slide 1 copyright © 2011, 2006 mosby, inc., an imprint of elsevier inc. all rights reserved....

Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Chapter 6Chapter 6

Lifting and Moving PatientsLifting and Moving Patients


OverviewOverview Body MechanicsBody Mechanics

LiftingLifting CarryingCarrying ReachingReaching Pushing and PullingPushing and Pulling

Principles of Moving PatientsPrinciples of Moving Patients Emergency MovesEmergency Moves Urgent MovesUrgent Moves Nonurgent MovesNonurgent Moves

EquipmentEquipment


Body MechanicsBody Mechanics

The principles of effective movement used in The principles of effective movement used in

lifting and moving patientslifting and moving patients

Use of proper body mechanics reduces the EMS provider’s chances of being injured.


Lifting TechniquesLifting Techniques Safety precautionsSafety precautions

Use legs, not back, to liftUse legs, not back, to lift Keep weight as close to body as possibleKeep weight as close to body as possible Consider weight of patient and need for additional Consider weight of patient and need for additional

helphelp Know physical ability and limitationsKnow physical ability and limitations Lift without twistingLift without twisting Have feet positioned properlyHave feet positioned properly Communicate clearly and frequently with partnerCommunicate clearly and frequently with partner


Improper Lifting TechniqueImproper Lifting Technique

Improper lifting Improper lifting technique with back technique with back twistedtwisted


Proper Lifting TechniqueProper Lifting Technique


Proper Lifting TechniqueProper Lifting Technique

Know the weight limitations of the devices!


Guidelines for StretchersGuidelines for Stretchers

When possible use a stair chair instead of a When possible use a stair chair instead of a stretcher, if medically appropriatestretcher, if medically appropriate



Know or find out the weight to be liftedKnow or find out the weight to be lifted Use at least two peopleUse at least two people Ensure enough help availableEnsure enough help available Use an even number of people to lift so that Use an even number of people to lift so that

balance is maintainedbalance is maintained Know or find out the weight limitations of Know or find out the weight limitations of

equipment being usedequipment being used



Using power-lift or squat-lift positionUsing power-lift or squat-lift position Use power grip to get maximum force from Use power grip to get maximum force from

handshands Lift while keeping back in locked-in positionLift while keeping back in locked-in position When lowering cot or stretcher, reverse stepsWhen lowering cot or stretcher, reverse steps Avoid bending at the waistAvoid bending at the waist


Video Clip: The Squat Lift for Lifting a StretcherVideo Clip: The Squat Lift for Lifting a Stretcher


CarryingCarrying

Precautions for carrying—whenever possible, Precautions for carrying—whenever possible, transport patients on devices that can be rolledtransport patients on devices that can be rolled

It is always best to let the equipment perform the work.


Guidelines for CarryingGuidelines for Carrying

Know or find out the weight to be liftedKnow or find out the weight to be lifted Know limitations of the crew’s abilitiesKnow limitations of the crew’s abilities Work in a coordinated manner and Work in a coordinated manner and

communicate with partnerscommunicate with partners Keep the weight as close to the body as Keep the weight as close to the body as

possiblepossible


Guidelines for CarryingGuidelines for Carrying

Keep back in a locked-in position and refrain Keep back in a locked-in position and refrain from twistingfrom twisting

Flex at the hips, not the waist; bend at the Flex at the hips, not the waist; bend at the kneesknees

Do not hyperextend the back (do not lean Do not hyperextend the back (do not lean back from the waist)back from the waist)


Correct Carrying Procedure Correct Carrying Procedure

Use correct lifting Use correct lifting techniques to lift the techniques to lift the stretcherstretcher

Partners should Partners should have similar have similar strength and heightstrength and height


One-Handed Carrying Technique One-Handed Carrying Technique

Pick up and carry with the back in the locked-Pick up and carry with the back in the locked-in positionin position

Avoid leaning to either side to compensate for Avoid leaning to either side to compensate for the imbalancethe imbalance


Carrying Procedure on StairsCarrying Procedure on Stairs

When possible, use a stair chair instead of a When possible, use a stair chair instead of a stretcher stretcher

Keep back in locked-in positionKeep back in locked-in position Flex at the hips, not the waist; bend at the Flex at the hips, not the waist; bend at the

kneesknees Keep weight and arms as close to the body as Keep weight and arms as close to the body as

possiblepossible


Carrying Procedure on StairsCarrying Procedure on Stairs

A stair chair provides more flexibility for handling and transporting patients in narrow or steep areas.


