EMT: Lifting and Moving and Patient Safety
Prehospital Academy Lesson 2.2
This lesson provides a comprehensive overview of the essential techniques for lifting and moving patients in the pre-hospital setting, with a strong emphasis on the principles of patient safety and the prevention of provider injuries.
Introduction to Safe Lifting and Moving
This lesson covers the core principles of safe patient handling, a critical skill for every EMS provider. It highlights the importance of mastering proper body mechanics to prevent injury, understanding the different categories of patient moves based on urgency, and adhering to strict safety considerations during all phases of patient transport.
The Foundation of Safety: Proper Body Mechanics
For an EMT, mastering proper body mechanics is not just a technique; it is a fundamental practice for career longevity and ensuring patient safety. The physical demands of lifting and moving patients place EMS providers at a high risk for career-ending back injuries. Therefore, a deep understanding and consistent application of these principles are crucial. Before any lift, it is essential to plan the move, communicate clearly with your team, and assess the weight of the load. Maintain a stable and balanced stance with your feet shoulder-width apart, and always lift with your powerful leg muscles, not your back. To do this, keep your back straight and bend at your knees and hips. It is also imperative to keep the patient's weight as close to your body as possible to maintain a stable center of gravity. Twisting while lifting is a common cause of injury and must be avoided; pivot your feet instead. Whenever possible, push rather than pull heavy objects. Most importantly, never hesitate to request additional help if you feel the lift is beyond your team's capacity, and always make use of available assistive devices like power stretchers and stair chairs to minimize physical strain.
Categorizing Patient Moves: Emergency, Urgent, and Non-Urgent
Patient moves in EMS are strategically categorized into three types based on the urgency of the situation and the immediate risks to the patient and providers. Emergency moves are performed when there is an immediate, life-threatening danger to the patient or providers, such as a fire, an explosion, or other unstable scenes. In these situations, the move is performed as quickly as possible to remove the individuals from harm's way, often with little to no consideration for spinal immobilization due to the imminent threat.
Urgent moves are employed when the scene itself is safe, but the patient's condition necessitates immediate transport or intervention that cannot be performed in their current location or position. Examples include a patient with a deteriorating level of consciousness or inadequate breathing. While still performed quickly, urgent moves allow for a more deliberate approach, with precautions taken for spinal immobilization and patient stabilization before the move.
Finally, non-urgent moves are used when both the scene and the patient are stable. This allows the EMS crew to conduct a complete on-scene assessment and meticulously plan the move to ensure maximum patient comfort and safety. This is the preferred method in most medical calls, as it allows for a controlled and coordinated effort, minimizing the risk of further injury.
Upholding Patient Safety During Transport
Ensuring patient safety during transport is a paramount responsibility for every EMT. This process begins well before the ambulance is in motion, with a thorough on-scene patient assessment and stabilization of any life-threatening conditions. Once the patient is ready for transport, all equipment, including the patient on the stretcher, must be securely fastened to prevent movement or falls during transit. The ambulance itself should be well-maintained, and the patient compartment must provide a temperature-controlled and safe environment. EMS providers must be proficient in proper patient handling and transfer techniques to move the patient from the scene to the ambulance and from the ambulance to the hospital bed. Throughout the transport, continuous monitoring of the patient's vital signs and condition is essential, with any changes being promptly addressed and documented. Clear and concise communication between the transport team, the patient, and the receiving facility is also critical for a safe and effective handoff, ensuring an unbroken chain of high-quality care.
Conclusion
Mastering the principles of safe lifting and moving is a fundamental and non-negotiable skill for every EMS provider. By consistently using proper body mechanics, selecting the appropriate type of patient move for each unique situation, and adhering to rigorous safety protocols, EMTs can protect themselves from career-threatening injuries and ensure the ultimate well-being of their patients throughout the entire call.
Critical Thinking Questions
Describe a scenario where you would choose an urgent move over an emergency move for a patient found in a vehicle after a motor vehicle collision. What specific patient findings would justify this decision?
What are the potential long-term consequences for an EMT who consistently fails to use proper body mechanics when lifting heavy patients?
How can an EMT ensure both their safety and the patient's safety when moving a bariatric patient from a third-floor apartment with no elevator?
Discuss the importance of clear, closed-loop communication and teamwork when performing a complex patient move, such as extricating a patient from a confined space.
What proactive steps can an EMS agency take to foster a culture of safety and reduce the incidence of lifting and moving injuries among its providers?