Operations, Patient Care

Girth Hitch: A Little Horse Sense For Ya

Issue 10 and Volume 34.

Any school kid with a few horseback-riding lessons can tell you, some horses are real smart. As Bugs Bunny_s pal Elmer Fudd used to say, they_re “twickstas.” If a horse doesn_t feel like totin_ you all over the countryside, one of his twicks is to fill his lungs as he_s being saddled. Watch out especially on hot days or when it_s about hay time. (You have legs. You can walk.)„

That can fool an inexperienced rider into believing the saddle is on snug when it_s really not. Try to mount that nag, and the saddle just sort of slides off sidewaysƒrider and all. Who knows, maybe you_ll break your neck and forget the whole thing. You know that nickering sound horses make sometimes? I think that_s them laughing as they look down their long noses at us and think how goofy we are.

Well, a seasoned handler can outsmart a horse. Smacking the horse in the gut a couple of times prompts the horse to exhale. Meanwhile, the handler uses a simple hitch called a girth hitch to cinch up the saddle strap (called a girth strap). The girth hitch (also called a lark_s foot, lark_s head, cow_s hitch or lanyard hitch) runs through a metal brass ring in one end of the strap, and that_s what makes it easy to tighten. Before the horse can say, “Dang me, I_m goin_ for a walk,” the saddle_s on.

Turns out, Life-Saver, the girth hitch is also a handy EMS tool. Need to pull somebody out of a car feet-first onto a backboard and don_t have a lot of room to work? You can fashion a girth hitch out of a standard sheet laid under both ankles with the tails pulled up and over the center of the ankles. It only takes about two seconds. That gets the EMT who_s doing the pulling out of the wayƒbehind the backboard handlersƒand enables him to exert a smooth, steady pull with good traction instead of all those back-breaking, herky-jerky movements. Smooth beats jerky every time.

Long ago, when ambulance cots had footpads with handholds in them, we used a sheet fastened to the ankles this way as a primary restraint device for the ankles. You applied the hitch, ran the tails of the sheet through the handhold, and tied the tails to the top frame of the cot. Combine that with a buckle strap across the thighs, just above the knees, and you didn_t worry about the strongest patient kicking their way free. I haven_t had any experience with the newest cots, but they look like they will still accommodate the use of that technique.„

Need to restrain a patient to a backboard? The girth hitch is also an option when you can_t get an unruly patient to your cot, and the cot won_t go where the patient is. You can use it on any backboard that has a handhold at its foot end. In that case, run the tails through the foot-end handhold, then back through the last handhold on each side, and tie them across the front of the shins. You can use several layers of 2” cloth tape to restrain the knees.

Ever had to pull a stretcher up an incline? If so, then you know how hard it is for a bunch of people to stay off of each other_s feet. Turns out, if you attach a girth hitch to the uphill end, you can split the tails, which will then accommodate as many as four “pullers.” Or, you can tie the tails together and use a winch to do the pulling while you support the weight.„

Need to move a patient from a little room into a big room? Roll him onto the head end of a sheet, leaving extra sheet length at the foot end. Tie a small overhand knot in the free end of that sheet, and twist all the slack into the tails of a girth hitch attached to the patient_s ankles. The knot keeps the end of the bottom sheet stuck between those tails. The bottom sheet eliminates the friction between the patient_s skin and the floor and makes it easy to slide him across just about any residential surface. The two sheets, twisted into the same handle, will give you and your crew a non-slip, dignified grip on the patient.

Elmer would be so impwessed.JEMS

Thom Dickhas been involved in EMS for 39 years, 23 of them as a full-time EMT and paramedic in San Diego County. He_s currently the quality care coordinator for Platte Valley Ambulance, a hospital-based 9-1-1 system in Brighton, Colo. Contact him at[email protected]

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