for patient's with difficulty breathing. Do not use on patients with neck/spine injury, or unresponsive patients

Moving a Patient w/o Suspected Spine Injury

Extremity lift, direct ground lift, draw sheet method, and direct carry. methods of moving a patient onto a stretcher.

Bariatric stretchers

For the obese.

Fighfighter's carry with assist

Have someone lift the patient. The second rescuer helps to position the patient

When reaching

Keep back in a locked in position Avoid twisting while reaching Avoid reaching more than 15-20" in front of the body Avoid prolonged reaching when strenuous effort is required

Example of Urgent Move

Moving a patient to a long spine board (backboard) used when there is an immediate threat to life and suspicion of spine injury. If patient is supine, a log roll maneuver is used to move him onto his side. Once the patient is secured and taped, the board and patient are lifted onto the stretcher, the board is secured to the stretcher, the stretcher is loaded into the ambulance. Keep back straight, lean from hips, and use shoulders Another example is a rapid extrication procedure from a vehicle.

Moving a Patient with Suspected Spine Injury

Must have head, neck, and spine immobilized before move. Manual stabilization, place a rigid cervical collar, and maintain manual stabilization until patient is immobilized to a spine board. ( if in a vehicle, use short then long board.

Non-Urgent Moves

No immediate life threats. Patient is moved from the site onto a patient carrying device

Scoop Stretchers

Orthopedic stretchers, split in 2, allowing patient to be scooped. Does not offer back support.

Piggyback carry

Patient stands, places arms over shoulder so they cross your chess. Bend over and lift.

One-Rescuer Assist

Patients arm around your neck and hold patients hand, Place your other hand on the patient's waist. Help the patient walk to safety.

Cradle Carry

Place oen arm across the patient's back with your hand under patient's arm. place your other am under her knees and lift. If the patient is conscious, haver patient place near arm over your shoulder *for light patients

Twos rescuer assist

Place patient's arms around the shoulder of both rescuers. They grip the hand and place their free arm around patient's waist

Firefighter's carry

Place your feet against the patient's feet and pull her toward you. Bend your waist and flex your knees. Duck and pull her across your shoulder, keeping hold of one of her wrists. Use your free arm to reach between your legs and grasp her thigh. This way, the weight of the patient falls onto your shoulders. Stand up. Transfer your grip on her thigh to the patient's wrist

When pushing/ pulling

Push, rather than pull, whenever possible Keep your back locked in Keep the line of pull through the center of your body by bending your knees Keep the weight close to your body If the wight is below your waist, push/pull from a kneeling position Avoid pushing/pulling overhead Keep elbows bent and arm close to your sides

Urgent Moves

Required when the patient must be moved quickly for treatment of an immediate threat to life. Performed with precautions for spinal injury. used when the required treatment can only be performed if the patient is moved, or if factors at the scene cause patient decline (i.e. extreme heat/cold)

When to use Emergency Moves

Scene is hazardous- traffic, fire or threat of, possible explosions, electrical hazards, toxic gases, radiation Care of life-threatening conditions requires repositioning, ie CPR/ bleeding Need to reach other patients

Spine boards

Short: Used for removing patients from vehicles when a neck/spine injury is suspected. Vest-type extrication device is sued instead. The patient is then transferred to a supine position on a long board.

Body Mechanics

The proper use of the body to facilitate lifting and moving and prevent injury. before lifting, consider: the object, your limitations, communication, position your feet on firm level surface shoulder-width apart, use your legs not your back, never turn or twist, do not compensate when lifting with one hand, keep the weight as close as possible to your body, use a stair chair when carrying a patient on stairs whenever possible. Keep back straight and locked, flex knees and lean forward from the hips not the waist.

Positioning Patients

Unresponsive patients with no suspected spine injury- recovery position, to drain fluid from mouth or if he vomits. No spine injury, position of comfort in a fowler or semi-fowler position Shock: Supine position.

Power Stretchers

Will lift a patient from the ground level to the loading position or lower the patient from the raised position. They will help to preven back injuries.

Draw-sheet method

a method od transferring a patient from bed to stretcher by grasping and pulling the loosened bottom sheet of the bed

Direct ground lift

a method of lifting and carrying a patient from ground level to a stretcher in which 2 or more rescuers kneel, curl the patient to their chests, stand, then reverse the process to lower the patient to the stretcher

Direct Carry

a method of transferring a patient from bed to stretcher, during which 2 or more rescuers curl the patient to their chests, then reverse the process to lower the patient to the stretcher

Power grip

gripping with as much of the hand surface as possible in contact with the object being lifted, all fingers bend at the same angle, and hands at least 10" apart. Facing up usually.

Pack Strap Carry

have the patient stand. Turn your back to patient, bring patient's arms over your shoulder to cross your chest. Keep her arms as straight as possible with her armpits over your shoulders. Hold the patient's wrists, bend, and pull her onto your back

When lifting a patient carrying device

it is best to use an even number of people. For a stretcher/backboard, one EMT lifts from the end near the head,, the other from the feet. If there are 4 EMTs, one at each corner, if 3 don't allow the 3rd person to lift because it will be unbalanced.

Vacuum mattress

patient is placed on the device and air is withdrawn by means of pump. the mattress then becomes rigid and conforming.

Danger of Emergency Moves

the greatest danger is that the a spine injury is aggravated. To minimize, move the patient in the direction of the long axis of the body