Lesson 5

 Moving injured victim likely to cause further

injury
 In most cases wait for professional help
 May have to move victim to protect from
danger at scene
 May have to move victim to flat surface to
provide CPR
Back injury is hazard
for First Responders
To minimize risks,
use good body
mechanics
Body mechanics are
principles of using
your body safely
 Know your physical ability and limitations
 Plan the lift
 Ensure you have a good grip
 Test the load
 Position your feet properly before starting lift
 Lift with your legs, not with your back
 Keep patient’s weight close to your body
 Avoid twisting your back during the lift
 Communicate clearly with your partner and
other EMS providers
 Reposition a patient only when necessary
 Reposition a breathing, unresponsive, non-
trauma patient in the recovery position
 Don’t move or reposition a trauma patient
unless necessary to treat life-threatening
condition
 Allow responsive patient to assume
comfortable position
Helps keep airway open
Allows fluid to drain from mouth
Prevents aspiration
If possible, put victim onto left
side
Continue to monitor breathing
Hold infant facedown
over your arm with
head slightly lower
than body
Support the head
and neck with your
hand, and keep nose
and mouth clear
Extend victim’s arm farther
from you above victim’s
head
Position victim’s other
arm across chest
Bend victim’s nearer
leg at knee
 Put forearm nearer
victim’s head under
victim’s nearer
shoulder with hand
under hollow of neck
Roll victim away from
you by pushing on
victim’s flexed knee
and lifting with
forearm while hand
stabilizes head and
neck
 Continue to support
head and neck.
Position victim’s hand
palm down.
Check airway and open mouth to
allow drainage.
 Use log roll to move patient from prone to
supine
 Three to five rescuers are needed to safely
roll patient
 For trauma patient with spinal injury,
stabilize head in line with body
1. The rescuer at the patient’s head holds
the head in line with the body as two or three
additional rescuers take position with hands
at the patient’s lower and upper leg, hip and
torso, and shoulder
2. At the direction of the responder at the
head, the rescuers in unison roll the patient
toward them, with the head held in line and
the spine straight
3. The rescuers complete the log roll,
positioning the patient on the back with head
and neck still in line with the body
Use only if:
◦ Patient faces an
immediate danger
◦ You cannot give
lifesaving care
because of
location or
position
 Moving patient quickly risks aggravating a
spinal injury
 Keep head and neck in line with spine
 It is impossible to protect spine while
removing patient from a vehicle quickly
 First Responders may be trained in
rapid extrication using cervical collar
and inline stabilization of head/neck
 Follow local protocol
 Wait for EMTs trained in special
extrication techniques
 Pull/drag patient in direction of long axis of
body
 Don’t drag patient sideways, and avoid
twisting neck/trunk
 Never pull head away from neck/shoulders
 Risk of spinal injury can be minimized by
using a blanket, rug, board, etc
 Choice of move depends on materials at
hand, patient’s condition, and situation
 Clothing Drag
 Blanket Drag
 Shoulder Drag
 Firefighter’s Drag
 Upper Extremity Drag
 Upper Extremity Drag for Rapid Extrication
 Used when patient must be moved
immediately
 One or more rescuers may carry patient
 Method used depends on patient’s size,
condition and situation:
◦ Walking assist
◦ Cradle carry
◦ Multiple-rescuer techniques are safer/less
stressful
Use good body
mechanics/lifting
techniques
Don’t try to
lift/carry person
before checking for
injuries
 Unresponsive victim
who cannot safely
be dragged
◦ Pack-strap carry
 Lighter victim or child
◦ Cradle carry (responsive
or unresponsive victims)
◦ Piggyback carry
(responsive victim)
 Support the patient’s weight with your arms
under the patient’s thighs
 If able, have the patient clasp hands and
lean forward; if not able, grasp the patient’s
hands with yours to keep patient from
falling back
Supportthe patient’s weight on your
shoulders while holding the patient’s thigh
and arm
 Responsive victim
who can walk with
help
◦ One-person
walking assist
 Responsive victim:
◦ Two-person walking assist
◦ Two-handed seat carry
To carry a patient
down steps, the
forward rescuer
grasps patient’s legs
under the knees while
the rear rescuer
reaches under
