Lecture Notes: Chapter 8 - Lifting and Moving Patients
Overview
- Subject: Emergency Care and Transportation of the Sick and Injured, 12th Edition
- Focus: Safe and effective methods for lifting and moving patients, body mechanics, and equipment use.
Key Learning Objectives
- Understand body mechanics of patient movement
- Principles of safe reaching and pulling
- Urgent and non-urgent moves
- Team-based patient transport
- Types of patient packaging and moving equipment
- Injury prevention for caregivers
- Use of medical restraints
Patient Movement Essentials
- Multiple Moves Required: Patients must be moved several times during care.
- Lift/carry to stretcher
- Move stretcher to ambulance
- Load stretcher into ambulance
- Body Mechanics: Proper lifting and carrying techniques are crucial for safety.
Equipment Overview
- Wheeled Ambulance Stretcher (Gurney): Most common device for transport.
- Features include a strong frame, guard rails, adjustable height, fluid-resistant mattress, and securing straps.
- Backboards: Used for immobilizing patients with specific injuries.
- Long holes for handles and straps for patient security.
Moving and Positioning
- Body Mechanics: Relationship between body structure and physical forces.
- Proper alignment minimizes strain on the spinal column.
- Lifting Techniques:
- Shoulder girdle alignment, feet positioning, and using legs for power lifting.
- Power Lift: Safe technique using legs and arms to lift.
- Power Grip: Provides maximum hand force.
Safe Reaching and Pulling
- Body Drag: Correct technique involves locked back, bent arms, and repositioning during pulling.
- Stretcher Transfer:
- Use of sheets/blankets to assist in dragging
- Techniques for bed transfers
Lifting and Carrying
- Estimating Weight: Appropriate team size based on weight.
- Adults typically weigh 120-220 lbs. Special equipment for >350 lbs.
- Carrying Techniques:
- Diamond Carry: Using multiple EMTs for even lifting.
- Stair Chair: For patient transport on stairs when possible.
Emergency and Urgent Moves
- Emergency Moves: Needed when immediate danger is present or patient position prevents care.
- Rapid Extrication: Quick removal from vehicle to backboard.
- Urgent Moves: Used for altered consciousness, shock, or extreme conditions.
Non-Urgent Moves
- Direct Ground Lift & Extremity Lift: Techniques for moving patients without spinal injury.
- Transfer Moves: Direct carry, draw-sheet method, and scoop stretcher.
Special Considerations
- Geriatric Patients: Use of specific devices due to brittle bones and spinal issues.
- Bariatric Patients: Increased equipment capacity and techniques for heavy patients.
Additional Devices
- Basket Stretchers: Used for rough terrain.
- Scoop Stretchers: For confined spaces.
- Neonatal Isolette: For transporting newborns safely.
Patient Positioning
- Based on Chief Complaint:
- Comfort positions for chest pain or respiratory distress
- Supine position for shock
- Recovery position for unresponsive patients
Medical Restraints
- Application: Assess for combativeness causes. Minimum five personnel required for restraint.
- Position: Patients should always be restrained supine.
Safety and Personal Considerations
- Injury Prevention: Proper lifting techniques and personal strength assessments.
- Equipment Decontamination: Essential for infection control.
Review Questions
- Understanding lifting rules, equipment use, and emergency move techniques.
These notes serve as a high-level overview of Chapter 8, focusing on the important concepts and techniques for lifting and moving patients in emergency care settings.