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Ch03 lifting&moving
- 1. Emergency Care CHAPTER Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe THIRTEENTH EDITION Lifting and Moving Patients 3
- 2. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Topics Protecting Yourself: Body Mechanics Protecting Your Patient: Emergency, Urgent, and Non-Urgent Moves
- 3. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Protecting Yourself: Body Mechanics Back to Topics
- 4. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Protecting Yourself: Body Mechanics • The proper use of your body to prevent injury and to facilitate lifting and moving continued on next slide
- 5. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Protecting Yourself: Body Mechanics • Consider the following before lifting any patient: The object • Its weight and whether it would require additional help to lift Your limitations Communication • Make a plan and communicate it with your partner. continued on next slide
- 6. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Protecting Yourself: Body Mechanics • Rules for lifting Position your feet properly Shoulder width apart. Use your legs. Never turn or twist. Do not compensate when lifting with one hand. Position the weight of the object as close to the body as possible. continued on next slide
- 7. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Protecting Yourself: Body Mechanics • Rules for lifting Keep weight as close as possible to your body. Use a stair chair when carrying patient on stairs whenever possible.
- 8. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Rules for Lifting • Moving a stair chair down steps.
- 9. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Power Lift and Power Grip Power Grip-Place all fingers and palm (palms up) in contact with the object being lifted. Hands should ne 10in apart.
- 10. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Protecting Yourself: Body Mechanics • When reaching: Keep back in a locked-in position. Avoid twisting while reaching. Avoid reaching more than twenty inches in front of body. Avoid prolonged reaching when strenuous effort is required. continued on next slide
- 11. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Protecting Yourself: Body Mechanics • When pushing or pulling: Push, rather than pull, whenever possible. Keep back locked in. Keep line of pull through center of body. Keep weight close to body. continued on next slide
- 12. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Protecting Yourself: Body Mechanics • When pushing or pulling: If the weight is below your waist, push or pull from kneeling position. Avoid pushing or pulling overhead. Keep your elbows bent and arms close to your sides.
- 13. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Protecting Your Patient: Back to Topics Emergency, Urgent, and Non- Urgent Moves
- 14. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Emergency Moves • Situations The scene is hazardous. Care of life-threatening conditions requires repositioning. You must reach other patients.
- 15. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Emergency Moves CLOTHES DRAG
- 16. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Emergency Moves INCLINE DRAG. Always head first.
- 17. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Emergency Moves FIREFIGHTER'S DRAG. Place patient on his back and tie his hands together. Straddle him, crouch, and pass your head through his trussed arms. Raise your body and crawl on your hands and knees. Keep the patient's head as low as possible.
- 18. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Emergency Moves BLANKET DRAG. Gather half of the blanket material up against the patient's side. Roll him toward your knees, place the blanket under him, and gently roll him onto the blanket. During the drag, keep the patient's head as low as possible.
- 19. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Emergency Moves ONE-RESCUER ASSIST.
- 20. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Emergency Moves TWO-RESCUER ASSIST. Place the patient's arms around the shoulders of both rescuers. They each grip a hand, place their free arms around the patient's waist, and help him walk to safety.
- 21. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Urgent Moves • Situations The required treatment can be performed only if the patient is moved. Factors at the scene cause patient decline. continued on next slide
- 22. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Urgent Moves • Moving a patient onto a long spine board Used if immediate threat to life and suspicion of spine injury Patient supine, log-roll onto side Place spine board next to body; log-roll onto board. continued on next slide
- 23. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Urgent Moves • Moving a patient onto a long spine board Lift onto stretcher. Secure to stretcher; load into ambulance. continued on next slide
- 24. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Urgent Moves • Rapid extrication Used when taking time to immobilize the patient with short backboard or vest before moving patient may cause a deadly delay Stabilize spine manually as patient is moved onto a long spine board.
- 25. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Non-Urgent Moves • Patient stable • No immediate life threat • Patient can be assessed, treated, and moved in normal way. • Take all required precautions not to aggravate existing conditions.
- 26. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Patient-Carrying Devices • Stretcher or any other device designed to carry the patient safely to the ambulance and/or to the hospital • Wheeled stretchers Power stretchers Manual stretchers Bariatric stretchers • Some rated to carry patients weighing 800 pounds or more
- 27. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Patient-Carrying Devices A wheeled stretcher is carried on every ambulance.
- 28. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Patient-Carrying Devices Power stretcher. © Ferno—Washington, Inc.
