Lifting and moving of Patients.

[+medic]

Hello and welcome

I work for the small transfer company we do mostly Dialysis, Nursing home, Hospital Discharges and the occasional emergency. The most difficult part of working in a transfer company I have found is the lifting and moving of patients. Most of our patients are very elderly and frail while others are very large. Some patients are easy to lift while other requires more than just me and my partner.

So I ask you all this question when you have a patient that needs to go up just a few steps, say just a set of five steps into a suburban home would you

A. Use a stair chair

B. Use the Patients own wheel chair and you and your partner bump it up the steps.

C. Bring the whole ambulance stretcher up the steps into the home.

I ask this since where I work I have seen all three done and I’m afraid the B and C options are the most dangerous and could cost me my job if the patient was to fall.

I ask this since I just want to get input from others who have different ranges of experiences.

Cheers and thanks!

[JTpaintball70]

I tended to use our whole cot. With the patient properly secured there shouldn't be any problems getting them up those stairs.

[Richard B the EMT]

I tended to use our whole cot. With the patient properly secured there shouldn't be any problems getting them up those stairs.

I believe the issue here is not the use of the cot, it's moving the cot up and/or down the stairs, and potential damage to the persons moving the cot, should one slip, or lose grip.

[P_Instructor]

Just be happy you have all three options available. Use what is best for the patient and especially your own well being. Make sure you have (or obtain one) an agreement with other public service agencies for lifting assistance. It is common in my area to use the FD for lifting assistance, especially the bariatric patients. It has come to the point that the FD responds to places for 'lift assist' requests only, and if they have more than they bargained for, call us for assistance if we're available. Heck, most of the time they're just sitting around anyhow.

Keep yourself in shape and routinely practice with the cot, stairchair, a wheelchair, or whatever other device you have to become more aware of how to handle the 'strenuous' situations.

[HERBIE1]

Lots of options available these days- such as the stair chairs with tracks or the oversized conveyance devices. When I was working for the privates- 30 years ago- our company frowned on the use of stair chairs(we owed them a cot ride because our service was so expensive, LOL), which meant we used the old 2 man Ferno/Washingtons in nearly every situation. Brutal, and one of the main reasons for my back problems today.

You need to scout out the home and check for obstacles, tight corners, strange furniture configurations, etc, and assess what equipment and routes to take with the patient. I've used kitchen chairs, the patient's own wheel chair, or simply carried the patient via a bucket lift past an especially tight corner. It all depends on the patient, their size, and the configuration of the home. Sometimes a side or basement door- maybe seldom used by the family- is the best choice. Take a few minutes before you move the patient to develop a plan and it can really make a difference. Move any furniture and potential obstacles ahead of time. Brainstorm with your partner, and even ask the family how the patient was transferred on their last trip.

In your example, the 5 steps are not the only issue. How wide are the hallways? Is it a regular sized door? Is the storm door an impediment? Are the interior doors wide enough? How many turns are there? Can you make the turns with the cot? Can the patient be sat up to get around a corner or do they need to lie flat? Can the cot make it all the way through the house and into the desired rooms? Any immovable objects that would impede the stretcher? Does their medical condition or injuries change how they must be handled or transferred?

[medicgirl05]

I usually just use the stretcher for five or so stairs. We have been doing that for about 5 years with no incident. Othertimes we have used a regular sturdy chair we may have found in a patients home. We have stairchairs but they are pretty lame, too low for proper lifting. Most of the time my patients are unable to sit up or we are in a hurry to get them out as I work for a 911 service. I do understand your concerns but you just have to do what is best for your crew and your patient when the time presents.

[HERBIE1]

I usually just use the stretcher for five or so stairs. We have been doing that for about 5 years with no incident. Othertimes we have used a regular sturdy chair we may have found in a patients home. We have stairchairs but they are pretty lame, too low for proper lifting. Most of the time my patients are unable to sit up or we are in a hurry to get them out as I work for a 911 service. I do understand your concerns but you just have to do what is best for your crew and your patient when the time presents.

I recall using those chairs-very low back rests. Horrible on your back and very unsteady for even an average sized patient. As often as possible and practical, I prefer using the full stretcher too- one less lift and patient transfer to worry about. Obviously it also depends on your location- if you have a lot of apartment buildings in your area, stair chairs are the only way to go.

[Richard B the EMT]

Some of my back problems can probably also be related to the Ferno model 30 T-C. It was a good solid multi-level cot, but the problems were, and are, mostly the lifting in and out of the ambulances.

As for borrowing a chair from the household, my suggestion is DO NOT DO IT!!! While I am too lazy to look it up, I do recall reading on this site (I think), of a patient that got injured when a crew, using a kitchen chair to move the patient down a flight of stairs, had the chair come apart on them, dumping the patient down the stairs, and causing bilateral peralysis below the waist to that patient. Home chairs were not designed for the strain of the front legs being pulled one way, while the chair back is being pulled the other, such as would be put on them in this type situation.

[HERBIE1]

Some of my back problems can probably also be related to the Ferno model 30 T-C. It was a good solid multi-level cot, but the problems were, and are, mostly the lifting in and out of the ambulances.

As for borrowing a chair from the household, my suggestion is DO NOT DO IT!!! While I am too lazy to look it up, I do recall reading on this site (I think), of a patient that got injured when a crew, using a kitchen chair to move the patient down a flight of stairs, had the chair come apart on them, dumping the patient down the stairs, and causing bilateral peralysis below the waist to that patient. Home chairs were not designed for the strain of the front legs being pulled one way, while the chair back is being pulled the other, such as would be put on them in this type situation.

You are right about the household chairs, Richard. I've only used them in a pinch a couple times. Cannot recall the specific circumstances- probably just a move from one room to another, but there's also the issue of them simply not ergodynamically designed to be lifted by 2 people while someone is in the chair. Not comfortable to do at all.

[medicgirl05]

Some of my back problems can probably also be related to the Ferno model 30 T-C. It was a good solid multi-level cot, but the problems were, and are, mostly the lifting in and out of the ambulances.

As for borrowing a chair from the household, my suggestion is DO NOT DO IT!!! While I am too lazy to look it up, I do recall reading on this site (I think), of a patient that got injured when a crew, using a kitchen chair to move the patient down a flight of stairs, had the chair come apart on them, dumping the patient down the stairs, and causing bilateral peralysis below the waist to that patient. Home chairs were not designed for the strain of the front legs being pulled one way, while the chair back is being pulled the other, such as would be put on them in this type situation.

Just to clarify, I would never use a houshold chair for an entire flight of stairs. However, there is an occasinal situation where a household chair works well. For intance, they generally slide well along linoleum surfaces to get you around corners with ease. I have used them to get my patient down an occasional step or two(or maybe 5).

Also, you should inspect the chair prior to use. I realize that all issues are not found on a visual inspection, if there is ANY doubt in your mind that a chair will not hold up find an alternative....JMO.

Edited January 21, 2011 by medicgirl05