Chapter 8: Lifting and Moving Patients

Introduction

• Importance of moving patients safely during emergency care and transport.
• Proper lifting techniques prevent injuries to EMTs and patients.
• Use of patient-moving devices like stretchers, backboards, and others.

Key Techniques

• Lifting and Carrying: Essential techniques include emergency body drags, lifts, and carrying patients up/downstairs.
• Spinal Injury Considerations: Special methods for suspected spinal injuries.
• Heavy or Rugged Terrain: Techniques for moving heavy patients or over difficult terrain.

Equipment

• Wheeled Ambulance Stretcher: Most common transport device.

  • Weighs 40-145 pounds; not for stairs or long-distance carries.
  • Features: head/foot ends, retractable guardrails, folding undercarriage.
  • Safety: Always secure patient with straps.

• Backboards: For spinal immobilization, made of rigid materials.

  • Traditionally made of plywood, now often lighter plastic.
  • Secures patients using straps.

Moving and Positioning Patients

• Proper body mechanics and physical fitness are key to preventing injury.

• Power Lift Technique:

  • Keep back straight, legs shoulder-width apart.
  • Use leg muscles for lifting, not the back.

• Power Grip: Maximum force with palms up, hands 10 inches apart.

• Reaching and Pulling:

  • Avoid twisting, keep arms close to body.
  • Kneel when pulling a patient from the ground.

Patient Weight and Communication

• Estimate patient weight; use four providers for heavier patients.
• Communicate clearly, anticipate each move, use commands for coordination.

Special Situations

• Stair Chair: For carrying conscious patients up/down stairs.
• Rapid Extrication: Removes patient from vehicle quickly, requires team coordination.

Emergency and Urgent Moves

• Emergency Moves: Used in danger; spinal protection secondary to patient safety.
• Urgent Moves: Due to conditions like inadequate ventilation; rapid extrication is a technique.

Non-Urgent Moves

• Direct Ground Lift: For non-spinal injury patients, with multiple providers.
• Extremity Lift: For narrow spaces, not for suspected spinal injuries.

Additional Equipment

• Bariatric Stretchers: For obese patients, wider and with higher weight capacities.
• Pneumatic/Electric Stretchers: Reduce injury risk with motorized controls.

Specialized Stretchers

• Portable/Folding Stretchers: Lightweight, without undercarriages.

• Flexible Stretchers: Useful in confined spaces.

• Basket Stretchers: For uneven terrain, typically used with a backboard.

Geriatrics and Bariatrics

• Geriatric Patients: Require careful handling due to brittle bones, sensitive skin.
• Obesity: Significant in the U.S., requires specialized equipment to prevent EMT injuries.

Decontamination and Patient Positioning

• Decontamination: Essential after each use to prevent disease spread.
• Patient Positioning: Adjust based on condition (e.g., spinal injury, shock).

Personnel Considerations

• Ensure physical readiness and proper team coordination before moving patients.
• Ask critical questions about strength, space, and need for additional help.