Lifting And Moving Patients: Techniques, Moves, And Safety Tips

OBJECTIVES

Upon completion of this lesson, you will be able to:

Define body mechanics and enlist basic rules to prevent injury while lifting loads.
Name five examples of situations that might require you to make an emergency move with a patient.
List three emergency moves and two non-emergency moves for lifting and moving a patient.
Demonstrate the techniques for immobilising and transporting a patient, using a backboard.

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1. Background

Before providing care, a patient may need to be moved or transported. Emergency situations may require you to act quickly while maintaining the safety of both the patient and yourself. Careless lifting or movement can cause serious injury to the EMS provider or the patient.

Each EMS system determines when and how a patient may be moved. Learn the guidelines and protocols of your agency.

2. Body Mechanics

Definition:
Using the proper use of your body to facilitate lifting and moving and to prevent injury.

Position your feet properly. Stand at a comfortable distance apart, with your feet flat on the ground for balance.
Bend your knees while keeping your back as straight as possible. Avoid bending at the waist or twisting your back.
Use your legs to lift, not your back.
Keep the weight of the object as close to your body as possible.
“Stack” — move your body as a unit. Visualize your shoulders in line with your hips and feet.
Pivot, don’t twist your feet.
Reduce the height or distance you need to move an object.
Reposition and lift in stages.

Apply these principles to lifting, pulling, pushing, carrying, moving, or reaching for an object. The key to preventing injury is maintaining the natural curve of the back. Keep wrists and knees in normal alignment.

Basic Moves

Teamwork is essential. Communicate during a task, clearly and frequently. Use commands that are easy for team members to understand. Verbally coordinate moves from beginning to end.

Proper body mechanics will not protect those who are not physically fit.
A proactive, well-balanced physical fitness program should include training in flexibility, cardiovascular exercise, strength, and nutrition. However, these components are beyond the scope of this course.

3. Moving Patients

Questions to consider:

How soon should you move the patient?
How much space do you have available for moving the patient?
What equipment should you spend on spinal protection?
How much time do you have?

These answers depend on the circumstances.

General advice:
If moving a patient is necessary, provide emergency care first and then move the patient. If the scene is potentially unsafe or presents immediate threat, you may need to move the patient before providing full treatment. This leads to emergency moves and non-emergency moves.

3.1 Emergency Moves

Make an emergency move only when there is immediate danger to the patient.

Examples of situations which might require you to make an emergency move:

Fire or threat of fire – always considered a great threat to patients and rescuers.
Explosion or threat of explosion (hazardous scene).
Inability to protect the patient from hazards at the scene:
- Unstable building
- Rolled-over car
- Hazardous materials (Haz-Mat)
- Spilled gasoline
- Extreme weather

To gain access to other patients who need care.

When life-saving care cannot be given due to the patient’s location or position:

Example: A patient in cardiac arrest must be supine on a hard flat surface to perform CPR properly. If the patient is sitting on a sofa or is lying in bed, you must make an emergency move.

The greatest danger in making an emergency move is the possibility of spinal injury.
Provide as much protection to the spine as possible – pull the patient in the direction of the long axis of the body.
Try not to move the head away from the neck and shoulders, and secure the hands and arms.

Moving patients away from a vehicle quickly and safely may be impossible. Move the patient only under the conditions mentioned above.

Types of Emergency Moves

Shirt drag
Blanket drag
Shoulder or forearm drag

Other Types:

Sheet drag
Piggyback carry
One-rescuer

Crutch carry
Firefighter drag

3.2 Non-Emergency Moves

Where there is no immediate threat to life, the patient should be moved only when ready for transport, using a non-emergency move. Complete your on-scene assessment and treat the patient first. Prevent additional injury and try to avoid causing discomfort and pain to the patient.

Non-emergency moves generally require minimal equipment. However, if you suspect spinal injury, provide proper spinal immobilization prior to moving the patient. Often patient-carrying devices can be utilized.

Examples of non-emergency moves:

Direct-ground / bed lift:
This move is difficult if the patient weighs more than 80 kilos, is on the ground or other low surface, or is uncooperative. Requires at least three people.
Extremity lift:
Commonly used to move patients from a chair or bed to a stretcher or the floor. Do not use on patients with extremity injuries.

