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TRANSCRIPT
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
CHAPTER
Principles of Lifting, Moving, and Positioning of Patients
6
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Topics
• Principles of Moving Patients• Emergency Moves• Standard Moves• Equipment for Transporting Patients• Patient Positioning• Restraining Patients
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
PRINCIPLES OF MOVING PATIENTS
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Principles of Moving Patients
• Body Mechanics– Proper and efficient use of your body to
facilitate lifting and moving. Plan what you will do; how you will do it. Estimate weight. Consider physical limitations. Communicate with your partner.
(continued)
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Principles of Moving Patients
• Body Mechanics– Position your feet properly.– Lift with your legs.– When lifting object with one hand, avoid
leaning to either side.– Minimize twisting during lift.
(continued)
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Principles of Moving Patients
• Body Mechanics– Keep weight as close to your body as
possible.– When carrying patient on stairways, use
chair or commercial stair chair instead of wheeled stretcher whenever possible.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
To begin the power lift, keep your back straight and eyes on your partner.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Lift with your legs.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
While moving, keep the weight as close to your body as possible.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
When you use a stair chair, have someone spot you as you walk backward down stairs.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Principles of Moving Patients
• When to Move a Patient– Only when absolutely necessary.– Dangerous environment.– Cannot adequately assess airway,
breathing, circulation or bleeding. – Unable to gain access to other patients
who need lifesaving care.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
EMERGENCY MOVES
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Emergency Moves
• Patient and/or rescuers are in immediate danger.
• Lifesaving care cannot be given because of patient's location or position.
• To gain access to other patients who need lifesaving care.
• Rarely provide protection for patient's injuries; may cause patient pain.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Emergency Moves
• Drags– Patients pulled by their clothes, feet, or
shoulders or by using a blanket.– Initiated from shoulders by pulling along
the long axis of body.– Avoid dragging patient sideways.
(continued)
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Emergency Moves
• Drags– To move patient down stairs or down
incline, grab under shoulders and pull head first as you walk backward.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Clothing drag, or shirt drag.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Blanket drag.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Shoulder drag.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Firefighter's drag.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Strap drag.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Emergency Moves
• Any emergency move must be justified and carried out as quickly as possible.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
One-rescuer crutch.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Cradle carry.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Pack strap carry.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Piggy back carry.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Firefighter's carry.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
STANDARD MOVES
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Standard Moves
• Preferred choice when situation is not urgent, patient is stable, have adequate time and personnel for a move.
• Standard moves carried out with help of other trained personnel or bystanders.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Standard Moves
• Patient uncomfortable or his position is aggravating the injury.
• Emergency care requires moving patient.
• Patient insists on being moved.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Standard Moves
• Complete the primary assessment.• Choose the number of rescuers.• Avoid compromising neck/spine injury.• Consider splinting suspected fractures.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Standard Moves
• Direct Ground Lift– Three rescuers move patient from ground
to bed or stretcher.– Patient lying face up (supine); arms placed
on chest.– Everyone lifts patient up to level of their
knees.
(continued)
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Position your arms under the patient. Be sure to cradle the head.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Standard Moves
• Direct Ground Lift– Rescuers roll patient toward their chests.– Everyone should stand while holding
patient.– Patient moved.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Lift the patient to your knees and roll toward your chests.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
On signal, move the patient to the carrying device.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Standard Moves
• Extremity Lift– Two rescuers, one lifting patient's arms and
one lifting patient's legs.– Ideal for moving patient from ground to
chair or stretcher.– Do not perform if head, neck, spine,
shoulder, hip, or knee injury, or suspected fractures to extremities.
(continued)
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Standard Moves
• Extremity Lift– Patient should be placed face up, with
knees flexed.– Kneel at head of patient, placing hands
under shoulders. – Have helper stand at patient's feet and
grasp his/her wrists.
(continued)
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
To get the patient into a sitting position, one rescuer pushes from behind while the other pulls from the wrists.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Standard Moves
• Extremity Lift– Slip your arms under patient's armpits and
grasp wrists.– Pull patient into sitting position.
