Lifting and moving of Patients.

[NYCEMS9115]

It all depends. They all are fine. Don't forget about the Folding, Reeve's, & Scoop Stretchers. Carrying with a sheet or under the patient's armpits and behind knees can be appropriate. There are pros and cons for every carrying device & method used.

The call, weather, egress, partner, self limitations, & patient condition will determine the device(s) & method(s) used.

You should survey the scene from the address front, path to doorway, path to patient, & patient area. This will determine the best device(s) and method(s) to safely move the patient.

There are no clear cut way like everything else in Prehospital Care and life.

What you learned, heard from others, seen from others, work experience, & lessons on other methods can guide you to make the right decision.

The three No-No's: DO NOT HURT THE PATIENT, YOURSELF, OR OTHERS... Good luck; all the best....

[+medic]

The three No-No's: DO NOT HURT THE PATIENT, YOURSELF, OR OTHERS... Good luck; all the best....

Agreed but thats easyer said then done at times. The reason why I ask is for personal reasons after a hard call the other day.

So given the three options with a wide set of five steps into a home with light snow falling with the patient a elderly women who cant walk and has NO mobility. I ask what would be the best option based on the info I have given.

[NYCEMS9115]

ABC? History of Present Illness? Trauma vs Medical? CUPS? Is there any pain? If so, where? OPQRST? Is she A/Ox3? GCS? Baseline? Can she sit up? Can she perform normal activities of daily living? Vitals? Head to Toe? Findings? ALS Intercept or Intervention? Contact OLMC? Anyone with her? SAMPLE? If she's alert, she can tell you the best way. Especially, if she's a frequent EMS user. Any help? Any treatment devices (Oxygen, ECG, Fluids) which needs to be with the patient during the disentanglement phase? How strong is your partner? How strong are you? What devices do you have?

If it is just plain transport to ER for something that's chronic or a non emergency call, there is no pain, and you have all carry devices in the textbook. Then slide the Reeve's under her to carry her out (cover her to maintain heat) or use the stairchair with sheet open with the longest side going across so the ends do not drag and place her on the chair, wrapping her like a cocoon; covering her with a blanket or use a folding stretcher and go head to toe to place her on; maintain body heat with sheets and blankets or use a scoop, making sure the snaps are fasten when she's on; maintaining body heat or if she's not heavy (I think the PC word is thick. LOL); place her on the stretcher; covering her with sheets and blankets, its only five steps (I've done that for many patients who were very thick). However, its foremost that the stretcher is waiting for you at the bottom with the straps unfasten and you've communicate which way to exit to make placing the pt on the stretcher easier. Unless your using the stretcher to carry her out. If you have many hands; then you can carry all the way (even with the stairchair; but roll it when you can. Unless the stretcher is situated in the ambulance which doesn't allow the chair to fit) to the back of the Ambulance with someone in the ambulance taking the hand off; the stretcher needs to be in the back though. Don't forget your equipment on scene.

There are so many options. Experience, situation, condition, and resource dictates the proper way.

[medicgirl05]

How heavy is she? And how serious is her condition?

[+medic]

Oh sorry I should given more info since there is more then one way to skin a cat it seems.

This pt is a 85 y/o women who cant walk or have any torso control besides use of her arms. She weighs only 80 pounds and its snowing lightly outside. She is being transfered by a two crew of EMT-B's into her home from a Dialysis clinic. She is Alert, oriented and stable, for a IFT company this is a very normal transfer.

There are so many options. Experience, situation, condition, and resource dictates the proper way.

Agreed 100% but I am trying to get good views on what could be done in this situation and how it can be done better and safer.

Edited January 22, 2011 by +medic

[medicgirl05]

I think this is just a personal preference situation. There are many options that are acceptable. It just depends what you and your partner are confortable with...

Personally, I would probably use the stretcher. If it is snowing I think it would be easier to keep her warm that way. Pus she is light enough that it won't be much trouble, and for me and my partner it would be the quickest way. However, that is just my personal preference and I'm sure others may have different opinions that are perfectly accepatable solutions......

[Richard B the EMT]

The three No-No's: DO NOT HURT THE PATIENT, YOURSELF, OR OTHERS... Good luck; all the best....

Good thought, but just commenting that the way a partner taught that to me had a different order and wording.

Look out for yourself, your partner, your patient, and your vehicle, and usually all will be all right in your world.

Deanne H, formerly of Nassau Ambulance/Ambulette Service of Freeport NY, and Elmont NY VFD.

[queensland paramedic]

Hello All,

We have had this trouble within the ambulance service whom I work for, a new manual handling package was designed to reduce the risk of injury to our paramedics. This also included the introduction of new lifting equipment. We found that the traditional stair chairs were fine for carrying people down stairs, but not for lifting up again. Even the new stryker rugged stairchair are brilliant for carrying patients down but not up stairs. Our new policy is for any patient that requires lifting back up stairs again requires 2 crews to be dispatched...depending on weight of patient of course, this has reduced the back injury rate for lifting patients up stairs significantly.

Hope this helps.

[NYCEMS9115]

Even with the rugged yellow strykers; carry ups are possible. It adds 30lbs to the patient. You can still use it like the old ferno's or you can pull up the steps with the track. If they are mildly, moderately, or severely obese; you'll still would call for backup even with the older stairchair. Its about perserving yourself (partner included)and patient's well being.

http://www.ems.stryker.com/detail.jsp?id=5

[MedicCraig]

One other option if the house has a porch. If there is enough room beside the steps, place the loading wheels on the porch, retract the legs, then push the stretcher onto the porch. It's just like loading the stretcher into the ambulance. It's a good idea to have your partner get up on the porch first and hold on to the head end of the stretcher so it doesn't back off the porch and fall. You might want to practice this trick with an unloaded stretcher first to get the hang of it. I've used this technique 100's of times without any problems.