4. Positioning the Patient

How you position a patient depends on the patient’s condition.
Examples:

Patient showing signs of shock
Patient with respiratory problems
Patients with abdominal pain generally want to be on one side with legs drawn up.
A responsive patient, nauseated or vomiting
Trauma patients, especially suspected spinal injury patients
Place patient in recovery position if unconscious and not contraindicated.

5. Patient-Carrying Equipment

Such equipment includes stretchers and other devices designed to carry patients safely to their destination. You should become completely familiar with the use of these devices. You should also know the limitations of the equipment. It is very important to regularly maintain and inspect these devices.

Typical equipment used to move patients includes:

Wheeled stretchers – some have a collapsible undercarriage, usually seen in ambulances or transportation units.
Lightweight portable stretchers (folding or collapsible)
Scoop stretcher – splits into two pieces to scoop up a patient without rolling them.
Vest-type extrication devices – used for stabilizing and extricating patients from vehicles or confined spaces.
Stair chair – designed for carrying patients up and down stairs.
Basket stretcher – ideal for rough terrain or confined spaces.
Flexible stretcher – can conform to the patient’s shape and is useful in tight spaces.
Draw sheet – used for short-distance transfers, often from a bed to a stretcher.
Reeves stretcher – flexible stretcher with multiple handholds, great for confined spaces.
Long spine board – provides full body support and immobilization for spinal injury patients.
Short spine board – primarily used for stabilizing patients in seated positions, like in vehicle extractions
Backboards: These devices are usually made of splinter-resistant wood or synthetic material that will not absorb blood. They usually have handholds or carrying straps. There are two types:

Long backboard: 6–7 feet long, used for patients found lying down or standing and who must be immobilized.
Short backboard: 3–4 feet long, used primarily to remove patients from vehicles when neck or spinal injuries are suspected.

The backboard is slid between the patient’s back and the seat. Once secured to the short board and wearing a rigid cervical collar, the patient can be removed from this sitting position in the vehicle to a supine position on the long board. Vest-type devices are often used as a short backboard.

MFR Lesson 19: Skills Checklist for Stations 1, 2, 3, and 8

Stations 1 or 2 and 3 or 4, 5 or 6, and 7 or 8

Student Name: ____________________________
Date: ____________________________

Instructions:

Check the box showing on which attempt the participant was able to perform the step successfully. UTP indicates unable to perform successfully within four attempts.

Performance Guidelines

Performance Guidelines	Successful on Attempt	UTP
Station 1 OR Station 2	1	2
Use PPE
Assess the mother.
Station 3 OR Station 4	1	2
Use PPE
Care of the newborn infant.
Station 5 OR Station 6	1	2
Use of PPE.
Normal delivery.
Station 7 OR Station 8	1	2
Treat prolapsed umbilical cord.
Treat breech birth.
Treat umbilical cord wrapped around the neck.

Comments:

Overall Performance

Station	Performance	Instructor Signature
Station 1 OR 2	□ Outstanding □ Successful □ Needs Improvement	____________________________
Station 3 OR 4	□ Outstanding □ Successful □ Needs Improvement	____________________________
Station 5 OR 6	□ Outstanding □ Successful □ Needs Improvement	____________________________
Station 7 OR 8	□ Outstanding □ Successful □ Needs Improvement	____________________________

Lifting and Moving Patients: Checklist and Situations

List three emergency moves and two non-emergency moves for lifting and moving a patient.

Emergency Moves:

Shirt drag
Blanket drag
Shoulder or forearm drag

Non-Emergency Moves:

Direct-ground/bed lift
Extremity lift

Name five examples of situations that might require you to make an emergency move with a patient:

Fire or threat of fire.
Explosion or threat of explosion.
Presence of hazardous materials (e.g., spilled gasoline, toxic chemicals).
Unstable structure, such as a collapsing building or vehicle.
Patient’s location prevents life-saving care, such as performing CPR.

Let me know if you need additional details!

Emma Lee

Emma Lee, an expert in fire safety with years of firefighting and Rescuer experience, writes to educate on arescuer.com, sharing life-saving tips and insights.