Chapter 8: Lifting and Moving Patients

In order to facilitate a safe and coordinated move, the team leader should:

use preparatory commands to initiate any moves.

The proper technique for using the power grip is to

lift with your palms up

The direct carry is used to transfer a patient:

from a bed to the ambulance stretcher

Prior to applying medical restraints to a combative patient, you should:

evaluate the patient for potentially correctible cause of combativeness, such as head injury, hypoxia, or hypoglycemia

It is essential that you ____________ your equipment to prevent the spread of disease.

decontaminate

Which of the following statements regarding an emergency patient move is correct?

An emergency move is performed before the primary assessment and treatment.

A folding or portable stretcher is MOST beneficial when:

a second patient must be transported on the squad bench of the ambulance

The _________ is both the mechanical weight-bearing base of the spinal column and the fused central posterior section of the pelvic girdle.

sacrum

What is the MOST appropriate method to use when moving a patient from his or her bed to the wheeled stretcher?

draw sheet method

Which of the following statements regarding the neonatal isolette is correct?

The isolette serves to keep the neonate warm and protects from excess handling

Which of the following statements regarding patient weight distribution is correct?

The majority of a horizontal patient's weight is in the torso

Which of the following statements regarding the scoop stretcher is NOT correct?

A scoop stretcher will provide adequate immobilization of a patient's spinal column

When moving a conscious, weak patient down a flight of stairs, you should:

place the wheeled stretcher at the bottom of the stairs and carry the patient down the stairs with a stair chair.

The extremity lift would NOT be appropriate to use on a patient:

with a deformed humerus

With proper technique, you and your partner should be able to safely lift a patient who weighs up to ______ lb.

220

Which of the following conditions or situations presents the MOST unique challenge to the EMT when immobilizing an elderly patient on a long backboard?

abnormal spinal curvature

Upon arriving at the scene of a motor vehicle crash, you find a single patient still seated in his car. There are no scene hazards. As you approach the vehicle, you note that the patient is semiconscious and has a large laceration to his forehead. You should:

direct your partner to apply manual in-line support of the patient's head

To avoid injury when pushing a patient or other object, you should

avoid pushing the patient with your elbows fully extended.

The MOST appropriate carrying device to use when moving a patient across rough or uneven terrain is the:

basket strecher

Which of the following MOST accurately describes the correct position of the EMTs who are executing the diamond carry technique?

one at the head, one at the feet, and one on each side of the patient's torso

Which of the following situations would require an urgent patient move?

semiconscious patient with shallow respirations and signs of shock

An EMT may injure his or her back, even if it is straight, if the

back is bent forward at the hips.

You and your partner enter the residence of an elderly couple, both of whom are found unconscious in their bed. There is no evidence of trauma. As you begin your assessment, you and your partner notice the smell of natural gas in the residence. Which of the following should be your MOST appropriate action?

Rapidly remove the patients from their residence using a blanket or clothes drag

Which of the following statements regarding the power lift is correct?

It is the safest and most powerful method of lifting a patient.

Which of the following is the MOST appropriate device to use when immobilizing a patient with a suspected spinal injury?

long backboard

To minimize the risk of injuring yourself when lifting or moving a patient, you should:

keep the weight as close to your body as possible.

When using a body drag to pull a patient who is on the ground, you should

kneel to minimize the distance that you will have to lean over

The MOST serious consequence of a poorly planned or rushed patient move is:

injury to you or your patient.

Which of the following steps is NOT proper procedure when performing an emergency move?

lifting the patient by the belt to move him or her

You have two patients who were involved in a motor vehicle crash when their SUV struck a tree—one with neck and back pain, and the other with a deformed left femur. The patient with the deformed femur states that he does not want to be placed on a hard board, nor does he want a collar around his neck. What is the MOST appropriate and practical method of securing these patients and placing them into the ambulance?

