Unit 2-Lesson 3 Moving Patients PDF

Unit 2 Respond to a Medical Emergency Lesson 3 Moving Patients Lesson Goal At the end of this lesson, you will be able to place a patient in a recovery position or position of comfort to avoid positional asphyxia in a non-emergency situation. You will also be able to move a patient in an e...

Unit 2 Respond to a Medical Emergency Lesson 3 Moving Patients Lesson Goal At the end of this lesson, you will be able to place a patient in a recovery position or position of comfort to avoid positional asphyxia in a non-emergency situation. You will also be able to move a patient in an emergency using drags, lifts, and carries. In an emergency, you may have to move a patient to safety or to reposition them in response to their changing medical conditions. When you must move an injured person, choose the method carefully to avoid making the injuries worse and to avoid injuring yourself. You may also need to assist EMS in moving patients or removing an entrapped patient. Follow EMS direction and assist when needed. Perform an emergency move when a patient is in immediate danger or the patient’s location prevents providing care to them or another patient. Perform a non-emergency move when the situation is not urgent. Always perform BSI protocols and wear appropriate PPE when moving a patient. Proper Lifting Techniques ✅ HL223.1. Describe how to lift a patient properly When moving a patient, observe the rules of proper lifting and moving. Be aware of your physical limitations. Maintain correct alignment of your spine, shoulders, hips, and feet. Take a good athletic stance. Engage your abdominal muscles while lifting. Use proper breathing techniques. Look straight ahead. Do not look down. Lift with your legs, hips, and buttocks, not your back. Keep the patient’s weight as close to your body as possible. Limit the distance you need to move the patient if possible. 70 / Florida Basic Recruit Training Program (HL): Volume 2 Recovery Position Place an unresponsive, breathing patient with no suspected neck or back injuries in the recovery position. The recovery position helps maintain an open airway should the patient become nause- ated or vomit, and may prevent breathing restrictions, such as positional asphyxia. Figure 2-5 Recovery position Chapter 2 First Aid for Criminal Justice Officers / 71 ✅ HL223.2. Describe how to place a patient in a recovery position To place a patient in the recovery position: 1. Position the patient on their back without causing additional injuries and stand to one side of them. 2. Place the patient’s left or right arm straight up overhead, flat on the floor. 3. Place the back of the patient’s other hand on their opposite shoulder. 4. Grasp the patient on the shoulder and the knee and roll them towards you. 5. Pull the patient’s knee up and over towards you so that their leg is bending and resting on the floor, and their foot is either flat on the floor or hooked on their knee. Any patient placed in a recovery position is critically ill and should be reassessed every five minutes. Allow a responsive patient to assume a position of comfort, assuming it is safe to do so, while sitting up, or a tripod position where the patient sits down while leaning forward with their arms resting on their knees or standing with their arms resting on another surface. If a restrained suspect is complaining about not being able to breathe and is not combative, place them in a position of comfort. Positional Asphyxia Positional asphyxia occurs when someone’s body is in a position that interferes or prevents them from breathing adequately and leads to an insufficient intake of oxygen that the body needs. ✅ HL223.3. Describe factors that contribute to positional asphyxia Some patients may have risk factors that can contribute to positional asphyxia, such as obesity, alcohol and drug use, or pre-existing conditions including bronchitis, emphysema, and chronic lung disease. Positional asphyxia can happen if a person is face down, with their chest on a hard surface, arms restrained behind their back, and left in this position for a significant amount of time. Positional asphyxia may also happen because of accident or illness that places someone in a breathing-restricted position. Signs and symptoms of positional asphyxia include the patient making a gurgling or gasping sound with mucus or foam coming from their nose or mouth, visual signs that the patient is struggling to breathe, or a patient verbally complains of not being able to breathe. If the patient displays a change in mental status, escalating or de-escalating activity, a reduced LOC, or blue skin discolor- ation, these can indicate the patient is experiencing positional asphyxia. Prevention and treatment of positional asphyxia includes getting the patient out of a prone posi- tion (which may apply pressure to the diaphragm) as soon as practical and placing the unrespon- sive patient in a recovery position, or a responsive patient in a position of comfort. If the patient 72 / Florida Basic Recruit Training Program (HL): Volume 2 is a restrained suspect, search them, and place them in a position of comfort (often sitting upright leaning back against a solid surface). Walking Assist ✅ HL223.4. Describe how to perform a walking assist of a patient Perform a walking assist for a responsive patient with leg injuries or who is blind or has low vision and is still capable of walking but may need some assistance. 1. Stand next to the patient on the same side as the injury. 2. Place the patient’s arm across your shoulder. 3. Place your arm around the patient’s waist. Grasp their belt, if necessary. 4. Help the patient to a safe or comfortable place and encourage the patient not to put body weight on the injury. Emergency Drags Emergency drags are a life-saving component of first aid. Use an emergency drag when you need to move a patient quickly. Drags are physically demanding to perform over long distances. Be aware of any hazards that you may be dragging the patient over. ✅ HL223.5. Describe how to perform an emergency drag of a patient Figure 2-5 Walking assist A critical issue when moving a patient is the danger of making an existing spinal injury worse. Make every effort to maintain the patient’s head, neck, and shoulder alignment. Whenever a drag is performed, the patient should be immediately assessed and any interventions checked once the drag is complete. It is easy to dislodge a tourniquet or wound packing during a drag. Shoulder Drag 1. If the patient is unconscious, secure their hands by folding them across their chest to protect them during the move. 2. Stand behind the patient’s head and squat by bending your knees. Chapter 2 First Aid for Criminal Justice Officers / 73 3. Reach under the patient’s arms and grasp your own wrist. Consider grasping the patient’s opposite wrists. 