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Principal’s Of
Lifting & Moving Patient
Topics
• Principles of Moving Patients
• Emergency Moves
• Standard Moves
• Equipment for Transporting Patients
• Patient Positioning
• Restraining Patients
PRINCIPLES OF MOVING
PATIENTS
Principles of Moving Patients
(continued)
• Body Mechanics
– Proper and efficient use of your body to
facilitate lifting and moving.
▪ Plan what you will do; how you will do it.
▪ Estimate weight.
▪ Consider physical limitations.
▪ Communicate with your partner.
Principles of Moving Patients
(continued)
• Body Mechanics
– Position your feet properly.
– Lift with your legs.
– When lifting object with one hand, avoid
leaning to either side.
– Minimize twisting during lift.
Principles of Moving Patients
• Body Mechanics
– Keep weight as close to your body as
possible.
– When carrying patient on stairways, use
chair or commercial stair chair instead of
wheeled stretcher whenever possible.
To begin the power lift, keep your back straight and eyes on your partner.
Lift with your legs.
While moving, keep the weight as close to your body as possible.
When you use a stair chair, have someone spot you as you walk backward
down stairs.
Principles of Moving Patients
• When to Move a Patient
– Only when absolutely necessary.
– Dangerous environment.
– Cannot adequately assess airway,
breathing, circulation or bleeding.
– Unable to gain access to other patients who
need lifesaving care.
EMERGENCY MOVES
Emergency Moves
• Patient and/or rescuers are in
immediate danger.
• Lifesaving care cannot be given
because of patient's location or
position.
• To gain access to other patients who
need lifesaving care.
• Rarely provide protection for patient's
injuries; may cause patient pain.
Emergency Moves
• Drags
– Patients pulled by their clothes, feet, or
shoulders or by using a blanket.
– Initiated from shoulders by pulling along
the long axis of body.
– Avoid dragging patient sideways.
(continued)
Emergency Moves
• Drags
– To move patient down stairs or down
incline, grab under shoulders and pull head
first as you walk backward.
Clothing drag, or shirt drag.
Blanket drag.
Shoulder drag.
Firefighter's drag.
Strap drag.
Emergency Moves
• Any emergency move must be justified
and carried out as quickly as possible.
One-rescuer crutch.
Cradle carry.
Pack strap carry.
Piggy back carry.
Firefighter's carry.
STANDARD MOVES
Standard Moves
• Preferred choice when situation is not
urgent, patient is stable, have adequate
time and personnel for a move.
• Standard moves carried out with help
of other trained personnel or
bystanders.
Standard Moves
• Patient uncomfortable or his position is
aggravating the injury.
• Emergency care requires moving
patient.
• Patient insists on being moved.
Standard Moves
• Complete the primary assessment.
• Choose the number of rescuers.
• Avoid compromising neck/spine injury.
• Consider splinting suspected fractures.
Standard Moves
• Direct Ground Lift
– Three rescuers move patient from ground
to bed or stretcher.
– Patient lying face up (supine); arms placed
on chest.
– Everyone lifts patient up to level of their
knees.
(continued)
Position your arms under the patient. Be sure to cradle the head.
Standard Moves
• Direct Ground Lift
– Rescuers roll patient toward their chests.
– Everyone should stand while holding
patient.
– Patient moved.
Lift the patient to your knees and roll toward your chests.
On signal, move the patient to the carrying device.
Standard Moves
(continued)
• Extremity Lift
– Two rescuers, one lifting patient's arms and
one lifting patient's legs.
– Ideal for moving patient from ground to
chair or stretcher.
– Do not perform if head, neck, spine,
shoulder, hip, or knee injury, or suspected
fractures to extremities.
Standard Moves
(continued)
• Extremity Lift
– Patient should be placed face up, with
knees flexed.
– Kneel at head of patient, placing hands
under shoulders.
– Have helper stand at patient's feet and
grasp his/her wrists.
To get the patient into a sitting position, one rescuer pushes from behind while
the other pulls from the wrists.
Standard Moves
• Extremity Lift
– Slip your arms under patient's armpits and
grasp wrists.
– Pull patient into sitting position.
(continued)
The rescuer at the head places arms under patient's armpits and grasps
patient's wrists. While facing the patient, the rescuer at the feet grasps patient's
legs behind the knees.
Standard Moves
• Extremity Lift
– Both stand at same time.
– Move as unit when carrying patient.
– Avoid swinging patient.
You can now carry the patient a short distance or place her on a stretcher or
chair.
Standard Moves
• Direct Carry Method
– To move patient with no suspected spine
injury from bed or from bed-level position
to stretcher.
– Position stretcher perpendicular to bed,
with head end of stretcher at foot of bed.
(continued)
Stretcher is placed at 90-degree angle to bed, depending on room
configuration. Prepare stretcher by lowering rails, unbuckling straps, and
removing other items. Both Emergency Medical Responders stand between
stretcher and bed, facing patient.
Standard Moves
• Direct Carry Method
– Position arms under patient; slide patient
to edge of bed.
(continued)
Position your arms under the patient and slide the patient to the edge of the
bed.
Standard Moves
• Direct Carry Method
– Lift patient; curl toward your chests.
