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Kyphosis Spondylosis
Bariatrics (1 of 2)
Refers to management of obese people
100 million adults in the US are overweight
or obese.
Approximately 20% to 25% of children are
overweight or obese.
Back injuries account for the largest number
of missed days of work.
Bariatrics (2 of 2)
Stretchers and equipment are being
produced with higher capacities.
Does not address danger to EMTs of carrying
ever-heavier weights
Mechanical ambulance lifts are uncommon in
United States.
Patient-Moving Equipment
(1 of 3)
Stretcher is available in many models with
various features.
General features
Head and foot end
Strong metal frame (to push, pull, lift)
Hinges at center allow for elevation of
head/back.
Guardrail prevents patient from rolling out.
Patient-Moving Equipment
(2 of 3)
General features (contd)
Undercarriage frame allows adjustment to any
height.
Stretcher has locking mechanism when controls
are not activated.
Controls are located at the foot end and at one
or both sides of most stretchers.
Patient-Moving Equipment
(3 of 3)
Types of Stretchers (1 of 19)
Wheeled
ambulance
stretcher
Also called
a stretcher
or gurney
Most
commonly
used
device
Types of Stretchers (2 of 19)
Wheeled ambulance stretcher (contd)
Patient may be secured directly to stretcher
Or, patient may be secured to backboard first if:
Suspected spinal injury or multisystem
trauma
Patient is in need of CPR
Types of Stretchers (3 of 19)
Bariatric stretcher
Specialized for overweight or obese patients
Wider wheel base for increased stability
Source: Courtesy of Stryker Medical
Types of Stretchers (4 of 19)
Bariatric stretcher (contd)
Some have tow package with winch.
Rated to hold 850900 lb
Regular stretcher rated for 650 lb max.
Types of Stretchers (5 of 19)
Pneumatic and
electronic-powered
wheeled stretcher
Battery operated
electronic controls to
raise/lower
undercarriage
This increases the
weight of stretcher.
Hazardous for
uneven terrain or
stairs
Source: Courtesy of Stryker Medical
Types of Stretchers (6 of 19)
Loading a
wheeled
stretcher into
an ambulance
Ensure the
frame is held
firmly
between two
hands so it
does not tip.
Types of Stretchers (7 of 19)
Loading a wheeled stretcher into an
ambulance (contd)
Newer models are self-loading, allowing you to
push the stretcher into ambulance.
Other models need to be lowered and lifted to
the height of the floor of ambulance.
Clamps in ambulance hold stretcher in place.
See Skill Drill 35-11.
Types of Stretchers (8 of 19)
Portable/folding
stretcher
Strong, rectangular
tubular metal frame
with fabric
stretched across it
Types of Stretchers (9 of 19)
Portable/folding stretcher (contd)
Some models have two wheels.
Some can be folded in half.
Used in areas difficult to reach
Weigh less then wheeled stretchers
Types of Stretchers (10 of 19)
Flexible stretcher
Can be rolled into a
tubular package
Excellent for storage and
carrying
Conform around a
patients sides
Useful for confined
spaces
Uncomfortable, but
provides support and
immobilization
Types of Stretchers (11 of 19)
Backboard
Long, flat, and made of rigid rectangular
material (mostly plastic)
Used to carry and immobilize patients with
suspected spinal injury or other trauma
Types of Stretchers (12 of 19)
Backboard (contd)
Commonly used for patients found lying down
6 to 7 long
Holes serve as handles and a place to secure
straps.
Types of Stretchers (13 of 19)
Backboard (contd)
Short backboards
or half-boards are
used to immobilize
seated patients
Example: the
KED vest-type
device
Types of Stretchers (14 of 19)
Basket stretcher
Rigid stretcher also
called a Stokes
litter
Used for remote
locations
inaccessible by a
vehicle, including
water rescues and
technical rope
rescues
Types of Stretchers (15 of 19)
Basket stretcher (contd)
If spinal injury, secure patient to backboard and
place inside basket stretcher to carry patient out
of location.
When you return to ambulance, lift the
backboard out of basket stretcher and place on
wheeled stretcher.