- 29. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Bariatric Stretcher Many EMS services are now equipped with specially constructed stretchers and loading equipment for obese patients.
- 30. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Patient-Carrying Devices • Stair chairs Useful where stretchers cannot be easily maneuvered • Spine board Short • Primarily for removing patients from vehicles when neck or spine injury is suspected Long
- 31. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Patient-Carrying Devices Stair chair.
- 32. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Patient-Carrying Devices Short spine board.
- 33. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Patient-Carrying Devices Long spine boards.
- 34. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Patient-Carrying Devices • Other types of stretchers Portable stretcher Scoop stretcher Basket stretcher Flexible stretcher Vacuum mattress
- 35. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Patient Immobilizing Devices Vest-Type Extrication Device
- 36. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Patient-Carrying Devices Scoop (orthopedic) stretcher. © Ferno—Washington, Inc.
- 37. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Patient-Carrying Devices Basket stretcher. © Ferno—Washington, Inc.
- 38. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Patient-Carrying Devices Flexible stretcher. © Ferno—Washington, Inc.
- 39. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Patient-Carrying Devices A vacuum mattress may be used to transport a patient.
- 40. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Patient-Carrying Devices When the patient is placed on the device and air is withdrawn, the mattress becomes rigid and conforming, automatically padding voids.
- 41. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Think About It • How do you choose the appropriate patient-carrying device?
- 42. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Moving Patients onto Carrying Devices • Patient with suspected spine injury Immobilize head, neck, and spine before move. Perform manual stabilization. Place a rigid cervical collar. Maintain manual stabilization until the patient is immobilized to spine board. continued on next slide
- 43. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Moving Patients onto Carrying Devices • Patient with no suspected spine injury Extremity lift • Used to carry patient to stretcher or stair chair • Can be used to lift patient from ground or from sitting position continued on next slide
- 44. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Moving Patients With No Suspected Spinal Injury Extremity Carry
- 45. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Moving Patients onto Carrying Devices • Patient with no suspected spine injury Direct ground lift • Lifting from ground to stretcher
- 46. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Direct Ground Lift: 1. The stretcher is set in its lowest position and placed on the opposite side of the patient. The EMTs face the patient, drop to one knee, and if possible, place the patient's arms on his chest. The head-end EMT cradles the patient's head and neck by sliding one arm under the neck to grasp the shoulder, moving the other arm under the patient's back. The foot-end EMT slides one arm under the patient's knees and the other arm under the patient above the buttocks. Note: If a third rescuer is available, he should place both arms under the patient's waist while the other two slide their arms up to the mid-back or down to the buttocks, as appropriate.
- 47. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Direct Ground Lift: 2. On signal, the EMTs lift the patient to their knees.
- 48. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Direct Ground Lift: 3. On signal, the EMTs stand and carry the patient to the stretcher, drop to one knee, and roll forward to place him onto the mattress.
- 49. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Moving Patients onto Carrying Devices • Patient with no suspected spine injury Draw-sheet method Direct carry method
- 50. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Draw-Sheet Method: 1. Loosen the bottom sheet of the bed and roll it from both sides toward the patient. Place the stretcher, rails lowered, parallel to the bed and touching the side of the bed. EMTs use their bodies and feet to lock the stretcher against the bed.
- 51. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Draw-Sheet Method: 2. EMTs pull on the draw sheet to move the patient to the side of the bed. Both use one hand to support the patient while they reach under him to grasp the draw sheet. Then they simultaneously draw the patient onto the stretcher.
- 52. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Recovery Position A patient in the recovery position.
- 53. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Patient Positioning • Positioning for shock Place patients believed to be in shock in supine position Do not lower head Do not raise legs
- 54. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Transferring the Patient to a Hospital Stretcher • When you arrive at the hospital, you will move the patient from the ambulance stretcher to the hospital stretcher. Modified draw-sheet method
- 55. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe 1. Position the raised ambulance cot next to the hospital stretcher. Hospital personnel then adjust the stretcher (raise or lower the head) to receive the patient.
- 56. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe 2. You and the hospital personnel gather the sheet on either side of the patient and pull it taut to transfer the patient securely.
- 57. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe 3. Holding the gathered sheet at support points near the patient's shoulders, mid-torso, hips, and knees, you and the hospital personnel slide the patient in one motion onto the hospital stretcher.
