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A holy shit moment but again here's the media

Just Plain Ruff

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Unless the ground is rough or unstable or it's an...exceptionally...large...person I keep the gurney fully raised all the time. It really isn't the safest and is more dangerous, but it's also the easiest and safest way for the people pushing/pulling it. Like I said, while catastrophic failures of the gurney do happen, most likely it'll be operator error.

The problem is there isn't a great solution; while the gurney should be keep low if the ground isn't smooth, pushing or pulling while bent over is much worse for the back...so....damned if you do, damned if you don't.

Which is why not getting complacent is so important


Thats all good if you work in a world of pavement and smooth sidewalks. Out here we have gravel drives and stone or mud walkways to wheel on.

We always dropped down to low waist height so we could have all hands on cot and never let go. Sinking wheels in the dirt or mud happens every day out here.

Very common to go cross country for 50-100 yds to get around some of the big homes from the parking areas.

For years I have tried to talk the stretcher engineer's into designing one with inflatable off road wheel & tires. Something in a 12 in diameter with knobby treads to help get across soft ground & to track muck into the hospital ER's nice clean floors.

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I think we will be seeing more and more of this as our pts get bigger and bigger. That center of gravity will keep moving higher and become more unstable. We will get to the point where the slightest breeze will push them over.

And I can tell you this, I try not to put the patient in a full up position but sometimes it happens. But I can tell you that I'm not going to try to catch a patient when the cot goes down, As heartless as that sounds, the cot weighs at least as much as the patient does and there is no way that I can right that sinking ship.

Best thing to do is to not get into the situation in the first place.

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That is not heartless at all. There is no sense in creating a second and possibly third pt for something that is futile.

And again, the best way to avoid the situation is to not get into it in the first place.

I'll be honest, I have had some very close calls, and actually I have dropped a patient one time due to having the cot up in the full position, ran over a tree branch in a driveway. In full witness of the patient's family. A horrible horrible experience, but this was before cell phone video cameras. Patient was injured yes, but minorly so.

That began a journey of my realizing that having the cot up all the way was STUPID and irresponsible when having it up 1/2 way would have worked just as well. I no longer (when I work that is, and I don't work anymore) will have the cot up fullly.

Lots of paperwork, a free ambulance ride, a free ER visit and a couple of visits with Risk management and the hospital attorneys talking with me and my partner makes you change your practice.

Just don't put the cot all the way up and you decrease a drop by a factor of 10 in my opinion. At least I didn't drop the patien on a tuesday.

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It seems the cots you're using induce high risks even during their normal use. Isn't there any manufacturer that designs cots with bigger wheels?

The cots we use are either "up" or "down" no middle ground (we can block the "legs" in a certain angle to help the pt getting on the cot, but we won't push it around in that position). See some pics:

437029Capturedcran20140326210033.png 765449Capturedcran20140326210058.png

Also, when we're not in a "safe zone" (ER etc...) there is always an EMT in front with a hand on the cot to secure it and watch for troubles.

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