Patient Lifting and Moving Techniques

Overview

This lecture covers safe and effective lifting and moving techniques for EMS providers, focusing on body mechanics, equipment, patient assessment, and specific movement situations.

Roles and Responsibilities

• EMS providers need both physical ability and knowledge to safely move patients.
• Proper technique and equipment use prevent injury to providers and patients.
• Familiarity with your ambulance stretcher and its features is essential.

Body Mechanics and Lifting Techniques

• Use proper body mechanics: keep back straight, lift with legs, and keep weight close to your body.
• Strongest provider should be at the head of the stretcher, as most patient weight is there.
• Always push from the head and pull from the feet when moving a stretcher.

Equipment and Devices

• Wheeled ambulance stretcher is the primary device for moving patients; know its locking and height adjustment features.
• Use straps to secure the patient and prevent falls.
• Spine boards (being phased out), scoop stretchers, stair chairs, bariatric stretchers, and vacuum mattresses have specific uses.
• Stretcher types include folding, flexible, and basket stretchers for special circumstances.

Moving and Positioning Patients

• Move patients in an organized, unhurried, and coordinated manner.
• Use at least four providers for heavy or awkward patients.
• Avoid running to a scene; walk briskly to prevent injury.
• Use power grip (palms up, hands ~10 inches apart) and keep elbows close to the body.

Patient Handling Techniques

• Emergency moves are done when immediate danger exists before patient assessment.
• Urgent moves are used after assessment when patient condition is critical (e.g., rapid extrication).
• Non-urgent moves are for stable patients; plan the movement and use appropriate techniques (direct ground lift, extremity lift, draw sheet).

Special Populations and Considerations

• Geriatric patients may need extra padding and careful handling due to brittle bones and spinal curvature.
• Bariatric patients may require special equipment; never risk provider safety.
• Pregnant patients should be transported on their left side to prevent supine hypotensive syndrome.

Patient Positioning

• Chest pain or respiratory distress: position of comfort (usually semi-Fowler's).
• Shock: supine.
• Late pregnancy: left side.
• Unresponsive (no spinal injury): recovery position.
• Nausea/vomiting: position of comfort.

Medical Restraints

• Assess for underlying causes of combativeness before restraining.
• Use 5 personnel, secure each limb in supine position, and regularly reassess ABCs and circulation.

Key Terms & Definitions

• Body Mechanics — Proper posture and movement to prevent injury while lifting/moving patients.
• Wheeled Ambulance Stretcher — Main transport device with wheels, adjustable height, and safety features.
• Spine Board — Rigid device for full-body immobilization (being replaced by scoop stretchers).
• Scoop Stretcher — Stretcher that splits apart for easier patient loading, preferred over spine boards.
• Stair Chair — Chair device for moving conscious patients up/down stairs.
• Bariatric Stretcher — Specialized stretcher for obese patients.
• Power Grip — Palms up, fingers wrapped around handle, for maximum lifting strength.
• Emergency Move — Immediate move due to scene danger, prior to assessment.
• Urgent Move — Move after assessment due to critical patient status.
• Non-Urgent Move — Move when patient and scene are stable.

Action Items / Next Steps

• Practice body mechanics and lifting techniques regularly.
• Study the features and use of all patient-movement equipment in your organization.
• Review local protocols on patient restraint and movement.
• Read textbook chapter 8 on patient lifting and movement.