(continued)
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
The rescuer at the head places arms under patient's armpits and grasps patient's wrists. While facing the patient, the rescuer at the feet grasps patient's
legs behind the knees.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Standard Moves
• Extremity Lift– Both stand at same time.– Move as unit when carrying patient.– Avoid swinging patient.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
You can now carry the patient a short distance or place her on a stretcher or chair.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Standard Moves
• Direct Carry Method– To move patient with no suspected spine
injury from bed or from bed-level position to stretcher.
– Position stretcher perpendicular to bed, with head end of stretcher at foot of bed.
(continued)
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Stretcher is placed at 90-degree angle to bed, depending on room configuration. Prepare stretcher by lowering rails, unbuckling straps, and
removing other items. Both Emergency Medical Responders stand between stretcher and bed, facing patient.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Standard Moves
• Direct Carry Method– Position arms under patient; slide patient to
edge of bed.
(continued)
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Position your arms under the patient and slide the patient to the edge of the bed.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Standard Moves
• Direct Carry Method– Lift patient; curl toward your chests.– Rotate and place patient gently on the
carrying device.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Lift the patient and curl her toward your chests.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Rotate and place the patient gently on the carrying device.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Standard Moves
• Draw Sheet Method– From side of bed, loosen bottom sheet
under patient; position stretcher next to bed.
– Adjust height of stretcher to match level of bed, lower rails, unbuckle straps.
(continued)
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Standard Moves
• Draw Sheet Method– Grasp sheet firmly at patient's head, chest,
hips, and knees.– Draw patient onto stretcher, sliding in one
smooth motion.– Can also use slider boards and slide bags.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Draw sheet method of moving a patient from a bed to a stretcher.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Draw sheet method of moving a patient from a bed to a stretcher.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Example of a slider board.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Example of a slide bag.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
EQUIPMENT FOR TRANSPORTING PATIENTS
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Equipment for Transporting Patients
• Wheeled stretcher (gurney, cot, pram)– Used to transport patient from scene of
emergency to ambulance and from ambulance to hospital bed.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Equipment for Transporting Patients
• Types of Stretchers– Single-operator
(continued)
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Single-operator stretcher.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Single-operator stretcher.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Equipment for Transporting Patients
• Types of Stretchers– Dual-operator
(continued)
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Dual-operator stretcher.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Dual-operator stretcher.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Equipment for Transporting Patients
• Types of Stretchers– Electric/pneumatic-lift
(continued)
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Electric/pneumatic-lift stretcher. These eliminate the need for heavy lifting.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Equipment for Transporting Patients
• Types of Stretchers– Scoop
(continued)
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Scoop stretchers. (A) These stretchers are ideal for moving patients in the position they are found.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Scoop stretchers. (B) Once in place, the patient must be properly secured to the device before moving.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Equipment for Transporting Patients
• Types of Stretchers– Portable– Flexible– Stair
(continued)
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Portable stretcher. Beneficial for carrying supine medical patients down stairs.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Flexible stretcher. Used in restricted areas or narrow hallways.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Equipment for Transporting Patients
• Types of Stretchers– Basket
(continued)
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Basket stretcher. Used in rescue situations and to transport over rough terrain.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Equipment for Transporting Patients
• Types of Stretchers– Spine board
(continued)
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Long spine board. (A) This backboard is used to immobilize the spine of a supine patient.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Long spine board. (B) Long spine board with patient properly secured in place.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Equipment for Transporting Patients
• Types of Stretchers– Vest-type extrication device
(continued)
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Vest-type extrication device. This device facilitates the extrication of a seated patient, while stabilizing the patient's head, neck, and spine.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Equipment for Transporting Patients
• Types of Stretchers– Full-body immobilization device– Pedi-board
(continued)
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
PATIENT POSITIONING
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Patient Positioning
• Recovery Position– Patient with no suspected spine injury
placed on side to help maintain open airway (lateral recumbent).
(continued)
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Move the closest hand of the patient above his head.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Patient Positioning
• Recovery Position– Move closest hand of patient above head;
move far hand across to opposite shoulder, next to patient's cheek.
(continued)
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Move the patient's far hand across to the opposite shoulder, next to the patient's cheek.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Patient Positioning
• Recovery Position– Bring patient's far leg to flexed position.