Types of Stretchers (16 of 19)
Scoop stretcher
Also called orthopaedic stretcher
Types of Stretchers (17 of 19)
Scoop stretcher (contd)
Splits into two or four pieces
Pieces fit around patient who is lying on flat
surface and reconnect
Both sides of patient must be accessible.
Patient must be stabilized and secured on
scoop stretcher.
Types of Stretchers (18 of 19)
Stair chair
Folding aluminum
frame chairs with
fabric stretched
across to form a
seat and back
Most have rubber
wheels in the back
Types of Stretchers (19 of 19)
Neonatal isolette
Also called an incubator
Neonates cannot be transported on a wheeled
stretcher.
Isolette keeps neonate warm, protects from
noise, draft, infection, excess handling.
Isolette may be secured to wheeled ambulance
stretcher or freestanding.
Decontamination
Decontaminate equipment after use.
For your safety
For the safety of the crew
For the safety of the patient
To prevent the spread of disease
Medical Restraints (1 of 2)
Evaluate for correctible causes of
combativeness.
Head injury, hypoxia, hypoglycemia
Follow local protocols.
Restraint requires five personnel.
Restrain patient supine.
Positional asphyxia may develop in prone
position.
Medical Restraints (2 of 2)
Apply restraint
to each
extremity.
Assess
circulation
after restraints
are applied.
Document all
information.
Personnel Considerations (1 of 2)
Questions to ask before moving patient:
Am I physically strong enough to lift/move this
patient?
Is there adequate room to get the proper stance
to lift the patient?
Do I need additional personnel for lifting
assistance?
Personnel Considerations (2 of 2)
Remember, an injured rescuer cannot help
anyone.
Summary (1 of 13)
The first key rule of lifting is to always keep
your back in an upright position and lift
without twisting.
The power lift is the safest and most
powerful way to lift.
Summary (2 of 13)
Pushing is better than pulling.
If you do not have a proper hold, you will
not be able to bear your share of the weight,
or you may lose your grasp and possibly
cause a lower back injury to one or more
EMTs.
Summary (3 of 13)
It is always best to move a patient on a
device that can be rolled.
You must constantly coordinate your
movements with those of the other team
members and make sure that you
communicate with them.
Summary (4 of 13)
Ideally, members of the lifting team should
also be of similar height and strength.
If you must carry a loaded backboard or
stretcher up or down stairs or other inclines,
be sure that the patient is tightly secured to
the device to prevent sliding.
Summary (5 of 13)
Carry the backboard or stretcher foot end
first, so that the patients head is elevated
higher than the feet.
Directions and commands are an important
part of safe lifting and carrying.
Summary (6 of 13)
You and your team must anticipate and
understand every move and execute it in a
coordinated manner.
The team leader is responsible for
coordinating the moves.
You should try to use four rescuers
whenever resources allow.
Summary (7 of 13)
You should know how much you can
comfortably and safely lift and not attempt
to lift more than this amount.
Rapidly summon additional help to lift and
carry a weight that is greater than you are
able to lift.
Summary (8 of 13)
The same basic body mechanics apply for
safe reaching and pulling as for lifting and
carrying.
Keep you back locked and straight, and
avoid twisting.
Do not hyperextend your back when
reaching overhead.
Summary (9 of 13)
For a nonurgent move, move the patient in
an orderly, planned, and unhurried manner,
selecting methods that involve the least
amount of lifting and carrying.
At times, you may have to use an
emergency move to maneuver a patient
before providing assessment and care.
Summary (10 of 13)
You should perform an urgent move if a
patient has an altered level of
consciousness, inadequate ventilation, or
shock, or in extreme weather conditions.
Summary (11 of 13)
The wheeled ambulance stretcher is the
most commonly used device to move and
transport patients.
Other devices include portable stretchers,
flexible stretchers, backboards, basket
stretchers, scoop stretchers, and stair
chairs.
Summary (12 of 13)
Whenever you are moving a patient, you
must take special care so that neither you,
your team, nor the patient is injured.
Summary (13 of 13)
You will learn the technical skills of patient
packaging and handling through practice
and training.
Training and practice are required to use all
the equipment that is available to you.