Chapter 8: Lifting and Moving Patients

Learning Objectives

• Understand body mechanics of patient movement.
• Principles of safe reaching and pulling.
• Urgent and non-urgent moves.
• Team-based patient movement.
• Types of patient packaging and moving equipment.
• How to protect oneself from injury when moving patients.
• Use of medical restraints.

Importance of Proper Lifting and Moving

• Essential for providing emergency medical care and transport.
• Minimizes risk of injury to patients and emergency personnel.
• Knowledge of body mechanics and power grip is crucial.

Equipment for Patient Movement

Wheeled Ambulance Stretcher (Gurney)

• Most common device for moving and transporting patients.
• Features:
  • Head and foot end.
  • Strong tubular metal frame.
  • Retractable guard rails.
  • Adjustable undercarriage.
  • Fluid-resistant mattress.
  • Secured with straps.

Backboard

• Long flat boards for carrying and immobilizing supine patients.
• Used for suspected hip, pelvic, spinal, and lower extremity injuries.

Body Mechanics in Lifting

• Proper posture: Shoulder girdle aligned over pelvis.
• Lifting position: Legs spread, back upright, arms close to legs.
• Power lift: Use legs to lift, not back.
• Power grip: Palms up, thumbs extended upward.

Safe Reaching and Pulling

• Use body drag techniques.
• Avoid reaching beyond 15 to 20 inches.

Safe Lifting and Carrying

• Estimate patient's weight; use four providers if over 250 lbs.
• Use devices that can be rolled when possible.
• Diamond carry and one-handed carry details in Chapter 8 skills.

Specific Equipment

Stair Chair

• For moving conscious patients up/down stairs.
• Lightweight and foldable.

Loading into Ambulance

• Frame should be held firmly.
• Follow skill drills in Chapter 8.

Team Coordination

• Team leader assigns roles and coordinates actions.
• Use preparatory commands and countdowns.

Emergency Moves

• Used when immediate danger is present.
• Techniques include clothes drag, blanket drag, arm drag.
• Rapid extrication technique for urgent patient movement.

Non-Urgent Moves

• Used when scene and patient are stable.
• Methods include direct ground lift, extremity lift, transfer moves.

Special Considerations

Geriatrics

• Skeletal changes require careful handling.
• Use geriatric-specific devices like vacuum mattresses.

Bariatrics

• Specialized equipment for obese patients.
• Mechanical lifts are more common in Europe.

Additional Devices

• Basket Stretcher: For uneven terrain.
• Scoop Stretcher: For lifting from flat surfaces.
• Neonatal Isolette: Keeps neonatal patients warm and secure.

Decontamination and Safety

• Follow local SOPs for disinfecting equipment.

Patient Positioning

• Based on chief complaint (e.g., Fowler's position for respiratory distress).
• Special positions for shock, pregnancy, etc.

Medical Restraints

• Assess and secure patient if necessary.
• Requires a team leader and coordination.

Personal Consideration

• Assess personal ability and need for assistance before moving a patient.

Review Questions

• Questions focus on lifting techniques, emergency moves, and equipment safety.

This chapter provides essential guidelines and practical knowledge for safely lifting and moving patients in emergency settings.