6: Lifting and Moving Patients
Cognitive Objectives (1 of 4)
1-6.1Define body mechanics.
1-6.2Discuss the guidelines and safety precautionsthat need to be followed when lifting a patient.
1-6.3Describe the safe lifting of cots and stretchers.
1-6.4Describe the guidelines and safety precautionsfor carrying patients and/or equipment.
Cognitive Objectives (2 of 4)
1-6.5Discuss one-handed carrying techniques.
1-6.6Describe correct and safe carrying procedureson stairs.
1-6.7State the guidelines for reaching and theirapplication.
1-6.8Describe correct reaching for log rolls.
Cognitive Objectives (3 of 4)
1-6.9State the guidelines for pushing and pulling.
1-6.10Discuss the general considerations of movingpatients.
1-6.11State three situations that may require the useof an emergency move.
Cognitive Objectives (4 of 4)
1-6.12Identify the following patient-carrying devices:
–Wheeled ambulance stretcher
–Portable ambulance stretcher
–Stair chair
–Scoop stretcher
–Long spine board
–Basket stretcher
–Flexible stretcher
Affective Objectives
1-6.13Explain the rationale for properly lifting andmoving patients.
Psychomotor Objectives (1 of 2)
1-6.14Working with a partner, prepare each of thefollowing devices for use, transfer a patient tothe device, properly position the patient on thedevice, move the device to the ambulance,and load the patient into the ambulance:
–Scoop stretcher
–Long spine board
–Basket stretcher
–Flexible stretcher
–Wheeled ambulancestretcher
–Portable ambulancestretcher
–Stair chair
Psychomotor Objectives (2 of 2)
1-6.15Working with a partner, the EMT-B willdemonstrate techniques for the transfer of apatient from an ambulance stretcher to ahospital stretcher.
Moving and Positioningthe Patient
•Take care to avoid injury whenever a patientis moved.
•Practice using equipment.
•Know that certain patient conditions call forspecial techniques.
Body Mechanics
•Shoulder girdle should be aligned over the pelvis.
•Lifting should be done with legs.
•Weight should be kept close to the body.
•Grasp should be made with palms up.
Proper Lifting
Performing the Power Lift (1 of 3)
•Tighten your back innormal upright position.
•Spread your legs apartabout 5".
•Grasp with arms extendeddown side of body.
•Adjust yourorientation andposition.
•Reposition feet.
•Lift bystraightening legs.
Performing the Power Lift (2 of 3)
•A power grip gets the maximum force from yourhands
•Arms and hands face palm up.
•Hands should be at least 10" apart.
•Each hand goes under the handle with the palmfacing up and the thumb extended upward.
Performing the Power Lift (3 of 3)
•Curl fingers and thumbtightly over the top ofthe handle.
•Never grasp a litter orbackboard with thehands placed palms-down over the handle.
Weight and Distribution
•Patient will be heavieron head end.
•Patients on abackboard or stretchershould be diamondcarried.
Diamond Carry
•Four EMT-Bs lift devicewhile facing patient.
•EMT-B at foot end turnsaround to face forward.
•EMT-Bs at sides turn.
•Four EMT-Bs facesame direction whenwalking.
One-Handed Carrying
•Face each other and useboth hands.
•Lift the backboard tocarrying height.
•Turn in the direction youwill walk and switch tousing one hand.
Carrying Backboard or Cot on Stairs
•Strap patient securely tothe backboard.
•Carry patient down stairsfoot end first, head endelevated.
•Carry patient up stairshead end first.
Wheeled Ambulance Stretcheror Cot
Stair Chair
Backboard
Directions and Commands
•Anticipate and understand every move.
•Moves must be coordinated.
•Orders should be given in two parts.
Additional Guidelines
•Find out how much the patient weighs.
•Know how much you can safely lift.
•Communicate with your partners.
•Do not attempt to lift a patient who weighs over250 lbs with fewer than four rescuers.
•Avoid unnecessary lifting or carrying.
Using a Stair Chair
•Secure patient to stair chair with straps.
•Rescuers take their places: one at head, one atfoot.
•Rescuer at the head gives directions.
•Third rescuer precedes.
Principles of Safe Reachingand Pulling (1 of 3)
•Back should always be locked and straight.
•Avoid any twisting of the back.
•Avoid hyperextending the back.
•When pulling a patient on the ground, kneel tominimize the distance.
Principles of Safe Reachingand Pulling (2 of 3)
•Use a sheet or blanket if you must drag a patientacross a bed.
•Unless on a backboard, transfer patient from thecot to a bed with a body drag.
•Kneel as close as possible to patient whenperforming a log roll.
Principles of Safe Reachingand Pulling (3 of 3)
•Elevate wheeled ambulance cot or stretcher beforemoving.
•Never push an object with your elbows locked.
•Do not push or pull from an overhead position.
General Considerations
•Plan the move.
•Look for options thatcause the least strain.
Emergency Moves
•Performed if there is some potential danger for youor the patient
•Performed if necessary to reach another patientwho needs lifesaving care
•Performed if unable to properly assess patient dueto location
Emergency Drags (1 of 2)
•Clothes Drag
•Blanket Drag
Emergency Drags (2 of 2)
Arm-to-Arm Drag
Arm Drag
One-Person Rapid Extrication
One-Rescuer Drags, Carries,and Lifts (1 of 3)
Front cradle
Fire fighter’s drag
One-Rescuer Drags, Carries,and Lifts (2 of 3)
One-personwalking assist
Fire fighter’s carry
One-Rescuer Drags, Carries,and Lifts (3 of 3)
Pack strap
Urgent Moves
•Used to move a patient who has potentiallyunstable injuries
•Use the rapid extrication technique to movepatients seated in a vehicle.
When to Use RapidExtrication Technique
•Vehicle or scene is unsafe.
•Patient cannot be properly assessed.
•Patient requires immediate care.
•Patient’s condition requires immediate transport.
•Patient is blocking access to another seriouslyinjured patient.
Rapid Extrication (1 of 3)
•Provide in-linesupport and applycervical collar.
Rapid Extrication (2 of 3)
•Rotate patientas a unit.
Rapid Extrication (3 of 3)
•Lower patient to thebackboard.
Nonurgent Moves (1 of 2)
•Directgroundlift
Nonurgent Moves (2 of 2)
•Extremity lift
Transfer Moves
Direct carry
Draw sheet method
Scoop Stretcher
•Adjust stretcher length.
•Lift patient slightly andslide stretcher intoplace, one side at atime.
•Lock stretcher endstogether.
•Secure patient andtransfer to the cot.
Geriatrics
•Emotional concerns
–Fear
•Skeletal concerns
–Osteoporosis
–Rigidity
–Kyphosis
–Spondylosis
•Pressure sores
•Use special immobilizing techniques.
•Be compassionate.
Bariatrics
•“Care of the obese”
•Increase in back injuries among EMTs
•Manufacturing of higher capacity equipment
•Use proper lifting techniques.
Wheeled Ambulance Stretcher
•Most commonly used device
•Has specific head and footends
•Has a folding undercarriage
•EMT-B must be familiar tospecific features of cots usedin the ambulance.
Loading the WheeledAmbulance Cot
•Tilt the head of the cot upward.
–Place it into the patient compartment.
•Release the undercarriage lock and lift.
•Roll the cot into ambulance.
•Secure the cot to ambulance clamps.
Patient-Moving Equipment (1 of 3)
Portable stretcher
Flexible stretcher
Patient-Moving Equipment (2 of 3)
Backboard
Basket stretcher
Patient-Moving Equipment (3 of 3)
Scoop stretcher
Stair chair
