Lifting, Handling & Moving

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• Review Risk factors
• Examine Body mechanics
• Importance of proper posture & fitness
• Guidelines for lifting & moving
• Emergency moves
• Non-emergency moves
• Patient positions
• Patient carrying devices
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Risk Factors
Sporadic or continuous lifting
Poor posture from constant sitting in the unit
Burst of exertion on tired, stiff, unfueled bodies
Mental attitude
Most providers are young, healthy, and have a strong sense of
invulnerability
Lifestyle, posture and stress
Overweight/Obesity
Flexibility, (Lack of)
Poor physical condition
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Lifting Dynamics

Every situation is unique

Apply the basic principles of lifting to each situation
Think it through - Know what you are going to do
before you start
Determine who will be the team leader - Only one
person calls the shots
Communicate with team members

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Lifting Dynamics
Check your footing
Maintain the most balanced position possible
Use your leg muscles, not your back - Use smooth
continuous motions, do not jerk
Exhale during exertion - This can add power to the lift
Keep the weight close to your body - With palms up, the
load is brought closer to your body
Know your limits

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Body Mechanics
Keep the weight of the
weight of the object as
close to the body as
possible.
Use leg, hip & buttock
muscles plus contracted
abdominal muscles.
“Stack”
Reduce weight or distance
that must be moved
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Guidelines for Lifting & Moving
• Know your physical abilities & limitations

• Know the weight of the patient prior to lifting

• Know the weight limitations of the equipment

• Call for additional help if necessary

• Try to use even number of persons for lifting

• Use wheeled stretchers whenever possible

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 Body Mechanics During
Lifting and Moving
• Only move a victim you can safely handle
• Get additional help if needed
• Look where you’re walking or crawling
• Move forward if possible
• Take short steps
• Bend at hips and knees
• Lift with legs, not back
• Keep load close to the body
• Keep patient’s body in line when moving
Injury Prevention
Don’t hurry - The faster you go, the less you think out your plan
Communicate - Let others know what, how & who is to do which
job
Lack of communication can prove detrimental
Avoid awkward positioning - Be aware of body position & footing
When maintained properly, your back is a powerful
tool
Once injured, you are 3-5 times more likely to
experience future injury

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Injury Prevention

Think about lifting dynamics before and during each

lift

Consider the use of a back support belt

Use help wisely - Bystanders like to help, be sure you

explain what needs to be done before the lift is done to
prevent injury to the bystander & yourself

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 POWER LIFT

• Get in position

• Your feet should be shoulder width apart

• Turn your feet slightly outward

• Ensure that your feet are flat on the ground

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 POWER LIFT

As you begin your lift:

• Your back should remain locked

• Your feet should remain flat

• Tighten the muscles of your back

• Tighten the muscles of your abdomen

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 POWER LIFT
In the power grip,

Palms & fingers should come in complete

contact with the object & fingers should

be bent at the same angle.

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 POWER LIFT

As you return to the standing position,

make sure your back is locked in and

your upper body comes up before your

hips.

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Emergency Moves

You should use an emergency move to move

a patient before initial assessment & care are

provided when there is some potential danger,

and you and the patient must move to a safe

place to avoid possible serious harm or death.

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Non-Emergency Moves

When both the scene & the patient are stable,

you & your partner may choose one of several

methods for lifting & carrying a patient. The

two general methods are the Direct Ground Lift

and the Extremity Lift.

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Direct Ground Lift
Is used for patients with no suspected spinal
injury who are found lying supine on the ground.

• Line up on one side of the patient

• One person should be at the patient’s head

• One person should be at the patient’s waist

• One person should be at the patient’s knees

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Direct Ground Lift

As a team and on signal, each Paramedic rolls

the patient in toward his / her chest.

Again on signal, the team stands & carries the

patient to the ambulance cot.

The steps are reversed to lower the patient onto

the ambulance cot.

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Extremity Lift
The extremity lift may also be used for patients
with no suspected extremity or spinal injuries
who are supine or in a sitting position on the
ground.

The first Paramedic kneels behind the patient’s

head as the second Paramedic kneels at the
patient’s feet.

The patient’s hands should be crossed over

their chest.

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Extremity Lift
The first Paramedic places one hand under each
of the patient’s armpits while the second
Paramedic grasps the patient’s wrists.

The two Paramedics pull & lift the patient into a

sitting position.

The first Paramedic then reaches his / her arms

through the patient’s armpits & grasps the
patient’s wrists.

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Extremity Lift

The second Paramedic moves to a position

between the patient’s legs, facing in the same
direction as the patient.

The second Paramedic will then slip his / her

hands under the patient’s knees.

Both Paramedics then move up to a crouching

standing position.

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Extremity Lift
Both Paramedics will make sure they are
balanced with a good grip on the patient.

On command, both Paramedics stand fully

upright & move the patient to a stretcher.

Keep in mind that this lift & carry method

increases pressure on the patient’s chest,
so the patient may be uncomfortable in this
position.

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Patient Carrying Devices

• Wheeled Stretcher / Ambulance Cot

• Scoop Stretcher

• Long Spine Board

• Stair Chair

• Portable Stretcher

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Wheeled Stretcher / Ambulance Cot
Advantages
• Enables movement without carrying
• Accommodates variety of positions & heights
• Safe traversal of stairways & curbs
• Can be lifted & lowered from ends or sides
• Durable
• Mechanically simple
• Comfortable
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Wheeled Stretcher / Ambulance Cot
Disadvantages

• Requires two Paramedics to load & unload

• X-ray opacity

• Adds extra weight

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Scoop Stretcher

Advantages

• Can be used in confined spaces

• Allows easy application of restraints

• Integrates well with other equipment

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Scoop Stretcher
Disadvantages

• Must be carried

• Requires padding

• Should be pre-warmed

• May consume considerable space

Not Recommended For Patients With
Suspected Spinal Injuries
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Long Spine Board
Advantages
• Great spinal immobilizer
• Good lifting device
• Can float
• Light & compact
• Can serve as a CPR surface
• Mechanically simply
• X-ray transluceny
• Can be carried & loaded from ends or sides
• Integrates well with other equipment

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Long Spine Board
Disadvantages

• Must be carried
• Usually must be left with the patient
• Unstable for moves up or down inclines
• Uncomfortable
• Wooden types may develop splinters
• May weaken with time

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 Stair Chair
Advantages
• Good for use in stairways, corridors & elevators
• Some models can be converted into stretchers
Disadvantages
• Must be carried
• Unstable to use with trauma patients
• Not to be used for pts with altered mental status
• Fairly complex
• May consume considerable space
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Portable Stretcher
Advantages

• Light weight, compact & easy to store

• Excellent use as an auxiliary stretcher

• Can be used in confined spaces

• Some models utilize folding wheels & posts

• Easily loaded & off loaded

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Portable Stretcher

Disadvantages

• Must be carried

• Metal styles interfere with some x-rays

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