– Rotate and place patient gently on the
carrying device.
Lift the patient and curl her toward your chests.
Rotate and place the patient gently on the carrying device.
Standard Moves
• Draw Sheet Method
– From side of bed, loosen bottom sheet
under patient; position stretcher next to
bed.
– Adjust height of stretcher to match level of
bed, lower rails, unbuckle straps.
(continued)
Standard Moves
• Draw Sheet Method
– Grasp sheet firmly at patient's head, chest,
hips, and knees.
– Draw patient onto stretcher, sliding in one
smooth motion.
– Can also use slider boards and slide bags.
Draw sheet method of moving a patient from a bed to a stretcher.
Draw sheet method of moving a patient from a bed to a stretcher.
Example of a slider board.
Example of a slide bag.
EQUIPMENT FOR TRANSPORTING
PATIENTS
Equipment for Transporting
Patients
• Wheeled stretcher (gurney, cot, pram)
– Used to transport patient from scene of
emergency to ambulance and from
ambulance to hospital bed.
Equipment for Transporting
Patients
• Types of Stretchers
– Single-operator
(continued)
Single-operator stretcher.
Single-operator stretcher.
Equipment for Transporting
Patients
(continued)
• Types of Stretchers
– Dual-operator
Dual-operator stretcher.
Dual-operator stretcher.
Equipment for Transporting
Patients
• Types of Stretchers
– Electric/pneumatic-lift
(continued)
Electric/pneumatic-lift stretcher. These eliminate the need for heavy lifting.
Equipment for Transporting
Patients
• Types of Stretchers
– Scoop
(continued)
Scoop stretchers. (A) These stretchers are ideal for moving patients in the
position they are found.
Scoop stretchers. (B) Once in place, the patient must be properly secured to
the device before moving.
Equipment for Transporting
Patients
• Types of Stretchers
– Portable
– Flexible
– Stair
(continued)
Portable stretcher. Beneficial for carrying supine medical patients down stairs.
Flexible stretcher. Used in restricted areas or narrow hallways.
Equipment for Transporting
Patients
• Types of Stretchers
– Basket
(continued)
Basket stretcher. Used in rescue situations and to transport over rough terrain.
Equipment for Transporting
Patients
• Types of Stretchers
– Spine board
(continued)
Long spine board. (A) This backboard is used to immobilize the spine of a
supine patient.
Long spine board. (B) Long spine board with patient properly secured in place.
Equipment for Transporting
Patients
• Types of Stretchers
– Vest-type extrication device
(continued)
Vest-type extrication device. This device facilitates the extrication of a seated
patient, while stabilizing the patient's head, neck, and spine.
Equipment for Transporting
Patients
• Types of Stretchers
– Full-body immobilization device
– Pedi-board
(continued)
PATIENT POSITIONING
Patient Positioning
• Recovery Position
– Patient with no suspected spine injury
placed on side to help maintain open
airway (lateral recumbent).
(continued)
Move the closest hand of the patient above his head.
Patient Positioning
• Recovery Position
– Move closest hand of patient above head;
move far hand across to opposite shoulder,
next to patient's cheek.
(continued)
Move the patient's far hand across to the opposite shoulder, next to the
patient's cheek.
Patient Positioning
• Recovery Position
– Bring patient's far leg to flexed position.
(continued)
Bring the patient's far leg to the flexed position.
Patient Positioning
• Recovery Position
– Using knee and shoulder, carefully pull
patient onto side.
(continued)
Using the knee and shoulder, carefully pull the patient onto his side.
Patient Positioning
• Recovery Position
– Adjust knee and shoulder to stabilize
patient; recheck patient's ABCs.
(continued)
Adjust the knee and shoulder to stabilize the patient. Then recheck the patient's
ABCs.
Patient Positioning
• Recovery Position
– Knee and elbow will support patient.
(continued)
Once properly positioned, the knee and elbow will support the patient.
Patient Positioning
• Fowler's and Semi-Fowler's Positions
– Fowler's position: patient is placed fully
upright in a seated position, creating a 90-
degree angle.
– Semi-Fowler's position: semi-seated
position; patient reclines at 45-degree
angle.
Patient Positioning
• Trendelenburg Position
– Patient placed flat on back with legs and
feet raised.
– May be used in patients with non-traumatic
shock.
• Shock position used for patients
exhibiting signs of shock but have no
evidence of trauma or injury.
Patient Positioning
(continued)
• Log Roll
– Method used to move patient with
suspected spine injury from prone position
to supine position.
– Few as two rescuers; three ideal.
Patient Positioning
(continued)
• Log Roll
– Manually stabilize patient's head and neck
as you place board parallel to patient.
Manually stabilize the patient's head and neck as you place the board parallel
to the patient. Maintain manual stabilization throughout the log roll.
Patient Positioning
• Log Roll
– Kneel at patient's side opposite board.
– Reach across patient and position your
hands.
– Inspect patient's back.
(continued)
Kneel at the patient's side opposite the board. Reach across the patient and
position your hands. Inspect the patient's back.
Patient Positioning
• Log Roll
– As a unit roll patient toward you.
– Move spine board into place.
– Lower patient onto spine board.