When using a body drag to pull a patient who is on the ground you should?

Wheeled Stretcher:  Two basic types of stretchers are used: the two-person and the one-person. The two-person requires two EMTs to lift and load in the ambulance, whereas, the one-person stretcher has special loading wheels at the head that allows one EMT to load it into the ambulance. Stretchers are usually adjustable to different heights and different angles. Some can be adjusted to elevate the legs (Trendelenberg position). Additional equipment may be attached to the stretchers including oxygen, IV lines, and cardiac monitors or defibrillators.

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Guidelines for Moving Stretchers

  • Stretchers should be handled by two EMTs with both hands on the stretcher. Other personnel or bystanders may be asked to help carry additional equipment if necessary.
  • Never leave the patient alone on the stretcher.
  • Load the stretcher with the foot end first or going upstairs.
  • Position one EMT at the foot and one EMT at the head of the stretcher when rolling it. The EMT at the foot should pull while the EMT at the head should push.
  • Always maintain a firm grip on the stretcher when rolling to prevent a tipover.
  • Lower the stretcher and carry end to end if the ground is to rough to roll the stretcher safely.
  • Use four EMTs, one at each corner, when moving a stretcher across extremely rough terrain.
  • Turn corners slowly and squarely, avoiding sideways movements that might make the patient dizzy.
  • Lift the stretcher over rugs, grates, door jams, and other such obstacles on the ground or floor.
  • Keep the patient secured with belts at all times while on stretcher even if the stretcher is not being moved.

Loading the Ambulance

  • Place the head end of the two-person stretcher close to the bumper of the ambulance, and make certain it is locked at its lowest level.
  • The EMTs stand on opposite sides of the stretcher, bend at the knees while keeping their backs straight, and grasp the lowest bar of the stretcher.
  • Hands are positioned at each end of the lowest bar with both palms facing up.
  • On signal, both EMTs stand and move toward the rear of the ambulance until the front wheels rest on the floor at the back of the ambulance.
  • Roll the stretcher forward and guide it into the front of the stretcher catch. Then the foot end of the stretcher is locked into place.
  • NOTE: Load hanging and portable stretchers before the wheeled stretcher. Obstetrics patients may be loaded feet first so that it is easier to manage an impending delivery. Make sure that all patients and stretchers are secure before moving the ambulance.

Unloading the Ambulance

  • Unlock the latch at the foot end of the stretcher catch and pull the stretcher until the rear wheels are at the lowest end of the floor.
  • Grasp the lowest bar on each side of the stretcher with palms facing upwards as it is rolled out.
  • Once the head end of the stretcher is clear of the ambulance, keep the stretcher level and lower it to the ground by bending at the knees while keeping the back straight. The stretcher may then be raised by triggering the appropriate release handle.
  • Alternative. Once the head end of the stretcher is level and clear of the ambulance, the driver's side EMT may trigger the handle release and allow the base of the stretcher to slide down the legs of the EMTs. This method avoids the extra lift from the ground but requires the use of the main stretcher bar for lifting and simultaneous release of the handle.
  • Portable stretchers, or "folding stretchers" weigh 8-15 pounds and can carry a patient up to 350 pounds. They are more easy to use when carrying patients down stairs, down hill, or over rough terrain. It can be suspended from the ceiling with special brackets, placed on the floor, or secured to the squad bench.

Stair Chair

These are designed for patients that can sit up while being carried. They are useful for taking patients up or down stairs, or through narrow passageways. The patient must be transferred to the stretcher once back at the ambulance. 

The extremity lift is used to place the patient in the stair chair. All belts and straps must be secured before moving patient. The patients wrists may be loosely tied to prevent grabbing onto fixtures and causing loss of balancewhen moving them. The chair is tilted slightly backwards to allow movement with the wheels on the chair.

Long Backboard

There are several styles of backboards:

  • Ohio is coffin-shaped to fit easily into a basket stretcher or helicopter.
  • Farrington is rectangular with rounded corners.
  • Aluminum are usually foldable but they can be uncomfortable in cold weather and prevent x-rays from being taken.
  • Miller is made of molded plastic and is strong and buoyant.
  • Vacuum molds to the patient once they are positioned in it.

The importance of a backboard is in spinal immobilization and moving the patient, especially during rapid extrication, and providing secondary support when using a short spineboard.

Short Backboard

This is used when a spinal injury is suspected and the patient is in a seated position. They made be made from wood, aluminum, or plastic. A vest type is also used when a patient is found inside a small car or place. It wraps around the patient and has all the straps attached or enclosed.