- 58. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe 4. Make sure the patient is centered on the stretcher and the stretcher rails are raised before turning him over to the emergency department staff.
- 59. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Prehospital Lifting of Patients Video Click on the screenshot to view a video on the subject of prehospital lifting of patients. Back to Directory
- 60. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Chapter Review
- 61. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Chapter Review • The process of lifting and moving patients is a task that requires planning, proper equipment, and careful attention to body mechanics to prevent injury to your patient and to yourself. continued on next slide
- 62. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Chapter Review • The most important rule in lifting is to lift with your legs, not your back. Keep your feet shoulder-width apart and keep your knees bent. Rules for lifting are for patients as well as equipment. • Emergency moves are those that may aggravate spine injuries and, therefore, are reserved for life-threatening situations. continued on next slide
- 63. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Chapter Review • Urgent moves are used when the patient must be moved quickly but there is time to provide quick, temporary consideration toward preventing or aggravating spinal injury. continued on next slide
- 64. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Chapter Review • Non-urgent moves are normal ways of moving a patient to a stretcher after performing a complete on-scene assessment and completing any needed spinal stabilization and immobilization. • Positioning the patient for transport should take into account the patient's comfort, medical needs, and safety. continued on next slide
- 65. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Chapter Review • Remember the importance of correct lifting and moving techniques on every call. Protect your patient and protect yourself from injury to maintain a long and positive EMS experience.
- 66. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Remember • Proper lifting technique is important wellness strategy. • Biomechanics and rules of lifting help prevent injuries associated with lifting. • Many different patient-carrying devices exist. Choose the correct device based upon particular patient and needs of particular movement. continued on next slide
- 67. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Remember • Use proper technique to move patients onto patient-carrying devices and position them for transport based upon their condition.
- 68. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Questions to Consider • Why are body mechanics so important when lifting and moving patients? • Why is using the appropriate patient- carrying device an important consideration? • When would an emergency move be necessary? • In what ways can proper positioning help a patient's condition?
- 69. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Critical Thinking • You arrive at a vehicle crash and find an elderly driver slumped over the wheel. Upon examination you determine the patient is in respiratory arrest, but not trapped in the vehicle. Which move would be appropriate for this patient?
Editor's Notes
- Planning Your Time: Plan 60 minutes for this chapter. Protecting Yourself: Body Mechanics (30 minutes) Protecting Your Patient: Emergency, Urgent, and Non-Urgent Moves (30 minutes) Note: The total teaching time recommended is only a guideline. Core Concepts: How using body mechanics to lift and move patients can help prevent injury When it is proper to move a patient and how to do so safely The various devices used to immobilize, move, and carry patients
- Teaching Time: 30 minutes Teaching Tips: Assessing and preplanning a lift are very important components of safety. Spend time discussing these elements. Occupational and physical therapists teach lifting techniques to their patients every day. Invite one of these therapists to share their insight with your class. Practice these techniques. Even if your educational institution will not allow actual lifting, have students demonstrate position and body mechanics.
- Covers Objective: 3.2 Points to Emphasize: Ensure the students understand the potential for injury resulting from lifting and moving while working as an EMT. If possible provide examples of EMTs whose careers ended prematurely as a result of injury.
- Covers Objective: 3.2 Points to Emphasize: The proper use of your body during lifting and moving will help prevent injury. Proper lifting requires preplanning and communication. Discussion Topic: Describe the elements that you must consider before beginning a lift. Knowledge Application: Have students work in small groups. Assign each group a lifting scenario and have the group discuss preplanning, limitations, and communication.
- Covers Objective: 3.3 Point to Emphasize: Employ the "rules for lifting" to promote safety and prevent injury when moving patients. Talking Points: Position your feet properly on a firm, level surface and shoulder-width apart. Use your legs to lift—do not lift with your back. Never turn or twist. Attempts to make any other moves while you are lifting are a major cause of injury. Do not compensate when lifting with one hand. Avoid leaning to either side. Keep your back straight and locked.
- Covers Objective: 3.3 Point to Emphasize: Employ the "rules for lifting" to promote safety and prevent injury when moving patients. Talking Points: Position your feet properly on a firm, level surface and shoulder-width apart. Use your legs to lift—do not lift with your back. Never turn or twist. Attempts to make any other moves while you are lifting are a major cause of injury. Do not compensate when lifting with one hand. Avoid leaning to either side. Keep your back straight and locked.
- Covers Objective: 3.3 Discussion Topic: List and explain the rules of safe lifting.