patient’s armpits
from behind to grasp
the patient’s forearms
Both rescuers
position the patient’s
arms over their
shoulders
Each rescuer grasps
the patient’s wrist,
with the other arm
around the patient’s
waist
 Used to move patient when no threat to life
 Performed by multiple rescuers
 Not used if patient has suspected spinal
injury, internal bleeding, or uncontrolled
external bleeding
 Stabilize patients before moving them
 Minimize any chance of aggravating illness
or injury
 These moves are usually performed by
responding EMS personnel
Complete
primary/secondary
assessment
Correct any life-
threatening problems
Immobilize all
suspected
fractures/dislocations
Ensure there are no
signs/symptoms of
neck/spinal injury
 Non-emergency move for patients
without suspected neck or spinal
injuries
 Used to lift/carry supine patient from
ground to stretcher
 Rescuers kneel on one side of the
patient
 Rescuer at head places one arm under
the patient's neck and shoulder and
cradles the patient's head
 Rescuers lift patient to their knees and
roll the patient in toward their chests
 Rescuers stand and move patient to
stretcher
 Two-rescuer technique used for patients
without suspected injury to neck, spine, or
extremities
 May be used with responsive/unresponsive
patient
 May be used to carry patient a short
distance or move patient from chair to
stretcher
 May be used to carry a patient through a
tight space
 1. The first rescuer kneels at the patient's
head and the second rescuer kneels by the
patient's feet. The rescuer at the head
places one arm under each of the patient's
shoulders while the rescuer at the feet
positions the patient's arms.
2. The rescuer at the head then slips his or
her hands under the patient's armpits and
grasps the patient's wrists and crosses
them on the patient’s chest. The rescuer at
the feet turns around and reaches his or her
hands back and under the patient's knees.
3. Both rescuers move to a crouching position
and assess their grip on the patient
4. On a signal from the rescuer at the head,
the rescuers stand up simultaneously and
move forward with the patient
 Preferred if rescuers must move some
distance or over inclined surface
 Rescuer at patient’s feet may face patient and
other rescuer
 Can be used to move patient to side or short
distance
Transfer from Bed to Stretcher
 Assist EMS personnel transferring patient
from bed to stretcher
 Use either direct carry or draw sheet
technique
 Not used with patient with suspected spinal
injury
1. Position the stretcher at a right angle to
the bed, ideally, with the head end of the
stretcher at the foot of the bed. The stretcher
should be at the same height as the bed.
Unbuckle the straps and remove other items
from the stretcher. Both rescuers stand
between the bed and the stretcher, facing the
patient.
2. The rescuer at the head slides one arm
under the patient's neck and cups the
patient's farther shoulder. The second rescuer
slides one arm under the patient’s hips and
lifts slightly. The rescuer at the head slides
his or her other arm under the patient's back,
and the second rescuer places his or her
other arm underneath the patient’s thighs
near the knees. Together, both rescuers slide
the patient to the edge of the bed.
3. On a signal of the rescuer at the head, the
rescuers lift and curl the patient toward their
chests
4. The rescuers step back, rotate toward the
stretcher, and place the patient gently on the
stretcher
1.Loosen bottom bed sheet and roll its edge
on the side where you will place stretcher
2. Position stretcher alongside bed.
Prepare stretcher:
◦ Adjust height, lower rails, and unbuckle straps
◦ Both responders reach across stretcher and
grasp rolled sheet edge firmly at level of
patient's head, chest, hips, and knees
3. Slide patient gently onto stretcher
Rescuers first roll patient onto one side, and
one rescuer holds the patient in that position.
Second rescuer positions a sheet with rolled
edge beneath patient
The patient is rolled back into original
position, now on the sheet
The rescuers together pull on sheet to slide
patient onto stretcher
First Responders
often assist EMTs with
packaging and
moving patients
A wide range of
commercial devices
are used
Learn devices you
are likely to
encounter in your
area
Long Backboard
Short Backboard
Vest Extrication
Device
Standard Stretcher
Portable Stretcher
Orthopedic Stretcher
Basket Stretcher
Stair Chair