Reaching GuidelinesReaching Guidelines

Keep back in locked-in position Keep back in locked-in position

When reaching overhead, avoid When reaching overhead, avoid hyperextended positionhyperextended position

Avoid twisting the back while reachingAvoid twisting the back while reaching


Reaching TechniquesReaching Techniques

Avoid reaching more than 15–20 inches in Avoid reaching more than 15–20 inches in front of the bodyfront of the body

Avoid situations where prolonged (more than Avoid situations where prolonged (more than 1 minute) strenuous effort is needed to avoid 1 minute) strenuous effort is needed to avoid injuryinjury


Correct Reaching for Log RollsCorrect Reaching for Log Rolls

Keep back straight while leaning over patientKeep back straight while leaning over patient

Lean from the hipsLean from the hips

Use shoulder muscles to help with rollUse shoulder muscles to help with roll


Pushing and Pulling GuidelinesPushing and Pulling Guidelines

Push, rather than pull, whenever possiblePush, rather than pull, whenever possible

Keep back locked-inKeep back locked-in

Keep line of pull through center of body by Keep line of pull through center of body by bending kneesbending knees

Keep weight close to the bodyKeep weight close to the body


Pushing and PullingPushing and Pulling Push from the area between the waist and Push from the area between the waist and

shouldershoulder

If weight is below waist level, use kneeling If weight is below waist level, use kneeling positionposition

Avoid pushing or pulling from an overhead Avoid pushing or pulling from an overhead position if possibleposition if possible

Keep elbows bent with arms close to the sidesKeep elbows bent with arms close to the sides


Principles of Moving PatientsPrinciples of Moving Patients

Emergency movesEmergency moves

Urgent movesUrgent moves

Nonurgent movesNonurgent moves


Emergency MovesEmergency Moves There is an immediate danger to the patient if There is an immediate danger to the patient if

not movednot moved Fire or danger of fireFire or danger of fire Explosives or other hazardous materialsExplosives or other hazardous materials Inability to protect the patient from other hazards at Inability to protect the patient from other hazards at

the scenethe scene Inability to gain access to other patients in a Inability to gain access to other patients in a

vehicle who need lifesaving carevehicle who need lifesaving care Lifesaving care cannot be given because of the Lifesaving care cannot be given because of the

patient’s location or positionpatient’s location or position


Video Clip: Rapid Extrication of a Patient from Video Clip: Rapid Extrication of a Patient from a Vehiclea Vehicle


Urgent MovesUrgent Moves

Altered mental statusAltered mental status

Inadequate breathingInadequate breathing

Shock (hypoperfusion)Shock (hypoperfusion)


Nonurgent MovesNonurgent Moves

If there is no threat to life, the patient should If there is no threat to life, the patient should be moved when ready for transportation be moved when ready for transportation (nonurgent move)(nonurgent move)


Emergency Moves Emergency Moves

Clothes dragClothes drag


Emergency MovesEmergency Moves

Blanket dragBlanket drag


Emergency MovesEmergency Moves

Pulling the patient Pulling the patient under the armsunder the arms


Nonurgent Moves Nonurgent Moves

Direct ground lift Direct ground lift


Video Clip: Direct Ground Lift (No Suspected Video Clip: Direct Ground Lift (No Suspected Spine Injury)Spine Injury)



Extremity lift Extremity lift


Video Clip: Extremity Lift (No Suspected Video Clip: Extremity Lift (No Suspected Spine Injury)Spine Injury)



Stretcher to bed transferStretcher to bed transfer


Video Clip: Transfer of Supine Patient from Video Clip: Transfer of Supine Patient from the Stretcher to the Bed by the Direct Carry the Stretcher to the Bed by the Direct Carry MethodMethod


Video Clip: Transfer of a Supine Patient from Video Clip: Transfer of a Supine Patient from the Stretcher to the Bed by the Draw Sheet the Stretcher to the Bed by the Draw Sheet MethodMethod


EquipmentEquipment

Stretchers and CotsStretchers and Cots


Wheeled StretcherWheeled Stretcher


Portable Stretcher Portable Stretcher


Scoop Stretcher Scoop Stretcher


Flexible Stretcher Flexible Stretcher


Basket Stretcher Basket Stretcher


Stair Chair Stair Chair


Long BackboardLong Backboard


Seated Spinal DevicesSeated Spinal Devices


Patient PositioningPatient Positioning

SupineSupine



Fowler’sFowler’s



RecoveryRecovery



Pregnant patientPregnant patient



Children should be Children should be secured in car seats secured in car seats for transportfor transport


SummarySummary Body MechanicsBody Mechanics

LiftingLifting CarryingCarrying ReachingReaching Pushing and PullingPushing and Pulling

Principles of Moving PatientsPrinciples of Moving Patients Emergency MovesEmergency Moves Urgent MovesUrgent Moves Nonurgent MovesNonurgent Moves

EquipmentEquipment

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