Chapter 8: Lifting and Moving Patients

Overview

• Focus on body mechanics and patient movement.
• Understand principles of safe reaching, urgent and non-urgent moves.
• Learn about patient packaging, equipment, and self-protection.
• Use of medical restraints.

Patient Movement

• Patients are moved several times during a call:
  • To the stretcher.
  • To the ambulance.
  • Into the patient compartment.
• Proper lifting and carrying techniques prevent injuries.

Equipment

Wheeled Ambulance Stretcher

• Also known as stretcher or gurney.
• Preferred for rolling patients to prevent injuries.
• Features:
  • Specific head and foot end.
  • Strong metal frame.
  • Retractable guard rails.
  • Adjustable undercarriage.
  • Fluid-resistant mattress.
  • Securing straps.

Backboards

• Rigid rectangular boards.
• Used for patients with spinal, hip, or multiple trauma injuries.
• Serve handles and allow securing the patient.

Lifting and Moving Techniques

Body Mechanics

• Align vertebrae over sacrum for weight-bearing.
• Proper lifting position:
  • Shoulder girdle over pelvis.
  • Hands close to legs.
  • Align force through spinal cord.
• Lifting techniques:
  • Spread legs shoulder-width.
  • Balance weight on balls of feet.
  • Bend at legs, keep back straight.
  • Use the power lift (arms close, lift with legs).

Safe Reaching and Pulling

• Body drag:
  • Keep back locked.
  • Alternate pulling with repositioning.
• Log roll for side positioning.

Safe Lifting and Carrying

• Estimate patient weight.
• Use 4 providers for patients over 250 pounds.
• Use diamond or one-handed carry.
• Stair chair for conscious patients on inclines.
• Secure patient on stairs with backboard.

Emergency Moves

• Needed when danger prevents proper assessment or care.
• Techniques:
  • Clothes drag, blanket drag, arm drag, etc.
• Rapid extrication for urgent vehicle exits.

Non-Urgent Moves

• For stable scenes:
  • Direct ground lift.
  • Extremity lift for confined spaces.
• Transfer moves:
  • Direct carry, draw sheet, scoop stretcher.

Special Considerations

Geriatric Patients

• Skeletal changes may require special considerations.
• Use geriatric-specific devices.

Bariatric Patients

• Equipment with higher capacity.
• Mechanical lifts for heavier patients.

Additional Devices

• Portable, flexible, and short backboards.
• Basket stretchers for uneven terrain and rescues.
• Scoop stretchers for confined spaces.
• Neonatal isolettes for infants.

Patient Positioning

• Based on chief complaint:
  • Fowler's position for comfort.
  • Supine for shock and certain conditions.
  • Recovery position for unresponsive patients.

Medical Restraints

• Evaluate for causes of combativeness.
• Minimum five personnel required.
• Supine position to prevent asphyxia.

Personal Considerations

• Assess physical strength and need for assistance.
• Prevent EMT injuries during patient movement.

Review Questions

• Cover practical lifting techniques and scenarios.
• Emphasize safety and correct positioning.