PATIENTPATIENT LIFTINGLIFTING

OBJECTIVEOBJECTIVE

Identify the procedures for safely Identify the procedures for safely lifting a patientlifting a patient

PATIENT LIFTINGPATIENT LIFTING

Principles of Safe LiftingPrinciples of Safe Lifting Principles of Safe Carrying Principles of Safe Carrying

PatientsPatients Patient Handling and EquipmentPatient Handling and Equipment

Principles of Safe LiftingPrinciples of Safe Lifting

Use Longest and Strongest muscle Use Longest and Strongest muscle groupsgroups

Keep arms and legs close to your Keep arms and legs close to your bodybody

Use legs, not back, to liftUse legs, not back, to lift Evaluate every situationEvaluate every situation Plan in advance and assemble Plan in advance and assemble

resourcesresources

Guidelines for Safe LiftingGuidelines for Safe Lifting

Consider weight of patient and Consider weight of patient and need for additional helpneed for additional help

Know physical ability and Know physical ability and limitationslimitations

Lift without twistingLift without twisting Communicate clearly and Communicate clearly and

frequently with partner(s)frequently with partner(s)

Guidelines for Safe Lifting Guidelines for Safe Lifting (cont)(cont)

LIFTING COTS AND LIFTING COTS AND STRETCHERSSTRETCHERS• Know or find out weight to be liftedKnow or find out weight to be lifted• Use at least two peopleUse at least two people• Use even # of people; maintain balanceUse even # of people; maintain balance

– Know weight limitation of equipmentKnow weight limitation of equipment– What if patient exceeds weight limit?What if patient exceeds weight limit?

Lift PositionsLift Positions

Power Lift PositionPower Lift Position• Weak knees and thighsWeak knees and thighs• Procedures:Procedures:

– Spread feetSpread feet– Straddle cot/backboard; feet flatStraddle cot/backboard; feet flat– Distribute weight on balls of feetDistribute weight on balls of feet– Stand; back locked and upper body up Stand; back locked and upper body up

before hipsbefore hips

Lift Positions (cont)Lift Positions (cont)

Power GripPower Grip• Maximum force from handsMaximum force from hands• Palm and fingers in complete contact Palm and fingers in complete contact

with objectwith object– All fingers are bent at same anglesAll fingers are bent at same angles– Hands should be at least 10” apartHands should be at least 10” apart

Principles of Safe CarryingPrinciples of Safe Carrying

Guidelines for Safe Carrying:Guidelines for Safe Carrying:• Know weight to be liftedKnow weight to be lifted• Know crew’s abilitiesKnow crew’s abilities• Coordinate & communicate with Coordinate & communicate with

partnerspartners• Keep wt. close to bodyKeep wt. close to body• Keep back “locked-in”; do not twistKeep back “locked-in”; do not twist

Principles of Safe Principles of Safe Carrying(cont)Carrying(cont)

Guidelines (cont)Guidelines (cont)• Flex at the hips; bend at the kneesFlex at the hips; bend at the knees• Do not hyperextend backDo not hyperextend back

Principles of Safe Principles of Safe Carrying(cont)Carrying(cont)

Carrying a StretcherCarrying a Stretcher• Partner of similar strength/heightPartner of similar strength/height• 4 or more EMT-B’s4 or more EMT-B’s

– Lift “face on” with both handsLift “face on” with both hands– Once lifted to carrying height, turn in proper Once lifted to carrying height, turn in proper

direction and switch to using one handdirection and switch to using one hand

Patient Handling EquipmentPatient Handling Equipment

Wheeled StretchersWheeled Stretchers Portable StretchersPortable Stretchers Scoop StretcherScoop Stretcher Basket Stretcher (Stokes Litter)Basket Stretcher (Stokes Litter) Flexible StretcherFlexible Stretcher BackboardsBackboards LitterLitter

Wheeled StretcherWheeled Stretcher

Two RescuerTwo Rescuer• Used in narrow spaces; requires more Used in narrow spaces; requires more

strengthstrength• Rescuers should face each otherRescuers should face each other• Easily unbalancedEasily unbalanced

Wheeled Stretcher (cont)Wheeled Stretcher (cont)

Four RescuerFour Rescuer• One at each cornerOne at each corner• More stability; less strength requiredMore stability; less strength required• Safer over rough terrainSafer over rough terrain

Scoop stretcher - interim deviceScoop stretcher - interim device• Place scoop around patientPlace scoop around patient• Lock scoop stretcher and transfer patientLock scoop stretcher and transfer patient• Unlock and remove scoop stretcherUnlock and remove scoop stretcher

Portable StretchersPortable Stretchers

Used when wheeled stretcher Used when wheeled stretcher cannot be usedcannot be used

Weighs less than wheeled Weighs less than wheeled stretcherstretcher

Patient and equipment must be Patient and equipment must be supported by EMT’ssupported by EMT’s

Scoop StretcherScoop Stretcher

Splits into two or four piecesSplits into two or four pieces Fitted around patient lying on Fitted around patient lying on

ground or flat surfaceground or flat surface Requires both sides of pt. Requires both sides of pt.

accessibleaccessible Not adequate when used alone Not adequate when used alone

for spinal injuryfor spinal injury

Basket Stretcher (Stokes Basket Stretcher (Stokes Litter)Litter)

