Principal’s Of Lifting & Moving Patient - Dr Rohit Bhaskar

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
(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.

(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.

• 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.

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.

• 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
• 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.

Emergency Moves
• Any emergency move must be justified
and carried out as quickly as possible.

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
– 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
– 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.

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.

Patients
• Types of Stretchers
– Single-operator
(continued)

Patients
(continued)
– Dual-operator

Patients
– Electric/pneumatic-lift
(continued)

Electric/pneumatic-lift stretcher. These eliminate the need for heavy lifting.

Patients
– 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.

Patients
– Portable
– Flexible
– Stair
(continued)

Portable stretcher. Beneficial for carrying supine medical patients down stairs.

Flexible stretcher. Used in restricted areas or narrow hallways.

Patients
– Basket
(continued)

Basket stretcher. Used in rescue situations and to transport over rough terrain.

Patients
– 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.

Patients
– 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.

Patients
– Full-body immobilization device
– Pedi-board
(continued)

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
– 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
– Bring patient's far leg to flexed position.
(continued)

Bring the patient's far leg to the flexed position.

Patient Positioning
– Using knee and shoulder, carefully pull
patient onto side.
(continued)

Using the knee and shoulder, carefully pull the patient onto his side.

Patient Positioning
– 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
– 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.

On command from the rescuer at the head, as a unit roll the patient toward you.
Then move the spine board into place.

Lower the patient onto the spine board at the command of the rescuer at the
head. Center the patient on the board.

Restraining Patients
• Process of securing combative patient's
body and extremities to prevent injury
to himself/herself or others.
– Physical restraint: holding patient with your
hands or legs so they cannot move.
– Mechanical restraint: applying device to
patient to restrict movements.

• Hard restraints: handcuffs, shackles,
plastic zip-ties, belly chains.
• Soft restraints: leather or fabric cuffs,
cloth straps, rolls of gauze, cravats,
sheets, clothing.

Restraining a patient to a gurney.

Examples of soft restraints. (A) Restraint of the arm.

Examples of soft restraints. (B) use of restraints for the legs.

• Patient Restraint
– Secure limbs with appropriate restraining
equipment.
– Do NOT secure patient face down.
– Consider administering supplemental
oxygen.
– Check patient's airway, breathing, and
circulation.
(continued)

• Patient Restraint
– Clearly document reason for restraining.
– Ensure that group uses only force required.

• Positional asphyxia
– Death resulting from securing a person in
the prone position (restraint asphyxia).

• Restraint Injuries
– Being prepared, communicating, and taking
decisive action will help minimize the risk
of injury to rescuers and patient.
– Be sure to train with the restraint
equipment available to you.

Summary
• Critical to understand and apply proper
body mechanics when lifting either
patients or objects.
• When lifting, always keep weight as
close to body as possible, avoid leaning
or twisting, use your leg muscles to lift
the weight.

Summary
• When two or more responders are
preparing to move a patient, eye
contact and effective communication
are important.
• Sometimes it is necessary for patient to
be moved from immediate area for
safety or care.

Summary
• Recovery position is effective to care for
an unresponsive patient's airway when
a spine injury is not suspected.
• It is important to only use force
necessary to apply proper restraints.
• Never restrain patient in prone position.

Principal’s Of Lifting & Moving Patient - Dr Rohit Bhaskar

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