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Lifting and

Moving
Patients
Lesson 5

5-1

Moving Victims
Moving injured victim likely to cause further
injury
In most cases wait for professional help
May have to move victim to protect from danger
at scene
May have to move victim to flat surface to
provide CPR

5-2

Body Mechanics
Back injury is hazard
for First Responders
To minimize risks, use
good body mechanics
Body mechanics are
principles of using
your body safely

Body Mechanics and Lifting


Techniques

Know your physical ability and limitations


Plan the lift
Ensure you have a good grip
Test the load
Position your feet properly before starting lift
Lift with your legs, not with your back
Keep patients weight close to your body
Avoid twisting your back during the lift
Communicate clearly with your partner and other EMS
providers

5-4

Patient Positioning
Reposition a patient only when necessary
Reposition a breathing, unresponsive, nontrauma patient in the recovery position
Dont move or reposition a trauma patient unless
necessary to treat life-threatening condition
Allow responsive patient to assume comfortable
position

5-5

Recovery Position

Helps keep airway open


Allows fluid to drain from mouth
Prevents aspiration
If possible, put victim onto left side
Continue to monitor breathing

Recovery Position for


Unresponsive Breathing Infant
Hold infant facedown
over your arm with
head slightly lower
than body
Support the head and
neck with your hand,
and keep nose and
mouth clear

Skill:
Recovery
Position
(Modified HAINES)
5-8

Extend victims arm farther


from you above victims
head

5-9

Position victims other


arm across chest

5-10

Bend victims nearer


leg at knee

5-11

Put forearm nearer


victims head under
victims nearer
shoulder with hand
under hollow of neck

5-12

Roll victim away from


you by pushing on
victims flexed knee
and lifting with
forearm while hand
stabilizes head and
neck

5-13

Continue to support
head and neck.
Position victims hand
palm down.

5-14

Check airway and open mouth to


allow drainage.

5-15

Log Roll
Use log roll to move patient from prone to
supine
Three to five rescuers are needed to safely roll
patient
For trauma patient with spinal injury, stabilize
head in line with body

5-16

Log Roll continued


1. The rescuer at the patients head holds the head in line
with the body as two or three additional rescuers take
position with hands at the patients lower and upper leg,
hip and torso, and shoulder
2. At the direction of the responder at the head, the
rescuers in unison roll the patient toward them, with the
head held in line and the spine straight
3. The rescuers complete the log roll, positioning the
patient on the back with head and neck still in line with
the body

5-17

Emergency Moves
Use only if:
Patient faces an
immediate danger
You cannot give
lifesaving care
because of location
or position

Risk of Spinal Injury


Moving patient quickly risks aggravating a spinal
injury
Keep head and neck in line with spine
It is impossible to protect spine while removing
patient from a vehicle quickly

5-19

Extrication from Vehicles


First Responders may be trained in rapid
extrication using cervical collar and inline
stabilization of head/neck
Follow local protocol
Wait for EMTs trained in special extrication
techniques

5-20

One-Rescuer Emergency Drags


Pull/drag patient in direction of long axis of body
Dont drag patient sideways, and avoid twisting
neck/trunk
Never pull head away from neck/shoulders
Risk of spinal injury can be minimized by using a
blanket, rug, board, etc
Choice of move depends on materials at hand,
patients condition, and situation

5-21

One-Rescuer Emergency Drags

Clothing Drag
Blanket Drag
Shoulder Drag
Firefighters Drag
Upper Extremity Drag
Upper Extremity Drag for Rapid Extrication

5-22

Emergency Carries
Used when patient must be moved immediately
One or more rescuers may carry patient
Method used depends on patients size,
condition and situation:
Walking assist
Cradle carry
Multiple-rescuer techniques are safer/less stressful

5-23

With All Emergency Carries


Use good body
mechanics/lifting
techniques
Dont try to lift/carry
person before
checking for
injuries

Moving Victims If Alone


Unresponsive victim
who cannot safely be
dragged
Pack-strap carry

5-25

Moving Victims If Alone


Lighter victim or child
Cradle carry (responsive or
unresponsive victims)
Piggyback carry (responsive
victim)

5-26

Piggyback Carry
Support the patients weight with your arms
under the patients thighs
If able, have the patient clasp hands and lean
forward; if not able, grasp the patients hands
with yours to keep patient from falling back

5-27

Firefighters Carry

Support the patients weight on your shoulders


while holding the patients thigh and arm

Moving Victims If Alone


Responsive victim
who can walk with
help
One-person
walking assist

Moving Victims With Help


Responsive victim:
Two-person walking assist
Two-handed seat carry

Two-Rescuer Extremity Carry


To carry a patient
down steps, the
forward rescuer
grasps patients legs
under the knees while
the rear rescuer
reaches under
patients armpits from
behind to grasp the
patients forearms
5-31

