Chapter 8: Lifting and Moving Patients

Wheeled Ambulance Stretcher

• A stretcher that can be rolled along the ground

• Contains a head end and foot end

• Retractable guardrail

• 12 inches desired in ambulance

• 32–36 inches desired when rolled

• Mattress is fluid resistant

• Patient must be secured with straps

How do you secure a patient in a wheeled ambulance stretcher?

1. Secure safety belts over the patient’s shoulders and chest in a 4-point fashion.

2. Secure safety belts over the patient’s abdomen.

3. Secure safety belts over the patient’s thighs.

4. Secure safety belts over the patient’s ankles.

Backboard

• A long flat board made out of rigid rectangular material

• Restrict spinal motion in supine patients

How should you move and position the patient?

• Should be done in an orderly, planned, and unhurried manner

• Evaluate the appropriateness of the technique

• Maintain the equipment according to the manufacturer’s instructions

Body Mechanics

The relationship between the body’s anatomy and the physical forces associated with lifting, moving, and carrying.

The weight of anything lifted is reflected onto what anatomical structures?

• Shoulder girdle

• Spinal column

• Pelvis

• Legs

How do you perform the power lift?

1. Lock back in a slight curve. Spread and bend your legs. Keep your palms in front of you. Balance and center the weight between your arms.

2. Position your feet, straddle the object, and distribute your weight evenly. Lift by straightening your legs and keeping your back locked in.

Power Grip

• Gives you the maximum force when lifting a patient

• Grasp the handle with your palms up and thumbs extending up

Principles of Safe Reaching and Pulling

• Kneel to minimize the distance you have to lean over

• When pulling, your elbows should be slightly beyond the anterior torso

  • Extend your arms no longer than 15–20 inches

• For a patient at a different height, bend your knees so that your hips are below the height of the plane in which you’re pulling the patient

  • Extend your arms no longer than 15–20 inches, pull, and reposition

Body Drag

1. Position yourself beyond the patient’s shoulder and face their groin.

2. Place one arm on the armpit and the other on the torso.

3. Lift with your elbows and flex your arms to pull the patient.

Log Rolling

• Kneel as close to the patient’s side

• Roll the patient until they are on their side and are against your thighs

• Pull the patient toward your legs to prevent them from rolling

What are the guidelines for carrying a patient on a stretcher?

• Estimate the weight of the patient

• Coordinate with your team

• Don’t twist your body

• Keep the weight as close to your body as possible

• Don’t bend your waste

Diamond Carry

• One provider at the head, the foot, and the sides of the stretcher.

1. Position yourself facing the patient.

2. The providers on each side put their head-end hand down and release the other hand

3. The providers on each side turn toward the foot-end, and the provider on the foot-end faces toward the head-end.

One-Handed Carry

• Four or more providers can support the backboard and walk forward

1. Face each other and use both hands.

2. Lift the backboard to carrying height.

3. Turn in the direction you will walk, and switch to using one hand.

Stair Chair

A lightweight folding chair with a molded seat, safety straps, and fold-out handles at both the head and feet.

How do you use a stair chair?

1. Strap the patient (lap belt and two straps for the chest). Take place at the head and foot of the chair.

2. Lower the chair to roll on landings and transfer to the stretcher.

How do you carry a patient on the stairs?

1. Strap the patient securely. Make sure the strap is across the upper torso, under the arms, and secured to the handles.

2. Carry the patient down the stairs, foot-end first.

How do you load a stretcher into an ambulance?

1. Lift the stretcher into the load position, and place it into the patient compartment with the wheels on the floor and the safety bar latched on the hook.

2. Release the undercarriage lock and lift the undercarriage.

3. Roll the stretcher into the back of the ambulance.

4. Secure the stretcher to the clamps mounted in the ambulance.

How do you give proper directions and commands?

Use preparatory commands and commands of execution (e.g., “All ready to stop. STOP!”).

Emergency Move

A move in which the patient is dragged or pulled from a dangerous scene before assessment and care are provided.

How do you perform an emergency move on a patient lying on his or her back?

• Pull on the patient’s clothing in the neck and shoulder area

• Place the patient on a blanket, coat, or any other item that can be pulled

• Arm drag

• Arm-to-arm drag

How do you remove an unresponsive patient from a vehicle?

Move the patient’s legs away from the pedal. Have their back facing the door. Grasp the patient under the arms and drag them into the supine position.

Rapid Extrication Technique

A technique to move a patient from a sitting position inside a vehicle to supine on a backboard in less than 1 minute when conditions do not allow for standard immobilization.

How do you perform the rapid extrication technique?

1. The first provider provides in-line support of the head and cervical spine.