1. Lifting and Moving Patients

2. Body Mechanics
Safety Precautions
• Using specific methods
to lift large weights
without injury
• Safety Precautions
• Use legs, not back to lift
• Largest bone/muscle
group
• Keep weight close to
body
• Shifts center of
gravity to patient
• More leverage

3. Body Mechanics
Condiserations
• Guidelines for lifting/carrying
• Consider pt weight
• Know your limitations
• Lift without twisting
• Position feet one in front of the
other
• Communicate with partner
• Keep back locked and don’t twist
• Flex at hips (not at waist)
• Bend at knees
• Keep elbows bent with arms close
to sides
• Don’t hyperextend your back
• Avoid reaching more than 15”-20”
in front of your body
• Push rather than pull
• Keep line of pull through midline

4. Power Lift
• Know/find out pt weight
• Consider pt exceeding limitations
• “Power lift”
• Keep back locked in normal
curvature
• Place your feet a comfortable
distance apart
• Tighten your abs and lock back
into a slight inward curve
• Bring center of your body over
object
• Vertical lift
• Distribute your weight to the
balls of your feet OR just
behind them
• Lock your back and allow
upper body to rise before the
hips as you lift

5. Power Grip
• “Power Grip”
• Maximizes force from
hands
• Palm and fingers are in
contact with object
• All fingers are bent at the
same angle
• Hands at least 10” apart

6. Carrying
One-handed carrying technique
• One-handed carrying
technique
• Multiple providers
positioned around pt
• Keep back in locked
position
• Don’t lean to either side
• Lift as normal

7. Stairs…
• Whenever possible use stair
chair
• Keep back locked
• Flex at hips (not waist)
• Bend at knees (not with
back)
• Keep your weight close to
the device
• Have stronger rescuer at
the bottom

8. Log Rolling
• Log rolls
• Movement of a supine/prone pt
• EMT 1: Maintain C-spine
• EMT 2 & 3: Position kneeling at pt
side
• EMT 2: Raise pt nearest arm over
pt head
• EMT 2: Place 1 hand on pt shoulder
the other on pt hip
• EMT 3: Place 1 hand on pt waist
and the other at knees
• EMT 2 & 3: On count of 3 from EMT
1, roll pt onto side
• Place pt on backboard, transport

9. Emergency Moves
• Fastest move
• No spinal immobilization
• Immediate danger to pt if not moved
• Fire or danger of fire
• Explosives or other hazardous materials
• Inability to protect pt from other hazards
• Inability to access other pts in a vehicle who need life saving care
• Life saving care cannot be given due to pt position
• Examples:
• Clothes drag
• Blanket drag
• Torso drag

10. Urgent Moves
• Fast
• Spinal immobilization
• Scene is safe, immediate threat to pt life
• Altered Mental Status (AMS)
• Inadequate breathing
• Shock/Hypoperfusion
• Example
• Rapid extrication
• Moving pt from MVA with constant spinal immobilization

11. Rapid Extrication
• Rapid extrication from vehicle
• 1 EMT provides manual C-Spine support
• 2nd
EMT applies C-Collar
• 3rd
EMT places back board near door and moves to the
passengers seat
• 2nd
EMT supports thorax as 3rd
EMT frees pt feet from pedals
• At direction of 2nd
EMT he and 3rd
EMT rotate pt so that pt
back is not in doorway
• Tx C-Spine control
• 1st
EMT exits vehicle and supports head from outside
• Back board is places against pt buttock
• 1st
EMT and 2nd
EMT lower pt to back board
• 2nd
and 3rd
EMT slide the pt onto the board
• Rapid Extrication Demo

13. Non-Urgent Moves
 Scene Safe
 Stable pt
 Suspect spinal injury
 Examples:
– Direct Ground Lift
– Extremity Lift
– Direct Carry
– Draw Shift

14. Direct Ground Lift
• Direct Ground Lift (No spine injury)
• Two or more rescuers lifting a patient from the side -Cradle
• 2-3 rescuers line up on one side of pt
• Rescuers kneel on one knee
• Pt arms placed on pt chest
• Rescuer @ head places one arm under pt neck and cradles head.
He places other hand under pt lower back
• Second rescuer places one under the pt knees and the other
under the pt buttock
• On signal the rescuers lift pt to their knees and roll pt towards their
chest
• On signal the rescuers stand and tx pt to stretcher
• Steps are reversed to lower pt

