Ch 6 - Lifting and Moving

4 basic body mechanics

1. keep weight of the object as close to the body as possible

2. use the leg, hip, a gluteal muscle when lifting

3. “stack” the shoulders, hips, and feet

4. reduce the height distance through which the object must be removed

When lifting and moving:

• keep the spine the alignment

• whenever possible, substitute equipment for manual force

What can poor posture and fitness do?

• can fatigue back and abdominal muscles and increase risk of injury

Lordosis

swayback

Kyphosis

slouch

proper standing posture

• ears, shoulders, and hips are in vertical alignment

• pelvis is slightly tucked forward

• knees are slightly bent

proper sitting posture

• ears, shoulders, and hips are in vertical alignment

• pelvis is slightly tucked forward

• weight is evenly distributed on both ischia

• feet are fat on floor/crossed at ankles

What can good body mechanics not fully compensate for?

• poor physical fitness

communication and teamwork in moving and lifting

• all team members must be properly trained

• team members should be physically matched when lifting

• communicate and coordinate throughout the lift

• tell pt what you’re doing

using good teamwork while lifting and moving

• size up scene immediately and accurately

• consider weight of the pt

• be aware of abilities and limitations of each team member

• select most appropriate equipment for the job

What is it important to know

your abilities and limits

What number of rescuers do you always want to use?

an even number

Power Lift

• offers the best defense against injury and promotes a safe and stable move

• use a power grip

Squat Lift

• alternative technique if you have a weak ankle

• avoid bending at waist

Who is the lead of the lift

the person who is at the head

one handed equipment carrying technique

• keep your back in a locked position

• maintain proper mechanics

• avoid leaning to the opposite side to compensate for imbalance

reaching

• get as close to the object being lifted as possible to decrease the effort needed

• limit reaching to 15-20 inches in the front of your body

• keep the back locked in and don’t twist

pushing and pulling

• when possible, push rather than pull

• when pulling:

  • keep the load between the shoulders and hips and close to your body

  • keep back straight and slightly bend your knees

emergency move

• should be performed when there is immediate danger to the patient or rescuer

• armpit-foreman drag

• shirt drag

• blanket drag

urgent move

• performed when the pt is suffering an immediate threat to life and must be moved quickly and transported for care

• rapid extrication

• self-extrication

nonurgent moves

• no immediate threat to life exists and the pt can be moved in a normal manner when ready for transport

  • direct ground lift

  • extremity lift/ for & aft carry

  • direct carry method (bed to bed)

  • draw sheet method (most common)

packaging

• readying the pt for transport

• once pt is stabilized, select and prepare a carrying device and move the pt to the ambulance

wheeled stretcher

• can accommodate up to 650 lbs.

• limited to use on smooth terrain

• fasten all straps to secure the pt

• never leave a pt unattended

bariatric stretchers and devices

designed to hold up to 1600 lbs

portable stretcher

useful for carrying pt in confined spaces or for calls involving more than one pt

stair chair

• useful when a wheeled stretcher cannot transverse narrow walking spaces or stairs

• don’t use for a pt with altered mental status, spinal injury, or lower extremity injuries

backboards

• used for spine motion restriction and carrying

  • long spinal board

  • short spinal board

  • vest-type immobilizer

  • full body vacuum mattress

full body vacuum mattress

• can be used for immobilization or for moving the pt

• pit is secured to a rigid, conforming vacuum mattress

scoop stretcher

• can be assembled and disassembled around the pt

• not recommended for pts with spinal injury

basket stretcher

• aka Stokes basket

• accommodates scoop stretcher and most backboards

• can be placed on a wheeled stretcher

flexible stretcher

• aka Reeves stretcher

• useful in restricted spaces

pt positioning

• the pt is most commonly placed in the supine or sitting position

what are special considerations for pt positioning

• infant or toddler

• pregnant women

• elderly pt

• pt’s with physical disabilities

packing pt for air transport

• decontaminate pt (if needed)

• manage the airway appropriately

• leave the chest accessible

• secure all equipment

• communicate with the pt

• cover eyes, ears, and exposed wounds

• listen to the directions of the flight crew

general guidelines

• use wheeled stretcher (if possible)

• secure the pts hands

• consider your lifting limitations

• communicated with partner

• keep weight close to the body

two person carry

• position one person at the pt's head and one at the feet, with the stronger person at the end

• rescuers must be facing each other

  • EMT at foot must walk backwards

• if present, use a 3rd person as a spotter

four-person carry

• one rescuer at head

• one at the foot, facing away from the head

• one rescuer on each side, facing forward

• alternatively:

  • 2 rescuers at head

  • 2 at feet

carrying supine on stairs

• stair chair is preferred, but not always feasible

• ensure that the pt is secured to the device

• secure the pts hands

• use a spotter

neonatal isolette

• used to transport newborns

• engages in stretcher mounts of ambulance