Slide 1 Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Chapter 6 Chapter 6 Lifting and Moving Lifting and Moving Patients Patients
Slide 1Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
Chapter 6Chapter 6
Lifting and Moving PatientsLifting and Moving Patients
Slide 2Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
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
Slide 3Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
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.
Slide 4Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
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
Slide 5Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
Improper Lifting TechniqueImproper Lifting Technique
Improper lifting Improper lifting technique with back technique with back twistedtwisted
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Proper Lifting TechniqueProper Lifting Technique
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Proper Lifting TechniqueProper Lifting Technique
Know the weight limitations of the devices!
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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
Slide 9Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
Guidelines for StretchersGuidelines for Stretchers
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
Slide 10Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
Guidelines for StretchersGuidelines for Stretchers
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
Slide 11Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
Video Clip: The Squat Lift for Lifting a StretcherVideo Clip: The Squat Lift for Lifting a Stretcher
Slide 12Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
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.
Slide 13Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
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
Slide 14Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
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)
Slide 15Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
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
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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
Slide 17Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
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
Slide 18Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
Carrying Procedure on StairsCarrying Procedure on Stairs
A stair chair provides more flexibility for handling and transporting patients in narrow or steep areas.
Slide 19Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
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
Slide 20Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
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
Slide 21Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
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
Slide 22Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
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
Slide 23Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
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
Slide 24Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
Principles of Moving PatientsPrinciples of Moving Patients
Emergency movesEmergency moves
Urgent movesUrgent moves
Nonurgent movesNonurgent moves
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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
Slide 26Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
Video Clip: Rapid Extrication of a Patient from Video Clip: Rapid Extrication of a Patient from a Vehiclea Vehicle
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Urgent MovesUrgent Moves
Altered mental statusAltered mental status
Inadequate breathingInadequate breathing
Shock (hypoperfusion)Shock (hypoperfusion)
Slide 28Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
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)
Slide 29Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
Emergency Moves Emergency Moves
Clothes dragClothes drag
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Emergency MovesEmergency Moves
Blanket dragBlanket drag
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Emergency MovesEmergency Moves
Pulling the patient Pulling the patient under the armsunder the arms
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Nonurgent Moves Nonurgent Moves
Direct ground lift Direct ground lift
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Video Clip: Direct Ground Lift (No Suspected Video Clip: Direct Ground Lift (No Suspected Spine Injury)Spine Injury)
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Nonurgent MovesNonurgent Moves
Extremity lift Extremity lift
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Video Clip: Extremity Lift (No Suspected Video Clip: Extremity Lift (No Suspected Spine Injury)Spine Injury)
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Nonurgent MovesNonurgent Moves
Stretcher to bed transferStretcher to bed transfer
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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
Slide 38Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
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
Slide 39Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
EquipmentEquipment
Stretchers and CotsStretchers and Cots
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Wheeled StretcherWheeled Stretcher
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Portable Stretcher Portable Stretcher
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Scoop Stretcher Scoop Stretcher
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Flexible Stretcher Flexible Stretcher
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Basket Stretcher Basket Stretcher
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Stair Chair Stair Chair
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Long BackboardLong Backboard
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Seated Spinal DevicesSeated Spinal Devices
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Patient PositioningPatient Positioning
SupineSupine
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Patient PositioningPatient Positioning
Fowler’sFowler’s
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Patient PositioningPatient Positioning
RecoveryRecovery
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Patient PositioningPatient Positioning
Pregnant patientPregnant patient
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Patient PositioningPatient Positioning
Children should be Children should be secured in car seats secured in car seats for transportfor transport
Slide 53Copyright © 2011, 2006 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
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