15. Extremity Lift
• Extremity Lift (No extremity injuries)
• Two rescuers lifting the patient by the extremities
• One rescuer in the armpit-forearm drag position and the other
holding the patient behind the knees.
• 1 EMT kneels at the pt head, another kneels at pt side by the knees
• EMT at the head places 1 hand under each of the pt shoulders
• EMT at the knees grasps the wrists
• EMT at head slips his hands under the pt arms and grasps pt wrists
• EMT at feet slips his hands under the pt knees
• Both EMT’s move to a crouching position
• EMTs stand simultaneously and move pt to stretcher

17. Direct Carry
• Similar to direct ground lift except the pt is carried
• Tx of supine pt from bed to stretcher
• Place cot perpendicular to bed with head of cot at foot of bed
• Both EMTs stand between stretcher and bed facing pt
• 1st
EMT slips arm under pt neck and cups pt shoulders
• 2nd
EMT slips hand under hips and lifts slightly
• 1st
EMT slips other arm under pt back
• 2nd
EMT places arms under pt hips/calves
• EMTS slide pt to edge of bed
• Pt is lifted/curled towards EMTs chest
• EMTs rotate and place pt on stretcher

18. Draw Sheet
• Loosen sheets from bed
• Place stretcher next to
bed
• Reach across and firmly
grasp sheet
• Head
• Chest
• Hips
• Knees
• Slide pt gently onto
stretcher

19. Stretchers
• Most commonly used
• Easy to tip over
• High center of gravity

20. Stretchers
• Rolling
• Restricted to smooth terrain
• Pulled by foot end
• One person guides the head
• Carrying
• Two EMTs
• EMTs face each other from opposite ends of stretcher
• Ideal for small spaces
• Requires more strength
• Four EMTs
• One EMT on each corner
• Requires less strength
• Safer of rough terrain
• Loading into ambulance
• Use sufficient lifting power
• Follow manufacturers directions
• Ensure all pt and stretchers are secure
before moving

21. Portable Stretchers
• Lightweight, foldable
• Permits tx of pt
• Down stairs
• Over rough terrain
• Carried end to end

22. Scoop/Orthopedic Stretcher
• Function
• Splits apart to scoop up the
patient on the ground from
either side
• Facilitates easy lifting of
supine pt
• Form
• Aluminum frame
• Splits lengthwise in half
• Allows pt to be “scooped”
off ground
• For spinal injury pt,
• Cervical immobilization is
maintained

23. Scoop/Orthopedic Stretcher
• How to use it…
• Measure and adjust the length of the device to be just
longer than the pt
• Slide the stretcher under both sides of the pt
• Lock the head first
• Lock the feet
• Strap the pt in place
• Place pt on a secondary device and secure
• Ex. LBB

24. Stair Chair
• Designed to move pt who
are able to assume sitting
position
• Not used for
• Pt with spinal injuries
• Unconscious
• Extremity lift is preferred to
load pts
• Best to have a spotter
behind EMT at feet while
descending stairs

25. Backboards
• Long Spine Boards
• Function:
• Rigid support for spinal column
to prevent further injury
• Types:
• Wooden
• Plastic
• Uses:
• Primary device for
supine/recumbent pt
• Rapid extrications
• Secondary support in assoc
with short spine board

26. Short Spine Boards
• Function
• Extends from base of the buttock to
just above pt head
• Attached by straps or cravats Support
of spinal column to prevent further
injury
• Types
• Wooden
• Vest type
• Kendrick Extrication Device (KED)
• Uses
• Extricate pt in MVA who are in sitting
position

27. Stokes Basket
• Function
• Movement of pt over rough
terrain
• Form
• Large basket
• Flat bottom
• LBB can fit
• Pt can be immobilized as
normal

28. Patient Positioning
• Unresponsive pt (non traumatic)
• Rolled into recovery position (Left side)
• Pt with dyspnea or chest pain
• Position of comfort
• As long as hypotension doesn’t occur
• Suspected spine injury
• Immobilized to long backboard
• Pregnant Pt
• Left lateral recumbent
• Supine= Fetus on vena cava
• Shock
• Elevated legs 8”-12”
• Nausea/Vomiting
• Position of comfort
• EMT in position to control airway