1. 1
TEMS Lifting and Moving Patients Training
Shiv Saxena, CPT
In EMS we must regularly lift and move patients. TEMS is dedicated to ensuring this is done
safely and effectively. All members must complete this training.
This training will be broken up into two sections: knowledge and practical. The first section will
concern educating the EMT in safe and effective lifting while the second section will explain the
proper methods to guide the EMT through the physical movements.
The goals of this training are as follows. Members should be able to demonstrate knowledge of:
● the basic leverages of lifting
● safe biomechanics for lifting
● understanding of stair chair mechanics
● understanding how to lift a backboard
● proper spotting and communication
Goals are achieved through
● Barbell weight training (using barbells to deadlifts and squats)
● Use and practice with stair chair
● Use and practice with a backboard
Shiv Saxena: Last Updated 04/19/16

2. 2
Section One: Understanding Lifting
Leverages
Below is a diagram explaining the physics and forces involved in lifting. Note that the object
being lifted, whether on the back or in hands in the case of a deadlift should be over the middle
of the foot. The distance between the object and the hips/knees dictates the amount of force
being exerted on the EMT. ​The farther away the EMT is from the object the more force on
the hips.
Remember that the leverages of each EMT will be different; for the following practical section
take note of the EMT’s femur, arm, and torso lengths as these will affect the appearance of
proper form.
(image taken from
http://www.powerliftingtowin.com/powerlifting-technique-the-scientific-principles/)
Shiv Saxena: Last Updated 04/19/16

3. 3
Safe Biomechanics
Image below depicts safe biomechanics when lifting. Things to consider:
● Lower back should be straight.
● Shoulder blades should be pulled back and towards the low back (down and back).
● Feet should be flat on the ground, consider widening stance to achieve this.
● Abdomen must be rigid, like someone is about to punch you.
● Breathe into abdomen to create intra-abdominal pressure and hold during lift.
● Green line represent the path the object takes when lifting. Should be a straight line. Red
is wrong path.
(image taken from
http://www.powerliftingtowin.com/powerlifting-technique-the-scientific-principles/)
Shiv Saxena: Last Updated 04/19/16

4. 4
Lifting Patients on a Backboard
Apply the skills and knowledge learned with deadlifts to a patient on a backboard. EMTs make
eye contact and communicate how they will lift the patient e.g. on 3 we lift, Ready? 1, 2, 3! Keep
in mind height differences between EMTs.
(image taken from FernoEMS https://www.youtube.com/watch?v=sWuT5iLmZh4)
Shiv Saxena: Last Updated 04/19/16

5. 5
Stair Chair Basics
● Stairchair must be locked in before use
● Securely strap patient in
Stair Chair Mechanics
Ideally the taller person should be on the lower end of the stairs and grabbing the bottom of the
stair chair instead of the handles.​ ​The higher the bottom EMT holds the stair chair the more
clearance you will get​ (less likely for the bottom of the chair to hit the stairs).
Stair Chair Spotting
Person should stand behind the lower EMT and place hand on low back. ​Hand must make
contact.​ Additionally communicate how many stairs are left and when a landing is coming up.
(The author drew this image)
Shiv Saxena: Last Updated 04/19/16

6. 6
Section Two: Performing the Lift
Now that we have seen and understood the basic anatomy of safe lifting it is time to do it in real
life. Deadlifts are a great exercise to diagnose any muscular imbalances as well as teach the
proper motor patterns.
Load the barbell with two 10 lb bumper plates. Demonstrate a proper lift three times: first normal
speed, then slowed down, and again normal speed. Take special care to descend slowly during
the slowed down repetition.
Have the EMT try and lift the barbell. Note the following:
1. Does their lumbar spine remain flat? Is it rounded? Is it hyperextended?
2. Are their scapulae retracted and depressed?
3. Do their hips shoot up at the beginning of the lift?
4. Are they starting and ending with the bar over the middle of their foot?
5. Do they come to full hip extension at the top of the lift?
Lifting objects off the floor requires the work of muscles across the entire body so it is important
to remember that any of these issues can be affected by a different area of the body. Just one
example is lower back rounding. Rounding can be caused by improper upper back tightness,
inactivated core, hip positioning, etc. With this in mind, the following is a short list of movements
that will solve most problems in a deadlift:
1. Have the EMT roll their shoulder forward, up, back, then down. By the end their
shoulders should be back ​AND​ down. Tell the EMT to remember this positioning and
how it feels: this is the proper upper back set up for lifting.
2. Have the EMT take a deep breath in and tell them to expand their abdomen and push
out against their waistband. Then have them breathe out and try to pull their belly button
to their spine. Have them breathe in and expand again then tell them to flex in that
position as if they were trying to brace to get punched. Explain that this rigid and high
intraabdominal pressure is the proper core stabilization for lifting.
3. Take a look at their foot positioning. A person with very long femurs may find it difficult to
reach the bar while maintaining a neutral lumbar spine if their stance is too narrow. Try
out wider stances and test for improvement.
4. Tell the EMT to focus on flexing their glutes while standing. Explain that the top of every
lift is when the glutes are fully contracted.
5. After explaining all of this have the EMT deadlift again. Take note of any changes. Then,
starting from the top, have the EMT perform all of the aforementioned positions
(Shoulders down and back, rigid and expanded core, flexed glutes). Then have them
slowly descend while maintaining all of these positions (the glutes won’t remain flexed,
but it is important to flex them at the top for the EMT to understand that the glutes and
hips will be the prime movers in the deadlift).
Shiv Saxena: Last Updated 04/19/16

7. 7
Having gone through all of these steps the average person will be able to lift safely and
effectively. A few things will prevent someone from being able to lift safely:
1. Lack of clearance from a physician to lift
2. Inability to lift with a neutral spine
A lift doesn’t have to be perfect, but if after going through this system the EMT still cannot lift
with a neutral (flat) lumbar spine ​DO NOT CONTINUE TO HAVE THEM DEADLIFT.​ There are
many ways to approach such problems that require knowledge beyond the scope of what is
included in this protocol, but essentially if someone cannot lift with a neutral (flat) lumbar spine it
is no longer safe.
The EMT may ask how they can go about training this movement for EMS as well as overall
fitness. Starting Strength by Mark Rippetoe is one of the industry’s best recognized programs
for general strength training. Other good starting programs include CanditoTrainingHQ’s Linear
Program available for free at ​http://www.canditotraininghq.com/free-strength-programs/
Remind the EMT that this knowledge will improve their lifting ability, but that they should know
their limits and never lift any patients they aren’t completely sure they, and their partners, can
lift.
Additionally, practice with stairchairs and backboards are crucial for the EMT to understand the
different dynamics associated with lifting these devices with another person.
Now release them into the beautiful patient lifting world that we call Tufts EMS.
Shiv Saxena: Last Updated 04/19/16