Immobilize the patient with neck and back pain on a long backboard and place him on the wheeled stretcher; place the patient with the deformed femur on a folding stretcher secured to the squad bench

An 81-year-old female fell and struck her head. You find the patient lying on her left side. She is conscious and complains of neck and upper back pain. As you are assessing her, you note that she has a severely kyphotic spine. What is the MOST appropriate method of immobilizing this patient?

Leave her on her side and use blanket rolls to immobilize her to the long backboard.

The FIRST rule of safe lifting is to:

keep your back in a straight, vertical position.

When a person is standing upright, the weight of anything being lifted and carried in the hands is FIRST reflected onto the:

shoulder girdle

In which of the following situations would a direct ground lift be the MOST appropriate method of moving a patient?

a conscious patient complaining of abdominal pain

Situations in which you should use the rapid extrication technique include all of the following, EXCEPT:

a patient who can be properly assessed while still in the vehicle

In which of the following situations is an emergency patient move indicated?

The EMT is unable to protect the patient from scene hazards.

A 56-year-old female is found supine in a narrow hallway of her mobile home. She complains of severe weakness and dizziness, and states that she is unable to walk. There is no evidence of trauma and the patient states that she did not fall. How should you and your partner move this patient to a more spacious area?

extremity lift

General guidelines for carrying a patient on a stretcher include:

constant communication with your partners

You should not attempt to lift a patient who weighs more than 250 lb with fewer than _______ rescuers, regardless of individual strength

four

When carrying a patient up or down stairs, you should avoid:

using a wheeled stretcher whenever possible

An unrestrained patient is sitting in his car after an automobile crash. He is conscious and alert, has no visible trauma, and is complaining of neck and back pain. Before removing him from his car, you should:

apply a cervical collar and immobilize him with a vest-style device

In most instances, you should move a patient on a wheeled ambulance stretcher by:

pushing the head of the stretcher while your partner guides the foot

A critical aspect of the rapid extrication technique is to

maintain stabilization of the spine at all times

When carrying a patient on a backboard up or down stairs

keep the head end elevated

When performing the rapid extrication technique to remove a patient from their vehicle, you should..

apply a cervical collar and remove the patient on a long backboard

When pulling a patient you should extend your arms no more than.

15'" to 20 " in front of your torso

These situations you should use the rapid extrication technique

a patient whose condition requires immediate transport

a patient who needs immediate care that requires a supine position

a patient who blocks access to another seriously injured patient

you and your partner respond to the scene of a 49 yr old male with acute abdominal pain. as you enter his residence, you find him lying on the floor in severe pain. he is conscious and alert. the patient appears to weigh in excess of 350 pounds your first action should be to?

request additional personnel before making any attempt to lift him

an emt may injure his or her back even if it is straight, if the?

back is bent forward at the hips

In contrast to typical wheeled ambulance stretchers, features of a bariatric stretcher include?

Increased stability due to a wider wheelbase

________ safety depends on the use of proper lifting techniques and maintaining a proper hold when lifting or carrying a patient.

a. your

b. your team's

c. the patient's

d. all of the above

d

You should perform an urgent move in all of the following situations except:

a. if a patient has an altered level of consciousness

b. if the patient is complaining of neck pain

c. in extreme weather conditions

d. if a patient has inadequate ventilation or shock

b

You may injure your back if you lift:

a. with your back curved

b. with your back straight, but bent significantly forward at the hips

c. with the shoulder girdle anterior to the pelvis

d. all of the above

d

When lifting, you should:

a. spread your legs past shoulder width

b. lift a patient while reaching far in front of your torso

c. keep the weight that you are lifting as close to your body as possible

d. use your back muscles by bending at the waist

c

Which of the follow statements is false regarding proper lifting?

a. avoid twisting

b. bend at the waist

c. keep the weight close to your body

d. bend at the knees

b

In lifting with the palm down, the weight is supported by the _________ rather than the palm.

