Catawba County News
EMS Lifting and Moving Patients
Published: May 24, 2021
The field of EMS is a vast and adventurous field full of unpredictable and unexpected calls for service. With each day and with each patient encounter, paramedics and EMTs face new situations, new experiences. No shift or patient encounter is the same.
Paramedics and EMTs are required to be very skillful, knowledgeable, and versatile in their abilities to ensure the best care is provided in each situation. These abilities include conducting thorough assessments, starting IVs, interpreting cardiac rhythms, administering several medications, and performing advanced airway management techniques. Intellectual skills include effective communication, critical thinking, and most importantly, decision making. Lots and lots of decision making. Some simple, some difficult. Some life or death, and some not so life or death.
A decision that must be made with every patient encounter involves the best way to get the patient from the scene (residence, business, motor vehicle crash, etc.) to the ambulance in order to transport the patient to the hospital. Who would think that deciding the movement of a patient to the ambulance would be so important? Well, it is! It is very important, because it involves the safety of the patient and the EMS crew/first responders that are providing care to the patient.
Safety is the absolute key for facilitating patient movement. Lack of safety can cause harm to the patient or the crew involved, including worsening of the patient’s condition or ruining the career of the EMS crew member due to an injury. There are quite a few techniques that EMS crews utilize in order to facilitate the appropriate movement of the patient. The most recognized technique is the use of the stretcher. EMS and stretchers go together like peanut butter and jelly. Stretchers are wonderful tools, because they provide the most weight capacity (700lbs) to support patients as they are moved, they provide an adequate amount of comfort for the patient allowing for different possibilities of position for the patient riding during transport (sitting at a 90-degree angle to lying flat and all positions in between), and they allow for the easiest movement for the crew. The newest stretchers are more advanced, hydraulic powered cots. These powered stretchers do all of the manual lifting, raising, and lowering. They can also load themselves into the unit when appropriately attached to the powered lift in the ambulance. The older stretchers still require manual raising and lowering with a minimum of two personnel. Unfortunately, there are a number of limits that inhibit the use of the powered stretchers. First, the stretchers are extremely heavy. The weight of the stretcher ranges from 80lbs to 150lbs, not including the patient’s weight. The average weight of an adult male is 220lbs. Even though the stretchers have wheels, there are times that the stretcher must be lifted by the crew in order to continue movement over small steps, door jams, uneven ground/pavement, or across small objects in the path. In average cases, the EMS crew is still lifting 370lbs. It is no surprise that the most common job-related injuries are back injuries. EMS personnel will utilize the best and most appropriate technique to ensure the patients are safe (so we don’t drop them) and no injury occurs to the crew. Stretchers cannot be utilized when there are small, narrow, or tight pathways or hallways within residences. Stretchers cannot make narrowed 90 degree turns. Stretchers cannot be lifted up more than a few steps in a safe manner. The general rule of thumb in EMS is that stretchers do not go into the house unless the stretcher can easily be maneuvered within the house or business without significant lifting, carrying, or significant rearranging of furniture that impedes the pathway.
In situations where the stretcher cannot be utilized, paramedics and EMTs must utilize other techniques to safely get the patient outside to the stretcher. The easiest method is to simply have the patient walk, with assistance if needed, outside to the stretcher. Don’t be offended if EMS personnel ask you if you are able to walk. They aren’t intending to be lazy or inconsiderate. It is just an option in the process, the preferred option for many patients. If the patient is unable to walk for whatever reason, EMS personnel will use other techniques. One of those techniques is utilizing a stairchair. A stairchair is hard-structured seat that is similar to a wheelchair but has added tracks on the back side that allows for the chair to maneuver down steps and non-flat surfaces. These tracks resemble the tracks of a tank, which allow a smooth, controlled transition over the stairs. This is a very safe and preferred technique used by paramedics and EMTs all over the world. Another technique that you may see used is through the art of carrying. In some cases, patients cannot walk or maintain a seated position (typically bed bound patients or unresponsive patients). When the stretcher cannot be utilized, EMS personnel may elect to carry the patient from the residence to the stretcher. The patient may be carried by the torso and the legs by two personnel. The patient may be placed on a sheet or a commercial lift sheet with handles and carried to a more preferred area. The commercial lift sheet is called the Heavy Lift Sheet and it is a medical movement device. While it looks similar to a tarp, it is an actual medical tool. The patient may be placed on a rigid board, such as a back board, to allow for safe movements. The back board will also be used in the setting of an injury when proper immobilization of the spine during the movement of the patient is required. Although these carrying techniques may not be the most comfortable or the best “looking” techniques, understand that all of these techniques are safe and will be the most appropriate for that particular situation. Do not fear! They are professionals!
Lifting and moving patients is something that is needed with almost every patient encounter. Lifting includes getting the patient from the scene to the unit, from the unit to the hospital bed, or just getting the patient up from the floor after a fall. Lifting must be done in a safe and appropriate manner to ensure safety to all. EMS personnel are very agile and versatile in their ability to improvise and move the patient in the best possible way. Although the move may be non-orthodox from the patient, family, or bystander point of view, that specific technique may be the best option.