Patient Lifting and Moving Principles

Overview

This chapter covers the principles, techniques, and equipment essential for safely lifting, moving, and transporting patients, emphasizing proper body mechanics and teamwork to prevent injury.

Principles of Lifting and Moving

• Move patients multiple times during care, from scene to stretcher, ambulance, and hospital.
• Use proper body mechanics and the power grip to avoid injury.
• Practice techniques for emergency drags, lifts, and moving patients in confined spaces.
• Repeated training and equipment familiarity are essential for safety.

Equipment for Patient Movement

• The wheeled ambulance stretcher (gurney) is the primary transport device; always secure the patient with belts.
• Use backboards (long boards) to restrict spinal motion or move patients from difficult locations.
• Additional devices include stair chairs, portable/folding stretchers, flexible stretchers, and scoop stretchers.
• Bariatric stretchers and powered stretchers are used for obese patients to ensure safety.
• Use basket stretchers for rough terrain and neonatal isolettes for infant transport.

Lifting, Carrying, and Moving Techniques

• Keep the back straight and lift without twisting; use legs for strength (power lift).
• Maintain arms close to the body; center weight between arms.
• Communicate clearly with team members, use preparatory and execution commands.
• The diamond carry and one-handed carry distribute weight among providers for safe movement.
• Whenever possible, roll instead of carrying patients with wheeled devices.

Patient Transfer and Special Lifts

• Use direct ground lift or extremity lift for patients without suspected spinal injury.
• Use log roll, draw sheet, or direct carry methods for bed-to-stretcher transfers.
• Scoop stretchers can be assembled under patients for minimal movement.
• When moving patients upstairs or downstairs, use stair chairs if possible, or secure patients on backboards for supine transport.
• Adjust techniques for geriatric and bariatric patients to accommodate fragility and size.

Emergency, Urgent, and Non-Urgent Moves

• Emergency moves are used when scenes are unsafe; urgent moves for patients with compromised airway, breathing, or shock.
• Rapid extrication technique quickly removes patients from vehicles when required, prioritizing speed over spinal immobilization.
• Non-urgent moves allow careful planning and use of the appropriate method and equipment.

After Patient Transport

• Decontaminate all equipment per protocols after use.
• Evaluate team performance, clean and maintain equipment, and review skills after each call.

Patient Positioning Considerations

• Position patients based on their condition (e.g., supine for shock, left side for late pregnancy, Fowler's for chest pain).
• Secure patients with spinal or suspected injuries; position vomiting or unconscious patients to protect the airway.

Key Terms & Definitions

• Body Mechanics — use of proper movement and posture to prevent injury during lifting/moving.
• Power Lift — lifting technique using straight back and legs to generate force.
• Power Grip — grasp with palms up and all fingers wrapped around the object handle.
• Backboard — rigid board for spinal immobilization and patient movement.
• Stair Chair — device for moving patients up/down stairs in a seated position.
• Bariatric Stretcher — reinforced stretcher with higher weight capacity and larger surface area.
• Diamond Carry — four-person lift/carry with providers positioned at each corner.
• Rapid Extrication — technique for quickly removing a patient from a vehicle.

Action Items / Next Steps

• Practice lifting and moving techniques with your team.
• Review manufacturer instructions for all movement equipment.
• Clean and maintain equipment after each use.
• Read Chapter 36 for geriatric considerations and Chapter 29 for head and spine injuries.