- Covers Objective: 3.4 Point to Emphasize: Practice the power lift and the power grip to enhance body mechanics when lifting. Discussion Topic: Describe the power lift and the power grip.
- Covers Objective: 3.5
- Covers Objective: 3.5 Discussion Topic: Describe the proper technique for reaching, pulling, and pushing a patient. Class Activity: Practice body position. Have students, as a group, demonstrate the proper biomechanics of lifting. Consider the power lift and power grip techniques. As a group, have a lifting practice session. (Instructor must actively supervise any movement of an actual patient.) Critical Thinking: Consider the impossible lift. What if there were no way that you and your partner could move a particular patient? What additional resources could you employ? Knowledge Application: Work in small groups. Assign each group a different element of proper lifting biomechanics. Have the group research and demonstrate its technique to the class. Skill Demonstration: Use an anatomical model or programmed patient to demonstrate proper biomechanics when lifting (if your educational institution allows). Create lifting scenarios that demonstrate the following: the power lift, the power grip, pushing and pulling, reaching. An instructor must actively supervise any movement of an actual patient.
- Covers Objective: 3.5 Discussion Topic: Describe the proper technique for reaching, pulling, and pushing a patient. Class Activity: Practice body position. Have students, as a group, demonstrate the proper biomechanics of lifting. Consider the power lift and power grip techniques. As a group, have a lifting practice session. (Instructor must actively supervise any movement of an actual patient.) Critical Thinking: Consider the impossible lift. What if there were no way that you and your partner could move a particular patient? What additional resources could you employ? Knowledge Application: Work in small groups. Assign each group a different element of proper lifting biomechanics. Have the group research and demonstrate its technique to the class. Skill Demonstration: Use an anatomical model or programmed patient to demonstrate proper biomechanics when lifting (if your educational institution allows). Create lifting scenarios that demonstrate the following: the power lift, the power grip, pushing and pulling, reaching. An instructor must actively supervise any movement of an actual patient.
- Teaching Time: 30 minutes Teaching Tips: This lesson is truly about decision making. Spend most of your time discussing the process of choosing the correct movement technique. Use a scenario-based approach that will allow students the opportunity both to make decisions and to practice technique. Consider using manikins to practice lifting. Often this is a safer alternative to actually lifting students.
- Covers Objective: 3.6 Points to Emphasize: There are significant differences among emergency, urgent, and non-urgent moves. Consider how priority might alter your lifting strategy. Three situations may require the use of an emergency move: a hazardous scene, care of life-threatening conditions that require repositioning, and the necessity to reach other patients.
- Covers Objective: 3.7 Point to Emphasize: When conducting an emergency move, move the patient in the direction of the long axis of the body to protect against aggravating a possible spinal injury. Talking Points: There are several rapid moves called drags. In this type of move, the patient is dragged by the clothes, the feet, or the shoulders, or on a blanket. These moves are reserved for emergencies, because they do not provide protection for the neck and spine. Most commonly, a long-axis drag is made from the area of the shoulders. This causes the remainder of the body to fall into its natural anatomical position, with the spine and all limbs in normal alignment.
- Covers Objective: 3.7
- Covers Objective: 3.7
- Covers Objective: 3.7
- Covers objective: 3.7
- Covers Objective: 3.7
- Covers Objective: 3.6 Point to Emphasize: Urgent moves are required when the patient must be moved quickly for treatment of an immediate threat to life. Unlike emergency moves, urgent moves are performed with precautions for spinal injury.
- Covers Objective: 3.6 and 3.7 Talking Points: When reaching across the patient to perform a log roll, remember the principles of body mechanics: keep back straight, lean from hips, and use shoulder muscles to help with roll.
- Covers Objective: 3.6 and 3.7 Talking Points: When reaching across the patient to perform a log roll, remember the principles of body mechanics: keep back straight, lean from hips, and use shoulder muscles to help with roll.
- Covers Objective: 3.7
- Covers Objective: 3.6 Point to Emphasize: When there is no immediate threat to life, the patient should be moved using a non-urgent move. Non-urgent moves should be carried out in such a way as to prevent injury or additional injury to the patient and to avoid discomfort and pain. Discussion Topics: Describe the criteria that you would consider to deem a movement an emergency lift, an urgent lift, or a non-urgent lift. Discuss how the application of an emergency patient movement might differ from that of a non-urgent patient movement. Knowledge Application: Work in small groups. Present lifting scenarios. Discuss the strategy chosen for the lift and the lifting decision-making process.