a. fingers

b. forearm

c. lower back

d. wrist

a

When you must carry a patient up or down a flight of stairs or other significant incline, use a ___________ if possible.

a. backboard

b. stair chair

c. stretcher

d. short spine board

b

Because of the weight distribution on backboards and stretchers, the stronger the EMTs should be at the:

a. head

b. foot

c. side

d. front corner

a

A backboard is a device that provides support to patients who you suspect have:

a. hip injuries

b. pelvic injuries

c. spinal injuries

d. all of the above

d

Before any lifting is initiated, the team leader should do all of the following except:

a. give a command of execution

b. indicate where each team member is to be located

c. rapidly describe the sequence of steps that will be performed

d. give a brief overview of the stages

a

Special _________ are usually required to move any patient who weighs more than 350 pounds to an ambulance.

a. techniques

b. equipment

c. resources

d. all of the above

d

Which of the follow statements is false regarding the use of a stair chair?

a. keep your back in a locked-in position

b. lean back to help distribute the weight

c. keep the patient's weight and you arms as close to your body as possible

d. flex at the hips, not at the waist

b

When you use a body drag to move a patient:

a. your back should always be locked and straight

b. you should encourage twisting so that the vertebrae can flex during the move

c. consider hyperextending to gain more leverage

d. drag the patient by the ankles

a

When pulling a patient, you should do all of the following except:

a. extend your arms no more than about 15"-20"

b. reposition your feet so that the force of pull will be balanced equally

c. when you can pull no farther, lean forward another 15"-20"

d. pull the patient by slowly flexing your arms

c

When log rolling a patient, you should do all of the following except:

a. kneel as close to the patient's side as possible

b. lean solely from the hips

c. reach as far as possible to maintain stability

d. use your shoulder muscles to help with the roll

c

If the weight you are pushing is lower than your waist, you should push from:

a. the waist

b. a kneeling position

c. the shoulder

d. a squatting position

b

If you are alone and must remove an unconscious patient from a car, you should first move the patient's:

a. legs

b. head

c. torso

d. pelvis

a

Situations in which you should use an emergency move include all of the following except:

a. when fire, explosives, or hazardous materials are present

b. when the patient feels like he or she might pass out

c. when you are unable to gain access to others in a vehicle who need lifesaving care

d. when you are unable to protect the patient from other hazards

b

You can move a patient on his or her back along the floor or ground by using all of the following methods except:

a. pulling on the patient's clothing in the neck and shoulder area

b. placing the patient on a blanket, coat, or other item that can be pulled

c. pulling the patient by the legs if they are the most accessible part

d.placing your arms under the patient's shoulders and through the armpits, and while grasping the patient's arms, dragging the patient backward

c

The _________ is both the mechanical weight-bearing base of the spinal column and the fused central posterior section of the pelvic girdle.

a. lumbar spine

b. sacrum

c. coccyx

d. ileum

c

Which of the following is not an indication for use of the rapid extrication technique?

a. the patient is in severe pain

b. the patient's condition cannot be properly assessed before being removed from the car

c. the patient blocks access to another seriously injured patient

d. the vehicle or the scene is unsafe

a

To avoid the strain of unnecessary lifting and carrying, you should use _________ or assist an able patient to the stretcher whenever possible.

a. the direct ground lift

b. the extremity lift

c. the draw sheet method

d. a scoop stretcher

b

You should use a rigid _______, often called a Stokes litter, to carry a patient across uneven terrain from a remote location that is inaccessible by ambulance or other vehicle.

a. basket stretcher

b. scoop stretcher

c. molded backboard

d. flotation device

a

You should not attempt to lift a patient who weighs more than ______ without a least four rescuers.

a. 220lbs

b. 230lbs

c. 240lbs

d. 250lbs

d

Which of the following is false regarding the lifting and moving of geriatric patients?