Scoop (Orthopedic) Stretcher

This is designed to easily lift supine patients. The stretcher is made of a rectangular aluminum tube with V-shaped lifts to "scoop" patients from the floor or ground without changing their position. Its greatest advantage is that it can be used in confined spaces where other stretchers cannot fit.

 The scoop may be used to initially lift the patient with a suspected spine injury. The patient should then be placed immediately on a long backboard for immobilization. If no spine injury is suspected, the scoop can then be placed with patient onto the stretcher for transport.

    The following steps are used with the scoop stretcher:

  • Adjust the length of the scoop stretcher on the ground beside the patient to accommodate the patient.
  • Separate the stretcher halves and place one half on each side of the patient. Do not lift equipment over patient.
  • Slightly lift the clothing on one side of the patient while another EMT slides one half of the scoop under the patient's side. Repeat on the other side. If a spine injury is suspected, another EMT must maintain cervical spine support at all times.
  • Lock the head end of the scoop in place, then bring the foot end together until the assembly is locked. If any resistance is met, have an EMT gently lift one side of the patient. This move prevents the patient's clothing from being caught or their skin from being pinched.
  • Attach the padded head strap. Use at least three straps to secure the patient to the scoop stretcher before lifting.

Flexible Stretcher

Do not use the flexible, or "pole" stretcher if spine injury is suspected. It is designed for the following uses:

  • limited access space
  • on stairs or around cramped corners
  • when other equipment is not available

Patient Positioning

EMTs should consider not only the best equipment to use but the position of the patient. The following general rules apply:

  • Unresponsive patients without suspected spine injury should be placed in the recovery position on their left side.
  • Patients with chest pain or difficulty breathing should NOT be walked to the ambulance.
  • Patients with suspected spine injury should be fully immobilized on a long backboard.
  • Patients with signs and symptoms of shock should have their legs elevated 8-12 inches.
  • Place the pregnant patient with hypotension on her left side.
  • Load the pregnant patient whose delivery is imminent feet first into the ambulance to allow for more room to work.
  • An infant's own car seat should be used if possible. It can be secured to the stretcher with the straps. It can also serve as an immobilization device with padding and taping.
  • Patients with head injury and no suspected spine injury should be transported in a semi-sitting position at about a 45 degree angle. This reduces pressure inside the skull and risk for increased bleeding.
  • Trauma patients with multiple injuries should always be transported on the long backboard to provide full body immobilization.
  • Use discretion when moving and positioning a disabled patient. Increased communication is necessary with visually or hearing impaired patients. Take extra care when securing patients with physical deformities. Use pillows, rolled towels, or other supports and padding to create a more comfortable position.
  • Elderly patients should be placed in a position that will be as comfortable as possible for their condition. Extra time and care with patients with conditions such as arthritis, osteoporosis, or other conditions is important to reduce risk of further injuries.

Wheeled ambulance stretcher (ambulance stretcher, Gurney, or stretcher)

*Most commonly used device to transport and move patients* it's a specially designed structure that can be rolled along the ground and weighs between 40 and 145 pounds (adsbygoogle = window.adsbygoogle || []).push({});

Features and how to work the stretcher

*The stretcher has a specific head end and foot end* has a strong metal frame, and should be pulled pushed and lifted only by the main frame or handles*mattress must be fluid resistant * patients must always be secured with straps on the stretcher

Backboard (Long backboards, spine boards, trauma boards, long boards)

* A long flat board made of rigid, rectangular material* used to carry patients and to immobilize supine patients with suspected hip, pelvic, spinal, and lower extremity injuries or other multiple trauma in accordance with local protocols*6 to 7 feet long, commonly used for patients who are found lying down

After delivering the patient to the ED (emergency department) you and your team must begin preparation for your next call, what does this process of evaluation include?

* procedures that need more practice* equipment that needs to be cleaned* skills that you need to review or acquire

The relationship between the bodies anatomical structures in the physical force is associated with lifting, moving and carrying(The ways in which the body moves to achieve a specific action)

What is a good use of body mechanics?

Maintaining proper posture and body movement during daily activitiesUsing good body mechanics while lifting and moving patients reduces your risk of injury

What is the correct way to lift something?

