Effective: 09-24-21
Supersedes: 06-22-20
Purpose: EMS personnel frequently sustain disabling injuries when lifting and moving patients. Most of these injuries can be prevented by using proper lifting and moving techniques when using a stretcher or stair chair.
Policy: Team members should use the ambulance stretcher and all patient carrying devices in accordance with the manufacturer’s recommendations, and with good technique to prevent injury.
Body Mechanics and Lifting
Use of proper body mechanics is essential in performing EMS duties and greatly reduces crew’s chances of being injured when lifting and loading patients. All Brewster Ambulance EMTs, Paramedics and Chair Car Drivers must take safety precautions when lifting and moving patients. Keep your back straight & use your legs, not your back, to lift the patient. The closer you hold the patient’s weight to your body; the less strain is placed on you.
When preparing to lift the patient, consider the patient’s weight & if your crew requires additional help to safely lift the patient. It is your responsibility not to surpass your own limit.
When lifting, do not twist your torso. Position your feet about shoulder-width apart, making sure you have good traction under your feet.
At minimum, two people are required for a successful lift. Call for more help if necessary. The crew must also know the weight limitations of any equipment being used. Most lifting equipment at Brewster Ambulance Service has warning labels. Be familiar with manufacturer’s guidelines for equipment limits.
Stretchers
When using a stretcher for Brewster Ambulance Service, use the available straps to secure the patient to the device. If a stretcher is missing legs/waist/torso strap, or if straps are damaged, do not use the stretcher & immediately report the issue to the shift supervisor.
When inside the vehicle, stretchers must be secured to the commercial device/track supplied with the vehicle. If stretcher mount is defective/inoperable, the vehicle should be rendered out-of-service and shift supervisor must be notified.
Once the patient is safely secured to the stretcher, the stretcher should be moved with minimum of two crew members present and in control of the stretcher. If one of the crew members must perform other functions (open the ambulance doors, etc.), the stretcher has to stop and be stationary until the crew member returns to the stretcher. The second crew member will relocate to the side of the stretcher, “ground” the stretcher with his/her foot and hold the stretcher with both hands until his/her partner is ready to assist with the stretcher operations.
When walking forward, the crew member in the front of the stretcher must firmly hold the stretcher with one hand. The crew member in the back of the stretcher must have both hands on the stretcher. It is recommended that the crew member positions his/her hands in the same location that is used for lifting.
When negotiating turns, crew must bring the stretcher to the full stop, face each other, hold the stretcher with both hands, make the turn, and only then continue walking forward. Ideally, stretchers should not be moved sideways. When the situation requires the stretcher to be moved sideways, crew members will assume positions on each side of the stretcher while holding stretcher with both hands. Whenever possible, the crew member pushing the stretcher will “ground” the stretcher with his/her foot to prevent from tipping over.
Stretcher Safety Tips
Prior to moving a patient, personnel should assess the scene for hazards that may inhibit moving the patient safely (plush carpet; soft ground; inclined surfaces; narrow hallways etc.)
Select and utilize the proper lifting device
Know your physical abilities and limitations and also those of your partner
Use proper lifting techniques and keep the weight you are lifting close to your body
Communicate clearly and frequently with your partner(s). Verbalize all commands and emphasize eye contact
Don’t hesitate to request assistance with the lift or movement of the patient
Once on a wheeled-cot, a patient should never be left unattended.
Whenever moving a raised stretcher, especially on an incline or uneven surface, use a minimum of two operators to manipulate the cot.
Use a level position (rolling / transfer height) to roll the cot and for transferring the patient to or from the cot and an adjacent surface.
When the stretcher is stationary on a flat surface, such as at a hospital triage area, at least one member should remain with the patient to control the stretcher and prevent it from moving or tipping over. In such cases, whenever possible, the stretcher should be buttressed against a wall for additional support.
Power Stretcher: Unloading
The manufacturer’s Operation Guide lists two acceptable methods to lower the undercarriage assembly when removing a patient-loaded power stretcher from the ambulance: the Powered Method, or Manual Override.
To eliminate the chance of the wheel assembly catching on the bumper or other obstruction and inadvertently raising the stretcher, it is the policy of Brewster Ambulance to utilize the manual override technique to lower the undercarriage assembly when removing a patient-loaded stretcher from the rear of the ambulance. Once out of the ambulance and on level ground, the powered method may be used to adjust the height of the stretcher as needed.
Stretcher or Stair Chair Tip or Drop
In the event a patient loaded stretcher or stair chair tips over and strikes the ground, or a loaded stretcher is dropped when removing it from the ambulance, the crew shall ensure that they conduct a proper assessment of the patient and treat for any injuries. Such assessment and any treatment shall be documented on the patient care report. Whether there are any reported injuries or not, the involved Brewster Ambulance Service EMTs or Paramedics must immediately notify the Communication Center who in turn will notify the closest Field Supervisor. Whenever possible, the Field Supervisor should report to the scene or meet the crew at their destination.
The crew must fill out an online incident report detailing the incident. If a Brewster Ambulance Service EMT or Paramedic is injured as a result of a stretcher tip, follow the procedure in “Workplace Injury.” The Education Department will also be notified and will conduct remedial training as appropriate. Documentation of this training shall be placed in the employee’s file.
Stretcher or Stair Chair Evaluation
Whenever a stretcher is dropped from a height or flips over and sustains significant impact not expected during normal use, or a stair chair appears to have sustained damage, it must be evaluated by the Fleet Maintenance department prior to being placed back in service. This applies whether or not the device was patient loaded at the time.