a. many geriatric patients have great fear when being transported

b. most patients will be able to lie supine on a backboard without problems

c. geriatric patients tend to have brittle bones

d. some patients may require you to use towels and blankets to assist with immobilization

b

Bariatrics is:

a. the branch of medicine concerned with the elderly

b. the branch of medicine concerned with the obese

c. the branch of medicine concerned with infants

d. the method used to access blood pressure

b

You have been called to the scene of a high-speed motor vehicle collision involving two compact cars. The first vehicle was a roll-over, ejecting the driver. The second vehicle contained both a driver and a front-seat passenger who cannot be reached because the door is up against a building. What device will you use to put the roll-over victim onto the wheeled ambulance stretcher?

a. extremity lift

b. scoop stretcher

c. short backboard

d. backboard

d

You have been called to the scene of a high-speed motor vehicle collision involving two compact cars. The first vehicle was a roll-over, ejecting the driver. The second vehicle contained both a driver and a front-seat passenger who cannot be reached because the door is up against a building. For the passenger in the second vehicle, you may need to perform a(n) __________ on the driver in order to reach the patient.

a. extremity lift

b. emergency move

c. short backboard

d. you should do nothing different; treat each patient the same

b

You have been called to the scene of a high-speed motor vehicle collision involving two compact cars. The first vehicle was a roll-over, ejecting the driver. The second vehicle contained both a driver and a front-seat passenger who cannot be reached because the door is up against a building. Which of the following is an advantage of the diamond carry?

a. it uses an even number of people (less likely to drop)

b. it can be done with one person, freeing up others for patient care

c. the patient can be slid along the ground

d. it provides the best means of spinal immobilization

a

You have been called to the scene of a high-speed motor vehicle collision involving two compact cars. The first vehicle was a roll-over, ejecting the driver. The second vehicle contained both a driver and a front-seat passenger who cannot be reached because the door is up against a building. You'll likely use the ________ to transfer the patient from your stretcher to the hospital bed.

a. diamond carry

b. scoop stretcher

c. portable stretcher

d. draw sheet method

d

T/F A portable stretcher is typically a lightweight folding device that does not have the undercarriage and wheel of a true ambulance stretcher.

T

T/F The term "power lift" refers to a posture that is safe and helpful for EMTs when they are lifting.

T

T/F If you find that lifting a patient is a strain, try to move the patient to the ambulance as quickly as possible to minimize the possibility of back injury.

F

T/F The use of adjunct devices and equipment, such as sheets and blankets, may make the job of lifting and moving a patient more difficult.

F

T/F One-person techniques for moving patients should be used only when immediate patient movement is necessary due to a life-threatening hazard and only one EMT is available.

T

T/F A scoop stretcher may be used alone for a standard immobilization of a patient with a spinal injury.

F

T/F When carrying a patient down stairs or on an incline, make sure the stretcher is carried with the head end first.

F

T/F The rapid extrication technique is the preferred technique to use on all sitting patients with possible spinal injuries.

F

T/F It is unprofessional for you to discuss and plan a lift at the scene in front of the patient.

F

T/F Bariatrics is a new field of medicine that deals with the care of the obese.

T

T/F A minimum of five personnel should be present when restraining a combative patient.

T

T/F An isolette is used to transport neonatal patients.

T

T/F The flexible stretcher is the most comfortable of all of the various lifting devices.

F

T/F Pneumatic stretchers were developed to increase patient comfort on the road.

F

T/F The most important feature of the bariatric stretcher is the increased weight-lifting capacity.

T

To avoid injury to you, the patient, or your partners, you will have to learn how to lift and carry the patient properly, using proper __________ _________ and a power grip.

body mechanics

The key rule of lifting is to always keep the back in a straight, ________ position and to lift without twisting.

upright

The safest and most powerful way to lift, lifting by extending the properly placed flexed legs, is called a(n) _______ _________.

power lift

The arm and hand have their greatest lifting strength when facing ________ up.

palm

Be sure to pick up and carry the backboard with your back in the ________ position.

locked-in