Lisbon Fire Department Standard Operating Guidelines and Policies

– LIFTING AND MOVING PATIENTS

2. To provide mechanisms of patient movement and transport, which provide the greatest degree of patient and rescuer safety

2. Always pull in the direction of the long axis of the patient’s body

3. Do not pull a patient sideways; avoid bending or twisting the patient’s torso

4. The patient should be supine whenever possible

1. 
   BLANKET DRAG
   
   1. 
      Place patient on blanket
      
   2. 
      Drag blanket in direction of long axis of patient’s body
      
      1. 
         Keep head as close to floor as possible
         
      2. 
         Move patient head first whenever possible
         

2. 
   CLOTHES DRAG
   
   1. 
      Grasp patient’s clothing pulling from the neck or shoulder area
      
   2. 
      Drag in direction of the long axis of the patient’s body
      
      1. 
         Keep patient’s head as close to the floor as possible
         
      2. 
         Drag in direction of the long axis of the body
         

3. 
   ONE-RESCUER DRAG
   
   1. 
      Place hands under the patient’s armpits from the back
      
   2. 
      Grasp the patient’s forearms and drag in the direction of the long axis of the body
      

2. Always pull in the direction of the long axis of the patient’s body

3. Do not pull a patient sideways; avoid bending or twisting the patient’s torso

4. The patient should be supine whenever possible

4. 
   RAPID EXTRICATION (Patient sitting in vehicle)
   
   1. 
      First rescuer brings cervical spine into neutral, in-line position and provides manual stabilization
      
   2. 
      Second rescuer applies cervical immobilization device (rigid cervical collar)
      
   3. 
      Third rescuer positions the foot-end of a long spineboard at the door opening, then moves to opposite side of patient
      
   4. 
      Second rescuer supports and stabilizes the patient’s torso as the third rescuer frees the patient’s legs
      
   5. 
      At the direction of the rescuer holding manual C-spine stabilization, the patient is rotated in several short, coordinated moves until the patient’s back is in the open doorway and his/her legs are on the seat
      
   6. 
      The end of the long spineboard is placed against the patient’s buttocks. Additional rescuers support the opposite end of the board as the first and second rescuers lower the patient to the board
      
   7. 
      The second and third rescuers slide the patient into the proper position on the board in short coordinated moves while the first rescuer maintains manual C-spine stabilization
      
   8. 
      First rescuer maintains manual stabilization as the patient is moved to a place of relative safety
      

1. 
   To permit emergency extrication of a patient when their condition does not allow the time required to apply full head and torso immobilization with a short extrication device
   
2. 
   To permit emergency extrication in a hazardous situation (fire, haz/mat, etc)
   
3. 
   To provide an alternative extrication technique when a short immobilization device is not available
   
4. 
   To permit emergency patient movement when only one rescuer is available
   

1. 
   Hold a full size cloth blanket diagonally at opposite corners: Loosely swing like a jump rope to make a bulky, long cravat
   
2. 
   Position the blanket for C-spine control and movement
   
   1. 
      Place the middle of the blanket behind the patient’s neck
      
   2. 
      Bring the ends over the shoulders
      
   3. 
      Cross the blanket in front of the chest
      
   4. 
      Pass the ends under the armpits
      
   5. 
      Cross the ends behind the patient’s back
      
3. 
   Hold the blanket ends close to the armpits
   
4. 
   Tilt the patient’s upper body to clear the doorframe as needed
   
5. 
   Slide the patient off and lower into a sitting position onto the ground or directly on to a long spineboard
   
6. 
   Lower the patient to a supine position
   

Manual C-spine stabilization may be done if time and personnel allow

1. 
   Two or three rescuers line up on one side of the patient
   
2. 
   Rescuers kneel on one knee (preferably the same knee for all rescuers)
   
3. 
   The rescuer at the head places one arm under the patient’s neck and shoulders while cradling the patient’s head. S/he places the other hand under the patient’s lower back
   
4. 
   The second rescuer places one arm under the patient’s knees and the other arm just above the patient’s buttocks
   
5. 
   If a third rescuer is available, s/he should place both arms under the patient’s waist and the other rescuers should slide their arms either up to the mid-back or down to the buttocks as appropriate
   
6. 
   On signal, the rescuers lift the patient to their knees and roll the patient toward their chests
   
7. 
   On signal, the rescuers stand and move the patient to the stretcher
   
8. 
   To lower the patient, the steps are reversed
   

1. 
   Properly position the stretcher beside the patient
   
2. 
   One rescuer kneels at the patient’s head and one kneels at the patient’s side by the knees
   
3. 
   The rescuer at the head places one hand under each of the patient’s shoulders while the rescuer at the foot grasps the patients wrists and pulls the patient to a sitting position
   
4. 
   The rescuer at the head slips his/her hands under the patient’s arms and grasps the patient’s wrists
   
5. 
   The rescuer at the patient’s feet places his/her hands under the patient’s knees
   
6. 
   Both rescuers move to a crouching position
   
7. 
   Both rescuers stand simultaneously and move with the patient to the stretcher
   

1. 
   Position the stretcher perpendicular to the bed with the head end of the stretcher at the foot of the bed or the foot end of the stretcher at the head of the bed
   
2. 
   Both rescuers stand between bed and stretcher, facing patient
   
3. 
   First rescuer slides arm under patient’s neck and cradles patient’s head and shoulders
   
4. 
   Second rescuer slides hands under patient’s hips and lifts slightly
   
5. 
   First rescuer slides other arm under patient’s back
   
6. 
   Second rescuer places arms under hips and calves
   
7. 
   Rescuers slide patient to edge of bed
   
8. 
   On signal, patient is lifted and curled toward rescuer’s chests
   
9. 
   Rescuers rotate and place patient gently on stretcher
   

1. 
   Loosen bottom sheet beneath patient
   
2. 
   Position stretcher next to and parallel to bed
   
3. 
   Prepare stretcher and adjust to bed height
   
4. 
   Rescuers then reach across stretcher and grasp sheet firmly at the patient’s head, chest, hips and knees
   
5. 
   On signal, slide the patient gently onto stretcher
   

1. 
   The patient must be able to bear some weight
   
2. 
   One or two rescuers may be used
   
3. 
   Position the cot close to the patient with its height about the same as a chair seat
   
4. 
   The cot must be stabilized to avoid movement
   

1. 
   While facing the patient, grasp the patient by the waistband or under the armpits
   
2. 
   On the rescuer’s count, assist the patient to a standing position
   
3. 
   Assist the patient in turning (pivoting) so their posterior is toward the cot
   
4. 
   Once the patient’s legs are touching the cot, lower the patient to a seated position
   
5. 
   Position the patient on the cot
   

1. Stair Chair- Follow manufacturer’s instructions for proper use

2. Stretchers – Follow manufacturer’s instructions for proper use