- Covers Objective: 3.9 Teaching Tips: Have patient-carrying devices on hand. Demonstrate function. Take time to review specific devices and their safety features. Allow students to visualize and manipulate the straps, levels, and locking mechanisms for the individual devices. Remember that there is a tremendous variety of lifting devices in EMS. Teach students broad themes and impress upon them the need to educate themselves on the specific devices their service uses. Points to Emphasize: Patient-carrying devices are mechanical devices and EMTs must be familiar with how to use them. Errors in use of these devices may result in injuries to the patient and to the provider. Various patient-carrying devices exist. An EMT must assess the situation and decide which device would be most appropriate to use in a particular lifting scenario. Knowledge Application: Assign small groups to each patient-carrying device. Have each group demonstrate proper function and the movement of a patient onto the device.
- Covers Objective: 3.9 Discussion Topic: Describe the operation of a wheeled stretcher. Discuss its key features.
- Covers Objective: 3.9 Talking Points: Power stretchers were designed to reduce the stress of listing and lifting injuries. Not only do they assist when lifting the stretcher from the ground but they also assist when loading the stretcher into the ambulance. Many EMS agencies have invested in these devices and reduced EMT injuries resulting from lifting. Knowledge Application: Invite an EMS crew and ambulance to class. Ask the crew to demonstrate the various lifting devices their ambulance carries.
- Covers Objective: 3.9 Discussion Topic: Define the term bariatric stretcher. Discuss the uses of a bariatric stretcher.
- Covers Objective: 3.9 Teaching Tips: Have patient-carrying devices on hand. Demonstrate function. Take time to review specific devices and their safety features. Allow students to visualize and manipulate the straps, levels, and locking mechanisms for the individual devices. Remember that there is a tremendous variety of lifting devices in EMS. Teach students broad themes and impress upon them the need to educate themselves on the specific devices their service uses. Points to Emphasize: Patient-carrying devices are mechanical devices and EMTs must be familiar with how to use them. Errors in use of these devices may result in injuries to the patient and to the provider. Various patient-carrying devices exist. An EMT must assess the situation and decide which device would be most appropriate to use in a particular lifting scenario. Knowledge Application: Assign small groups to each patient-carrying device. Have each group demonstrate proper function and the movement of a patient onto the device.
- Covers Objective: 3.9 Discussion Topic: Describe the operation of a stair chair. Discuss its key features.
- Covers Objective: 3.9 Knowledge Application: Have students work in small groups. Assign each group a manikin and a lifting device. Ask each group to demonstrate the proper lifting technique for their specific device. Rotate groups through each device.
- Covers Objective: 3.9 Knowledge Application: Have students work in small groups. Assign each group a manikin and a lifting device. Ask each group to demonstrate the proper lifting technique for their specific device. Rotate groups through each device.
- Covers Objective: 3.9 Teaching Tips: Have patient-carrying devices on hand. Demonstrate function. Take time to review specific devices and their safety features. Allow students to visualize and manipulate the straps, levels, and locking mechanisms for the individual devices. Remember that there is a tremendous variety of lifting devices in EMS. Teach students broad themes and impress upon them the need to educate themselves on the specific devices their service uses. Points to Emphasize: Patient-carrying devices are mechanical devices and EMTs must be familiar with how to use them. Errors in use of these devices may result in injuries to the patient and to the provider. Various patient-carrying devices exist. An EMT must assess the situation and decide which device would be most appropriate to use in a particular lifting scenario. Knowledge Application: Assign small groups to each patient-carrying device. Have each group demonstrate proper function and the movement of a patient onto the device.
- Covers Objective: 3.9 Talking Points: Often, a vest-type extrication device is used in place of a short spine board. Knowledge Application: Invite a service equipment manager or a manufacturer's representative to class to discuss lifting device upkeep. Discuss specific preventative maintenance.
- Covers Objective: 3.9 Discussion Topic: Describe the types of patient movements for which you might use a scoop stretcher.
- Covers Objective: 3.9
- Covers Objective: 3.9 Knowledge Application: Obtain manufacturer's instruction booklets for lifting devices. Ask students to review the manufacturer's recommendations against common practices.