4. Pull the patient in as close as possible to your chest. 5. Stand up, lean back, and walk backwards. 6. Move the patient with you. The patient’s feet will drag on the ground. Figure 2-6 Shoulder drag 74 / Florida Basic Recruit Training Program (HL): Volume 2 Blanket Drag Perform a blanket drag as an emergency move when you need to move a patient who you should not lift or carry by yourself and the environment is safe to do so. If you do not have a blanket, any large piece of fabric, plastic, or litter will work for this move. 1. Place a blanket directly against the patient’s side. 2. Gather the blanket into accordion-style, lengthwise pleats. 3. Position yourself on the patient’s side opposite the blanket. 4. Extend the patient’s arm that is closest to you straight up and beside their head 5. Reach across the patient and grasp their hip and shoulder. 6. Roll the patient toward you onto their side. 7. Tuck the blanket under the patient. 8. Roll the patient onto the blanket and wrap the blanket around the patient. 9. Grasp the blanket so that it supports the patient’s head and neck. Drag the patient toward safety. Figure 2-7 Blanket drag Chapter 2 First Aid for Criminal Justice Officers / 75 Arm Drag Perform an arm or ankle drag when you need to move a patient short distances and in extreme emergency conditions. 1. Stand at the head of the patient and squat to grasp their wrist(s). 2. Pull the patient’s arms above their head and grasp their wrists or forearms. 3. Drag the patient to safety. Figure 2-8 Arm drag Ankle Drag 1. Stand at the feet of the patient and squat to grasp their ankle(s). 2. Drag the patient to safety. Figure 2-9 Ankle drag 76 / Florida Basic Recruit Training Program (HL): Volume 2 Two-Officer Extremity Lift ✅ HL223.6. Describe how to perform an extremity lift of a patient Extremity lifts are often easier than drags. Considered non- emergency moves, these lifts require at least two officers’ efforts. Use these techniques to move patients who are unrespon- sive or unable to move from the floor or ground. However, do not perform an extremity lift if you suspect or know a patient has an injury to the spine or an extremity injury. 1. Officer 1, kneel on one knee at the patient’s head. 2. Place your hands, palms up, under the patient’s shoulders. 3. Lift the patient to a sitting position. 4. Support an unconscious patient’s back with your kneeling leg. 5. Place your hands under the patient’s arms. 6. Firmly grasp the patient’s opposite wrists, and fold them across the patient’s chest. 7. Officer 2 has two options: a. (Option 1) Position to one side of the patient’s Figure 2-10 Two-officer extremity lift knees with your non- weapon side to the patient. Wrap your inside arm over the patient’s thighs and your outside arm under their thighs. Be careful where you grasp the patient’s legs, preferably above the knees, to avoid hyperextension. Grasp your wrist(s). Chapter 2 First Aid for Criminal Justice Officers / 77  b. (Option 2 pictured) Kneel between the patient’s knees with your back to the patient and grasp beneath the knees. Be careful when grasping the patient’s legs, prefer- ably above the knees, to avoid hyperextension. 8. Officer 1, at the patient’s head, delivers all commands. 9. Simultaneously both officers stand while lifting the patient. 10. Officer 2 should turn and face the direction of movement. SEAL Team 3 Carry ✅ HL223.7. Describe how to perform a SEAL Team 3 carry of a patient Use a SEAL Team 3 carry to move a patient who cannot walk. Remember to use proper lifting and moving techniques. Do not perform this carry if you suspect or know a patient has an injury to the spine or an extremity injury. 1. Officers 1 and 2 stand behind the patient. 2. Place the patient’s arms around the shoulders of both officers. 3. If conscious, instruct the patient to use their arms to hold onto the officers. 4. Hold the patient’s arms around the officer’s neck if the patient is not able to hold on. 5. Grasp the patient’s belt, pants, or back pocket. 6. Lift and go. When performing a SEAL Team 3 carry, always be aware of potential threats. One of the officers may have a free hand and should be prepared to provide security. Figure 2-11 SEAL Team 3 carry 78 / Florida Basic Recruit Training Program (HL): Volume 2 Log Roll ✅ HL223.8. Describe how to perform a log roll of a patient Use this technique only when moving the patient is necessary or when assisting medical person- nel. Ideally, this technique is performed with at least two or three people. The purpose of a log roll is to roll the patient onto their back, front, or side, possibly on a blanket or board. 1. Perform a log roll on the floor or ground with at least three officers on their knees. 2. Officer 1, constantly maintain head, neck, and spinal motion restriction. 3. Officer 2, take your position at the patient’s shoulder and hip. Stay far enough away from the side of the patient’s body so there is room to roll the patient toward you. 4. Officer 3, take your position on the same side of the patient as Officer 2. Position yourself at the patient’s thigh and lower leg. Stay far enough away from the side of the patient’s body so there is room to roll the patient toward you. 5. Officer 2, reach across the patient. Place your hand on the patient’s shoulder. Place your other hand on the patient’s hip. 6. Officer 3, reach across the patient. Place your hand Figure 2-12 Log roll above the other officer’s hand on the patient’s belt line. Place your other hand on the outside of the patient’s knee area. Chapter 2 First Aid for Criminal Justice Officers / 79 7. Officer 1, issue all commands to roll the patient toward Officers 2 and 3, and simultane- ously maintain the patient’s head, neck, and spine alignment. 8. Assess the patient for injuries. 9. If applicable, reverse the process to return the patient to their original position. 80 / Florida Basic Recruit Training Program (HL): Volume 2