Two-Rescuer Assist
Both rescuers
position the patients
arms over their
shoulders
Each rescuer grasps
the patients wrist,
with the other arm
around the patients
waist
5-32

Non-emergency Moves
Used to move patient when no threat to life
Performed by multiple rescuers
Not used if patient has suspected spinal injury,
internal bleeding, or uncontrolled external
bleeding
Stabilize patients before moving them
Minimize any chance of aggravating illness or
injury
These moves are usually performed by
responding EMS personnel
5-33

Before Using a Non-emergency


Move
Complete
primary/secondary
assessment
Correct any lifethreatening problems
Immobilize all suspected
fractures/dislocations
Ensure there are no
signs/symptoms of
neck/spinal injury

5-34

Direct Ground Lift


Non-emergency move for patients without
suspected neck or spinal injuries
Used to lift/carry supine patient from
ground to stretcher

5-35

Direct Ground Lift


Rescuers kneel on one side of the patient
Rescuer at head places one arm under
the patient's neck and shoulder and
cradles the patient's head
Rescuers lift patient to their knees and roll
the patient in toward their chests
Rescuers stand and move patient to
stretcher
5-36

Extremity Lift
Two-rescuer technique used for patients without
suspected injury to neck, spine, or extremities
May be used with responsive/unresponsive
patient
May be used to carry patient a short distance or
move patient from chair to stretcher
May be used to carry a patient through a tight
space

5-37

Extremity Lift
1. The first rescuer kneels at the patient's head
and the second rescuer kneels by the patient's
feet. The rescuer at the head places one arm
under each of the patient's shoulders while the
rescuer at the feet positions the patient's arms.
2. The rescuer at the head then slips his or her
hands under the patient's armpits and grasps
the patient's wrists and crosses them on the
patients chest. The rescuer at the feet turns
around and reaches his or her hands back and
under the patient's knees.
5-38

Extremity Lift continued


3. Both rescuers move to a crouching position and
assess their grip on the patient
4. On a signal from the rescuer at the head, the
rescuers stand up simultaneously and move
forward with the patient

5-39

Extremity Lift Alternative


Position
Preferred if rescuers must move some distance or over
inclined surface
Rescuer at patients feet may face patient and other
rescuer
Can be used to move patient to side or short distance
Transfer from Bed to Stretcher
Assist EMS personnel transferring patient from bed to
stretcher
Use either direct carry or draw sheet technique
Not used with patient with suspected spinal injury

5-40

Direct Carry
1. Position the stretcher at a right angle to the bed, ideally,
with the head end of the stretcher at the foot of the bed.
The stretcher should be at the same height as the bed.
Unbuckle the straps and remove other items from the
stretcher. Both rescuers stand between the bed and the
stretcher, facing the patient.

5-41

Direct Carry continued


2. The rescuer at the head slides one arm under the
patient's neck and cups the patient's farther shoulder.
The second rescuer slides one arm under the patients
hips and lifts slightly. The rescuer at the head slides his
or her other arm under the patient's back, and the
second rescuer places his or her other arm underneath
the patients thighs near the knees. Together, both
rescuers slide the patient to the edge of the bed.

5-42

Direct Carry continued


3. On a signal of the rescuer at the head, the rescuers lift
and curl the patient toward their chests
4. The rescuers step back, rotate toward the stretcher, and
place the patient gently on the stretcher

5-43

Draw Sheet Transfer

Draw Sheet Transfer


1.Loosen bottom bed sheet and roll its edge on the
side where you will place stretcher
2. Position stretcher alongside bed. Prepare
stretcher:
Adjust height, lower rails, and unbuckle straps
Both responders reach across stretcher and grasp
rolled sheet edge firmly at level of patient's head,
chest, hips, and knees

3. Slide patient gently onto stretcher

Draw Sheet Transfer


Alternative Method
Rescuers first roll patient onto one side, and one
rescuer holds the patient in that position. Second
rescuer positions a sheet with rolled edge
beneath patient
The patient is rolled back into original position,
now on the sheet
The rescuers together pull on sheet to slide
patient onto stretcher

EMS Equipment for Moving


Patients
First Responders
often assist EMTs
with packaging and
moving patients
A wide range of
commercial devices
are used
Learn devices you are
likely to encounter in
your area
5-47

Typical Equipment for Packaging


and Moving Patients
Long Backboard
Short Backboard
Vest Extrication
Device
Standard Stretcher
Portable Stretcher
Orthopedic Stretcher
Basket Stretcher
Stair Chair
5-48