- Covers Objective: 3.9 Skill Demonstration: Practice using patient-carrying devices. If your educational institution allows, actually move programmed patients. If not, simulate movements with unloaded devices. (Instructor must actively supervise any movement of an actual patient.) Critical Thinking: Think outside the box. Besides the patient-carrying devices demonstrated today, are there other devices that might be used to move patients? Class Activity: Provide various examples of lifting devices. Have students rotate through stations where the devices are presented and demonstrated. Allow time for hands-on examination of each device. Knowledge Application: Have students work in small groups. Assign each group a scenario and tell the group they do not have the proper lifting device. Ask each group to discuss how they might improvise a move using alternative devices.
- Covers Objective: 3.9 Skill Demonstration: Practice using patient-carrying devices. If your educational institution allows, actually move programmed patients. If not, simulate movements with unloaded devices. (Instructor must actively supervise any movement of an actual patient.) Critical Thinking: Think outside the box. Besides the patient-carrying devices demonstrated today, are there other devices that might be used to move patients? Class Activity: Provide various examples of lifting devices. Have students rotate through stations where the devices are presented and demonstrated. Allow time for hands-on examination of each device. Knowledge Application: Have students work in small groups. Assign each group a scenario and tell the group they do not have the proper lifting device. Ask each group to discuss how they might improvise a move using alternative devices.
- Covers Objective: 3.8 Talking Points: Selection of the carrying device will often be based on patient location, position, weight, and medical condition.
- Covers Objective: 3.10 Point to Emphasize: When moving a patient to a lifting device, the EMT must use teamwork and good body mechanics to ensure a safe lift for all parties involved. Discussion Topic: Describe the procedure for moving a patient with a suspected spine injury to an immobilization device.
- Covers Objective: 3.10 Discussion Topic: Describe the process for employing an extremity lift. Describe what type of patient you might use this type of lift on.
- Covers Objective: 3.10 Discussion Topic: Describe the process for employing an extremity lift. Describe what type of patient you might use this type of lift on.
- Covers Objective: 3.10
- Covers Objective: 3.10
- Covers Objective: 3.10
- Covers Objective: 3.10
- Covers Objective: 3.10 Discussion Topic: Describe the process for employing the draw sheet method. Describe what type of patient you might use this type of lift on. Class Activity: Describe a scenario to the class. Ask the class to discuss what the best type of lift would be and why. Compare and contrast the different answers provided.
- Covers Objective: 3.10 Discussion Topic: Describe the process for employing the draw sheet method. Describe what type of patient you might use this type of lift on. Class Activity: Describe a scenario to the class. Ask the class to discuss what the best type of lift would be and why. Compare and contrast the different answers provided.
- Covers Objective: 3.10 Discussion Topic: Describe the process for employing the draw sheet method. Describe what type of patient you might use this type of lift on. Class Activity: Describe a scenario to the class. Ask the class to discuss what the best type of lift would be and why. Compare and contrast the different answers provided.
- Covers Objective: 3.10 Points to Emphasize: Discuss how the recovery position assists with maintaining airway patency.
- Covers Objective: 3.10
- Covers Objective: 3.10
- Covers Objective: 3.10
- Covers Objective: 3.10
- Covers Objective: 3.10
- Covers Objective: 3.10
- Covers Objective: 3.9 Video Clip Prehospital Lifting of Patients Discuss the EMT's role of lifting and moving patients in the prehospital environment. Describe scenarios that would require an EMT to use an emergency move. List three ways to help prevent injury when moving a patient to an ambulance. What is body mechanics? Discuss the purposes of different types of equipment that can be used to move a patient. Describe the types of assists that an EMT might use on a call.
- Talking Points: Body mechanics are important so as to avoid injury to the EMT as well as to lift and move the patient efficiently and safely. Using an inappropriate device could result in further injury to the patient, the most obvious example being not using a backboard for a patient with a suspected spinal injury. It could also greatly impede moving the patient, as in using a stretcher instead of a stair chair to carry a patient down several flights of stairs. One example of a situation requiring an emergency move would be a scene with the potential for explosion. Another would be removing a patient from a vehicle involved in a crash amidst uncontrolled traffic. Unresponsive patients with no suspected spine injury should be placed in the recovery position to avoid breathing vomitus into the lungs. Patients with no suspected spine injury who are having difficulty breathing may be helped by raising the back of the stretcher to a semi-sitting position.
- Talking Points: This patient requires an emergency move. Airway management cannot be performed properly with the patient in the vehicle. The need to oxygenate the patient overrides the risk of further injury.