Twenty something years ago, as a new rookie, I was approached by a seasoned old guy—oops, I mean veteran. He posed two very simple questions to me: a young, green 23-year-old. His first question: “Do you drink coffee son?” I replied, “No.” Then he said, “You will.” His second question: “Do you have any back problems, son?” I again replied, “No.” Then he said, “You will.”
I had no idea at the time how prophetic his questions were. I not only carry multiple frequent flyer cards to every coffee shop in a 20-mile radius of where I live, but I have also experienced many different back injuries over the years and even have to sleep with my legs on pillows every night to avoid back spasms. Lifting and moving injuries are a big problem in EMS.
How did that seasoned veteran know I would end up with back problems? To understand the problem we need to look back in time. To correct the problem we need to look to the new products that have made their way into EMS with the sole purpose of making the job of getting a patient from point A (where you find them), to point B (your ambulance) and then to point “C” (delivery to a bed in the receiving facility) safer for the responder, and in many cases safer and more comfortable for your patient.
The emergency runs and the reasons people get sick or injured haven’t changed over the years. People still fall. They still get in car crashes. However, if you’ve been working in EMS for 20+ years, you know that the equipment we used years ago to move people wasn’t designed to promote the safe lifting and moving of patients.
We’ve all used a two-person stretcher. This stretcher and the patient, no matter how heavy they were, had to be lifted, usually by two or four people, and placed in the back of the ambulance. There was often a strange cadence involved in this, like “I’ve got one, I’ve got one, I’ve got two, I’ve got two,” as you removed the stretcher from the ambulance—proper lifting form was nearly impossible.
Then there were the original stair chairs. While a nice concept for moving patients from upper or lower floors, the chairs available still required you to lift and handle a majority of the patient’s body weight.
The backboard was the mainstay. The introduction of the flexible wood or plastic plank stretcher added handles and could then be used to get the supine patient out of tight areas. It also added some sense of security and safety for the patient with a little more comfort.
Looking at past practices, you can start to see why it was just accepted that back problems were a part of the job. And the patient also suffered in this whole process, because not only were they sick or injured—and probably scared—but the products we used to move them further added to their fear and anxiety. In some cases we may have even contributed to further injury.
Technology Meets Patient Moving
When looking at purchasing new equipment for moving and handling patients, you need to consider many things. Some questions you want to ask are:
>> What kind of structures are in your response area?
>> Are there multiple-story buildings with or without elevators?
>> Will your stretcher fit in the elevators?
>> Does your area have outdoor recreation areas with trails or ravines?
>> Are there senior living facilities?
>> Are there bariatric specialty facilities?
>> What is your manpower?
There are many new products out there to help you move patients in a safe manner. There are different variations of each product type depending on the manufacturer. Let’s look at some of the new ways technology has improved our ability to carry out our job and decrease injury.
Many services have already taken advantage of what I think is quite possibly the best invention in patient moving in the last 20 years—stair chairs. Stair chairs have been improved significantly in the past five years. They now feature extendable handles, comfortable seats and seatbelt straps that secure the patient.
But the best new feature these stair chairs now offer are the pullout tracks that span stairs and allow you to simply lower your patient down a flight of stairs without having to lift them. A newer model, offered by Ferno, even allows you to use the tracks to go upstairs via a battery-driven system. These tracks make for a smooth, comfortable ride for your patient and take the patient’s weight out of the equation. The extendable handles give you the ability to use proper lifting technique which will also help to decrease injury.
Vacuum splints are a great way to immobilize an injured extremity. The use of new vacuum mattresses is becoming more in vogue for patient packaging as opposed to the hard backboard. These devices allow you to immobilize a patient in the position found and allow you to safely and easily move patients. They feature multiple handles and are also easy to slide over most surfaces. This tool gives you the ability to immobilize a senior citizen with a curved spine and also eliminates the problem of pressure sores in the elderly from lying too long on a hard backboard.
Another new concept is the lift vest. These vests are easy to apply to a person who cannot get up off the floor, toilet, seat, etc. The vests have multiple handles that allow two or more rescuers to easily assist or lift the patient to a standing position, or from a chair or bed to your stretcher. They will become more popular and beneficial as the morbidly obese population increases.
For outdoor rescues in remote locations, many manufacturers have developed wheel systems that mount to most basket stretchers that roll easily over all types of terrain.
We all know how hard it is to move a very large patient from a bed to your stretcher, and we’ve always known that air can be used effectively to lift and move heavy objects. Products now on the market include sheet/mat formats that can be placed under a patient. Some have a friction-free surface and, in others, there are thousands of tiny holes on the bottom to disperse air and “hover” the patient. A portable electric blower fills the sheet/mat and raises the patient on a thin pillow of air that allows you to simply slide the patient over to your stretcher without any effort.
Moving patients in a safe manner with less risk of injury to rescuers and more comfort to patients is now possible via many products. New products are constantly being developed with this concept in mind. If cost is an issue, many states offer worker’s compensation grants that can help defer the cost of many of these new products. These products and many other like them will help to make the art of moving patients much easier in the future.