(continued)
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Bring the patient's far leg to the flexed position.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Patient Positioning
• Recovery Position– Using knee and shoulder, carefully pull
patient onto side.
(continued)
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Using the knee and shoulder, carefully pull the patient onto his side.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Patient Positioning
• Recovery Position– Adjust knee and shoulder to stabilize
patient; recheck patient's ABCs.
(continued)
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Adjust the knee and shoulder to stabilize the patient. Then recheck the patient's ABCs.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Patient Positioning
• Recovery Position– Knee and elbow will support patient.
(continued)
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Once properly positioned, the knee and elbow will support the patient.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Patient Positioning
• Fowler's and Semi-Fowler's Positions– Fowler's position: patient is placed fully
upright in a seated position, creating a 90-degree angle.
– Semi-Fowler's position: semi-seated position; patient reclines at 45-degree angle.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Patient Positioning
• Trendelenburg Position– Patient placed flat on back with legs and
feet raised.– May be used in patients with non-traumatic
shock.• Shock position used for patients
exhibiting signs of shock but have no evidence of trauma or injury.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Patient Positioning
• Log Roll– Method used to move patient with
suspected spine injury from prone position to supine position.
– Few as two rescuers; three ideal.
(continued)
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Patient Positioning
• Log Roll– Manually stabilize patient's head and neck
as you place board parallel to patient.
(continued)
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Manually stabilize the patient's head and neck as you place the board parallel to the patient. Maintain manual stabilization throughout the log roll.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Patient Positioning
• Log Roll– Kneel at patient's side opposite board.– Reach across patient and position your
hands.– Inspect patient's back.
(continued)
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Kneel at the patient's side opposite the board. Reach across the patient and position your hands. Inspect the patient's back.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Patient Positioning
• Log Roll– As a unit roll patient toward you. – Move spine board into place.– Lower patient onto spine board.
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Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
On command from the rescuer at the head, as a unit roll the patient toward you. Then move the spine board into place.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Lower the patient onto the spine board at the command of the rescuer at the head. Center the patient on the board.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
RESTRAINING PATIENTS
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Restraining Patients
• Process of securing combative patient's body and extremities to prevent injury to himself/herself or others.– Physical restraint: holding patient with your
hands or legs so they cannot move.– Mechanical restraint: applying device to
patient to restrict movements.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Restraining Patients
• Hard restraints: handcuffs, shackles, plastic zip-ties, belly chains.
• Soft restraints: leather or fabric cuffs, cloth straps, rolls of gauze, cravats, sheets, clothing.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Restraining a patient to a gurney.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Examples of soft restraints. (A) Restraint of the arm.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Examples of soft restraints. (B) use of restraints for the legs.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Restraining Patients
• Patient Restraint– Secure limbs with appropriate restraining
equipment.– Do NOT secure patient face down.– Consider administering supplemental
oxygen.– Check patient's airway, breathing, and
circulation.
(continued)
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Restraining Patients
• Patient Restraint– Clearly document reason for restraining.– Ensure that group uses only force required.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Restraining Patients
• Positional asphyxia– Death resulting from securing a person in
the prone position (restraint asphyxia).
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Restraining Patients• Restraint Injuries
– Being prepared, communicating, and taking decisive action will help minimize the risk of injury to rescuers and patient.– Be sure to train with the restraint equipment available to you.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
SUMMARY
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Summary
• Critical to understand and apply proper body mechanics when lifting either patients or objects.
• When lifting, always keep weight as close to body as possible, avoid leaning or twisting, use your leg muscles to lift the weight.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Summary
• When two or more responders are preparing to move a patient, eye contact and effective communication are important.
• Sometimes it is necessary for patient to be moved from immediate area for safety or care.
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Emergency Care, Twelfth EditionDaniel J. Limmer • O'Keefe • Grant • Murray • Bergeron • Dickinson
Emergency Medical Responder: First on Scene, Ninth EditionLe Baudour • Bergeron • Wesley
Summary
• Recovery position is effective to care for an unresponsive patient's airway when a spine injury is not suspected.
• It is important to only use force necessary to apply proper restraints.
• Never restrain patient in prone position.