Used in technical and water Used in technical and water rescuesrescues

Holes in bottom to allow water to Holes in bottom to allow water to draindrain

Line bottom with waterproof Line bottom with waterproof materialmaterial

Flexible StretcherFlexible Stretcher

Excellent support and Excellent support and immobilizationimmobilization

UncomfortableUncomfortable May be folded or rolledMay be folded or rolled Can be lowered by rope or slid Can be lowered by rope or slid

down a flight of stairsdown a flight of stairs

BackboardsBackboards

Used primarily for suspected Used primarily for suspected spinal injuriesspinal injuries

Long BackboardsLong Backboards• 6-7 feet long6-7 feet long• Commonly for patients found lying Commonly for patients found lying

downdown

Backboards (cont)Backboards (cont)

Short BackboardsShort Backboards• 3-4 feet long3-4 feet long• Used for patients found in sitting Used for patients found in sitting

positionposition• Designed to immobilize head and torsoDesigned to immobilize head and torso

LitterLitter

3-person lift and carry onto litter3-person lift and carry onto litter• Place litter next to victimPlace litter next to victim• All kneel on same side of victim (knee All kneel on same side of victim (knee

towards head is up)towards head is up)• Hand positionsHand positions

– Head - one under neck; one under shouldersHead - one under neck; one under shoulders– Middle - one under lower back; one below Middle - one under lower back; one below

buttocksbuttocks– Feet - one under ankles; one under kneesFeet - one under ankles; one under knees

Litter (cont)Litter (cont)

3-person (cont)• Lifting victim onto litter

– Rescuer at head gives commands– Lift victim onto knee, towards you– Move forward to litter– Lower victim onto litter(may need to slide

victim- positioning)

Litter (cont)Litter (cont)

4th Rescuer Available4th Rescuer Available• Stays on side of litter opposite victimStays on side of litter opposite victim• Slides litter into positionSlides litter into position• Steadies litter while victim is loweredSteadies litter while victim is lowered

Litter (cont)Litter (cont)

Carrying the LitterCarrying the Litter• Apply at least 2 litter straps(3 preferred), Apply at least 2 litter straps(3 preferred),

before lifting litterbefore lifting litter• 2 rescuers at head, one at foot; if 4th 2 rescuers at head, one at foot; if 4th

rescuer available, 2 at head, 2 at feetrescuer available, 2 at head, 2 at feet

Litter (cont)Litter (cont)

Carrying the Litter (cont)Carrying the Litter (cont)• Rescuer at victim’s right shoulder gives Rescuer at victim’s right shoulder gives

commandscommands– Lift on commandLift on command– Wait for command to move; carry feet firstWait for command to move; carry feet first– Procedures reversed for stopping and Procedures reversed for stopping and

loweringlowering

Litter (cont)Litter (cont)

On-loading victims into On-loading victims into ambulanceambulance• Load head firstLoad head first

– As approach ambulance, bear around so As approach ambulance, bear around so head is facing rear of ambulancehead is facing rear of ambulance

– Lower litter (using commands)Lower litter (using commands)– PositioningPositioning

• One rescuer at feet (tallest, strongest)One rescuer at feet (tallest, strongest)• Other two on either side, about midwayOther two on either side, about midway

Litter(cont)Litter(cont)

On-Loading Victims (cont)On-Loading Victims (cont)• Command from rescuer at feet, lift so Command from rescuer at feet, lift so

handles rest on seathandles rest on seat• Rescuers on sides go into ambulanceRescuers on sides go into ambulance

– One at headOne at head– One near middleOne near middle

• All slide litter into ambulanceAll slide litter into ambulance

Litter (cont)Litter (cont)

On-loading Victims (cont)On-loading Victims (cont)• Litters loaded in specific orderLitters loaded in specific order

– Upper rightUpper right– Lower rightLower right– Upper leftUpper left– Lower leftLower left

Litter (cont)Litter (cont)

On-Loading Victims (cont)On-Loading Victims (cont)• Loading litter into top positionLoading litter into top position

– Rescuers stay in position Rescuers stay in position – On command, litter lifted and inside On command, litter lifted and inside

position hooked first and inform position hooked first and inform other EMTsother EMTs

• Never mix deceased and live victimsNever mix deceased and live victims

Litter (cont)Litter (cont)

Off-loading patientsOff-loading patients• Reverse entire procedureReverse entire procedure• Most seriously injured last so off-loaded Most seriously injured last so off-loaded

firstfirst

SUMMARYSUMMARY

Principles of Safe LiftingPrinciples of Safe Lifting• Guidelines for Safe LiftingGuidelines for Safe Lifting• Lift PositionsLift Positions

Principles of Safe CarryingPrinciples of Safe Carrying• Guidelines for Safe CarryingGuidelines for Safe Carrying• Carrying a StretcherCarrying a Stretcher

SUMMARY (cont)SUMMARY (cont)

Patient Handling EquipmentPatient Handling Equipment• Wheeled StretcherWheeled Stretcher• Portable StretcherPortable Stretcher• Scoop StretcherScoop Stretcher• Basket StretcherBasket Stretcher• Flexible StretcherFlexible Stretcher• BackboardsBackboards• LitterLitter

NOW, LET’S PRACTICE…NOW, LET’S PRACTICE…