Lifting & 

Moving Patients

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   Thousands of patients are lifted and moved by EMTs and many EMTs are injured because they attempt to lift or move a patient improperly. A wide variety of patient conditions as well as circumstances affect how the patient is "packaged" for transport.

   The expression "Lift with your legs and not your back." is a very important part of proper body mechanics. Always get as close to the patient as you can when lifting. Keep your arms and patient as close to your body as you can to help create leverage and maintain balance. Bend at the knees while keeping your back as straight as possible. Recognize your limitations and call for back-up when needed to lift patient.

Guidelines for Safe Lifting

1. Consider the weight of the patient together with the weight of the stretcher or other equipment being carried and determine if additional help is needed.

2. Know your physical ability and limitations. Know your combined ability with your partner. If absolutely necessary, you can ask bystanders to help. You or your partner must be in charge and give the orders, not the bystander.

3. Lift without twisting. Avoid any kind of swinging motion when lifting as well.

4. Position your feet shoulder width apart with one foot slightly in front of the other. Wear proper boots that go above the ankle to protect your feet and help keep a firm footing. Boots should have nonskid soles.

5. Communicate clearly and frequently with your partner. Decide ahead of time how you will move the patient and what verbal commands will be used. Also, tell the patient what you will be doing ahead of time. A startled patient may reach out or grab something and cause a loss of balance.

Guidelines for Lifting Cots and Stretchers

Most back injuries to EMTs can be avoided by following the following guidelines:

Guidelines for Carrying Patients and Equipment

Guidelines for Safe Carrying on Stairs

    One of the most difficult carries an EMT must do is carry a patient backwards up a stairway. Try to carry heavy patients up a stairway with two people at the top, shoulder to shoulder, and two at the bottom of the stretcher.

Guidelines for Reaching

Guidelines for Pushing and Pulling

Principles for Moving Patients

Emergency Moves

    A patient should be moved immediately by an emergency move only when there is an immediate danger to the paitnet or the EMTs including:

Clothing Drag

1. Tie the patient's wrists together if you have something quickly available. If nothing is available, tuck the hands into the waist band to prevent them from being pulled upwards.

2. Clutch the patient's clothing on both sides of the neck to provide a support for the head.

3. Pull the patient towards you as you back up, watching the patient at all times. The pulling force should be concentrated under the armpits and NOT the neck.

Sheet Drag

1. Fold or twist a sheet or large towel lengthwise.

2. Place the narrowed sheet across the chest at the level of the armpits.

3. Tuck the sheet ends under the armpits and behind the patient's head.

4. Grasp the two ends behind the head to form a support and a means for pulling.

5. Pull the patient toward you while observing the patient at all times.

Blanket Drag

1. Lay a blanket lengthwise beside the patient.

2. Kneel on the opposite side of the patient and roll the patient toward you.

3. As the patient lies on their side while resting against you, reach across and grab the blanket.

4. Tightly tuck half of the blanket lengthwise under the patient and leave the other half lying flat.

5. Gently roll the patient onto their back.

6. Pull the tucked portion of the blanket out from under the patient and wrap it around the body.

7. Grasp the blanket under the patient's head to form a support and means for pulling.

8. Pull while backing up and while observing the patient at all times.

Bent Arm Drag

1. Reach under the patient's armpits from behind and grasp the forearms or wrists.

2. Use your arms as a cradle for the patient's head and keep the arms locked in a bent position by your grasp.

3. Drag the patient towards you as you walk backwards, observing the patient at all times.

Urgent Moves

    Sometimes a patient must be moved more quickly than usual due to reasons of an urgent nature. Weather conditions, hostile bystanders, uncontrolled traffic, and rapidly rising flood waters are some examples of situations requiring an urgent move.

Procedure for Rapid Extrication

Nonurgent Moves

    This is the most frequent type of move and the best way to make the move depends on the illness or injury, factors at the scene, and equipment and personnel resources available.

Direct Ground Lift

Extremity Lift

    This is only used when a spinal injury is not suspected. It is best used for short distances.

Transfer of Supine Patient from Bed to Stretcher

Direct Carry

Draw Sheet Method

Equipment for Moving Patients

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.

Guidelines for Moving Stretchers

Loading the Ambulance

Unloading the Ambulance

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 balance  when 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:

    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:

Flexible Stretcher

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

Patient Positioning

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

Review Questions:

1. What part of the body has the most powerful muscles for lifting?

2. List the seven guidelines for carrying patients and equipment.

3. A situation that presents an immediate and urgent threat to the patient or rescuers calls for which kind of move?

4. Which piece of equipment would be used to lift and transport a multiple trauma patient and why?

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