In last month’s column, we held the mirror up to ourselves as both professionals and a profession. We examined three every day patient and equipment handling errors that not only cause many of our injuries but also cause the patients a fair amount of anxiety and discomfort. From lifting and loading the cot to the classic sheet drag patient transfer, there are poor lifting techniques in our profession that we must stop doing.
There are better ways to get the job done, and get it done safer.
Let’s look at two more lifts that we do that can cause a lot of injury and look at better ways to get them done.
Danger zone lifts
The National Institute of Occupational Safety and Health (NIOSH) defines any lift below the knees “lifting in the danger zone”. Long board, cot and patient lifts from the floor are all in the danger zone. This is the area where the negative load on the tissue is so severe that you have the highest chance of sustaining an injury.
By far the long board lift is the most dangerous lift we do “in the danger zone” so it only makes sense to master that movement. When lifting a board always do the following:
a. Establish a wide base of support.
b. Get as close to the board as possible.
c. Use a “palm up” grip.
d. Keep your feet flat at all times, and your head up!
In the last 6 years I have trained thousands of responders to lift a long board. I can confidently say that less than 40% can do it properly. Everything from strength to flexibility can affect your biomechanics!
The next time you have to lift a spine board or a patient off the floor, use a flexible stretcher like a mega-mover or transfer tarp. Place it on the ground first, and then move the patient who is on a long board onto the flexible stretcher.
When you lift the board with the flexible stretcher your lift height is at roughly knee level, not from the floor. This gets you out of the lifting danger zone and takes the dangerous load off of your back. Flexible stretchers area great tool to use on most calls and not just for bariatric patients.
Many hands make light work
It never ceases to amaze me that there can be 4 or 5 responders on the scene, yet when it comes time to load the cot there is still just one person on the end and one lifting the carriage. One of the good things about the powered cot is that you have to load and unload the cot with 2 responders on the end due to its weight.
Since many services still have manual lift cots, this practice must become part of how you do business. It makes no sense to load a cot on scene by yourself if there are responders on scene to that can raise the carriage for you.
Two people loading the cot together at the foot distributes the load, and makes the lift easier. Your load angle is also higher, which means you will not have to “fight” to get the wheels into the patient compartment.
For those times that it’s just you and your partner having to load the cot, try this maneuver: Get into a deep squat with your chest against the foot end of the cot. Since you are in a deep squat when you stand up the cot is at a much higher load angle. All you have to do now is to push the cot into the ambulance.
Another benefit of this approach is that it limits spinal extension (leaning back at the top of the lift), reducing the load on your spine.
Think outside the box
Responders, step out of the box a bit and realize that one of the keys to making your job easier while also reducing your chance of getting hurt is to work smarter and not keep doing what you have been doing. Remember, insanity is doing the same thing over and over again expecting a different result. We can’t keep the insanity going! Lift smarter and reduce the load on your body every chance you get. We can do these every day tasks better and safer.