Always keep your back in a straight up right position, and lift without twistingFace the patient and keep your feet pointed in the same directionIf you need to turn with a patient, change the direction of your feet instead of twistingBend down with your legs, and then extend your legs to lift back up

Lifting by extending the properly placed flexed legs

Whenever you grasp a stretcher or backward, your hand should be at least 10 inches apart with your palms facing up. Then move your hands forwards until your thumb is tightly pressed against the object, and then curl your fingers and thumb tightly over the handle

What do you do when performing a body drag?

Your back should always be locked in a slight curve and you should be flexing your abs, keep your back in its normal upright position and avoid any twisting.

What can you do to minimize distance you have to lean over when pulling a patient?

How far do you extend your arms when pulling?

No more than 15 to 20 inches in front of your torso

How do you pull the patient in when you are in the correct position

You slowly flex your arms, once you have no room left you move back another 15 to 20 inches

When normally pulling a patient, is it OK to pull the patient as you move at the same time?

No, because it will prevent undesirable jostling of the patient and can protect a sudden force that will occur across your spine

How to reach and Pull a patient safely

A. Kneel to pull a patient who is on the groundB. When pulling, your elbow should only extend just beyond anterior torsoC. Bend your knees to pull a patient who is a different-you are. Position your feet or knees to balance the force

How to perform A body drag with an EMT on each side of the patient

1. Kneel just beyond the patients shoulder facing his or her groin, extend one arm across the front of your chest and grasp the armpit, and extend across your chest and grab the patients belt with the other arm2. Raise your elbows and flex your arms to pull the patient

How to log roll a patient

You will initially have to reach farther than 18 inches, to minimize the reach distance, Kneel as close to the patients side leaving only enough room so that your knees will not prevent the patient from being rolled. To minimize the amount of time you are extended, rolled a patient without stopping until the patient is resting on his or her side and braced against your thighs

What is the common adult patient weight?

Between 120 and 220 pounds

What weight should you not attempt to lift a person without four providers or more?

A diamond Carry is when a patient on a backboard or structure is lifted by four providers with one at the head, one at the feet, and one on each side

Where should the stronger provider be positioned with a backboard?

Definition of emergency move

When there is the potential of danger around, use an emergency move to drag or pull a patient to a safe place before assessment and care

rapid extrication technique

The rapid extrication technique makes it so that the patient can be moved from sitting in the vehicle to supine, and on a backboard if needed in one minute or less. This increase injury risk if there's a spinal problem however.

Used for patients with no suspected spinal injury who are found lying supine on the ground. Ideally three providers should be there, but two works too

Can be used for patients with no suspected extremity or spinal injuries who are lying supine or sitting

What's a transfer move and give an example

A transfer move is a way to transfer the patient from a bed onto the stretcherFor example... the direct Carry

What are two physiological changes in older people that you need to pay special attention to as an EMT?

1. Skeletal changes2. Fear

Kind of like a wheeled stretcher (modified for obese people) however it has a widened patient surface area for increased comfort, as well as a wide wheel base so that it doesn't feel as a rough off terrain. It can go up to 850 or 900 pounds as well

Portable/folding stretchers

Portable stretcher is a stretcher with a strong, rectangular, tubular metal frame and a rigid fabric stretched across it. Any ambulances carry one to use if a patient is in a difficult area to reach with a wheeled ambulance stretcher or if there's a second patient

A flexible stretcher forms a rigid stretcher that forms around the patients sides and does not extend beyond them. They are useful when you must remove a patient from a confined space, or if a patient must be belayed or repelled by ropes

Used to immobilize the torso, head, and neck of a seated patient with a suspected spinal injury until you can immobilize the patient onto a backboard

A patient is placed on the mattress and air is removed around the device, allowing it to mold around the patient. This can be useful for limiting pressure point tenderness, and high immobilization and comfort and insulation

Basket stretcher (stokes litter)

Use a basket stretcher to carry a patient across uneven terrain from a remote location that is inaccessible by an ambulance or other vehicle. If you suspect a spinal injury, secures the person on a backboard and then placed a backboard into the basket stretcher

Designed to be split into two or four pieces. The sections are fitted around the patient was lying on the ground. Then you reconnect it and lift a person on to a backboard or stretcher

Safely transport a neonatal patient, they must be placed inside of an Isolette, sometimes referred to as an incubator. This keeps them warm with moistened air in a clean environment and helps protect the infant. The Isolette is either placed directly on top of the wheeled stretcher and secured with seatbelts, or a freestanding Isolette is secured in the back of an ambulance

Always decontaminate your equipment after using it every call, to prevent the spread of disease and to protect you, your partners, and whoever uses it after you