EMT Chapter 3: Lifting & Moving Patients

Lifting and Moving Patients

• Basket Stretcher: Constructed from steel wire mesh or durable plastic, designed for transporting patients over various terrains or between elevation levels.
• Body Mechanics: Involves optimal body usage to lift and move patients safely, preventing injury.
• Direct Carry: Transfer technique where rescuers curl the patient to their chests from a bed, then lower them onto a stretcher.
• Direct Ground Lift: Involves rescuers kneeling and curling the patient to their chests before standing and placing them onto a stretcher.
• Draw Sheet Method: Utilizes the loosened bottom sheet of the bed to move a patient from bed to stretcher.
• Emergency Move: Focuses on quick patient removal from dangerous environments, prioritizing safety over spinal integrity.
• Extremity Lift: Patient lifting method where one rescuer supports under the armpits, while another supports the knees.
• Log Roll: Technique for moving a supine patient onto a backboard while maintaining spinal alignment, generally executed by multiple rescuers.
• Long Axis: Refers to the central line of the body extending from the head to the spine.
• Non-Urgent Move: Patient movement that can be done without haste; speed isn't the primary concern.
• Power Grip: Technique that maximizes hand surface contact during lifting, ensuring fingers are bent uniformly.
• Power Lift: Lifting from a squat position with the load close to the body to maintain balance and safety.
• Scoop (Orthopedic) Stretcher: Splits into halves to easily place underneath a patient for transport.
• Stair Chair: Portable chair with wheels designed for transporting patients in sitting positions up or down stairs.
• Urgent Move: Patient transfer that must be done quickly while still safeguarding spinal integrity.

Safe Lifting Techniques and Practices

• Lifting Safety: Always lift using legs rather than the back to minimize injury risk.
• Avoid Twisting: While lifting, it is crucial to maintain proper posture and avoid twisting to prevent strain.
• Balanced Lifting: Ensure an even number of rescuers support the stretcher to maintain balance during transport.

Patient Transfer Methods

• Emergency Moves: Used in critical scenarios like vehicle accidents or combustible hazards, emphasizing prompt action.
• Patient Positioning: For chest pain or high blood pressure cases, sitting positions are preferred, while those with shock should have their legs elevated.

Consent and Ethical Responsibilities

• Implied Consent: Assumed consent for treatment when patients are unconscious or unable to communicate.
• Expressed Consent: Legally informed consent from competent adults for medical intervention.
• Advanced Directive: Includes Do Not Resuscitate (DNR) orders established before emergencies.
• Abandonment: Leaving a patient without assuring transfer to qualified personnel after care initiation represents legal abandonment.

Legal and Ethical Concepts

• Negligence: Failure to act according to the standard of care expected from an EMT, leading to patient harm.
• Duty to Act: Obligation of EMTs to provide care upon being dispatched to a scene.
• Confidentiality: Legal and ethical duty to protect patient information unless authorized or legally mandated to share.
• Good Samaritan Laws: Offer legal protection for bystanders assisting in emergencies.

Reporting and Crime Scene Management

• Reporting Obligations: EMTs must report certain cases like abuse, violence, or sexual assaults to authorities.
• Preserving Evidence: Maintain the scene's integrity by not contaminating potential evidence and minimizing personal impact.

Techniques for Moving Patients with Special Considerations

• Walking Assist: For conscious patients, placing an arm around the responder and avoiding head/spinal injuries.
• Two-Person Seat Carry: Used for patients who are conscious and not seriously harmed, interlocking arms for support.
• Pack-Strap Carry: Requires at least one responder to safely carry either conscious or unconscious patients.
• Clothes Drag and Blanket Drag: Both methods suited for emergency scenarios prioritizing patient safety.
• Specific Situations for Evasive Action: Consideration for the patient's medical history such as allergies or existing conditions may require searching belongings for vital information.

Final Notes

• All EMTs must adhere to guidelines ensuring the safety and dignity of patients while pursuing ethical and legal standards in patient care and consent dynamics.### Patient Handling and Transport Techniques
• Emergency moves may be necessary in situations like fires in nursing homes; specific techniques are employed based on the patient's condition.
• Use of clothing for moving a patient is not recommended; it's essential to use safe and controlled methods.
• In cases of altered mental status, urgent moves should be employed to ensure patient safety and minimize risk.

Log Roll Technique

• When conducting a log roll, proper technique involves using shoulder muscles for assistance, ensuring effective patient handling without strain.

Patient Securing Methods

• Confirm that the patient is securely strapped to a wheeled stretcher, which is crucial for safety during transport.
• When transporting down stairs, consider using specialized equipment such as a stair chair for safer handling, especially with larger patients.

Special Considerations for Large Patients

• For obese patients (approximately 400 pounds and experiencing difficulty), a bariatric stretcher is preferred to ensure adequate support and care.

Equipment Knowledge

• Familiarity with various stretching devices is vital; a plastic basket stretcher is required when lowering patients from heights.
• A long spine board is the best choice for patients with suspected spinal injuries to avoid additional trauma.

Lifting Techniques

• Employ proper lifting techniques, including using a power lift stance to minimize the risk of injury.
• EMTs should always ensure their feet are positioned correctly: shoulder-width apart, on firm and flat ground.

Special Devices

• For patients with spinal injuries, a vacuum mattress provides comfort and safety during transport, adapting to the patient's shape when air is withdrawn.

General Safety Awareness

• While lifting with one hand, avoid compensating by leaning, as this can lead to strain and injury. Maintaining proper posture is critical for the safety of both the patient and provider.