By Robert Avsec
EMTs and paramedics are always on the lookout for the next big thing when it comes to the safe, effective and efficient movement of a patient. The challenges, it seems, are always growing in number and complexity, with the biggest being the fact that Americans are getting heavier.
The growing obesity problem is presenting situations for EMS providers where:
- Their existing stretchers cannot safely bear the weight of the patient or accommodate their increased girth.
- The EMS providers do not have an appropriate tool to move the patient from an above-grade building floor or from tight spaces within an occupancy; this applies to patients of any size.
Let’s take a look at some of the more interesting products that may have a positive influence on your department’s ability to move patients from Point A to Point B.
Stretchers
Ferno touts its new 28Z PROFlexx Chair-Cot as providing maximum versatility in confining environments. One of its more desirable features is its capability of being transformed from a cot to a chair when EMS providers are faced with tight hallways, narrow staircases and small elevators.
The Stryker Power-PRO XT has a battery-powered hydraulic system that raises and lowers the patient with the touch of a button that dramatically reduces strenuous lifting and the associated risk of back injury for EMS providers.
Stretcher adjunct devices
The LBS Bariatric Board Attachment folds flat for storage and can be deployed in minutes to convert a Ferno cot to a bariatric cot. The EMS provider attaches the LBS to the cot using the supplied system of pins and mounting blocks to increase the width of a standard cot to accommodate larger patients.
The LBS Bariatric Board Attachment is compatible with the Ferno’s POWERFlexx, 93P PROFlexx, and 35X PROFlexX ambulance cots.
Stryker EMS also provides a stretcher adjunct to better accommodate bariatric patients with its XPS (Expanded Patient Surface) device. XPS can be retrofitted to existing Stryker Power-PRO XT, Power-PRO TL and Performance-PRO cots.
Moving a patient via stretcher, even on a level surface, can be a tricky proposition when the stretcher is in its extended (upright) position. Yet, keeping the stretcher at ground level for better stability forces the EMS providers to push or pull in a bent-over posture, putting them at risk for a lower-back injury.
The Bariatric Push-Pull Handles (BPPH), a stretcher adjunct that enables EMS providers to walk upright while they push or pull an ambulance cot in its lowest position. Using the BPPH, EMS providers can move their patients, especially their bariatric patients, more safely and effectively with the cot in its most stable position with the lowest center of gravity.
The BEAR (Bariatric Equalizing Abdominal Restraint) is another stretcher adjunct that’s designed to help EMS personnel move their bariatric patients more safely and effectively using their standard ambulance stretcher. The BEAR is constructed of nylon mesh and webbing and uses a closure system that wraps around the patient’s abdomen from the bottom up.
By doing so, it holds a patient’s adipose tissue more in the midline to stabilize a large abdominal mass. With the abdominal mass stabilized relative to the cot, the cot is more maneuverable and less likely to tip. The BEAR also can be used when immobilizing bariatric patients with a long backboard to better control lateral movement and make for a more stable load.
Immobilization and extrication devices
The Wauk Spine Board provides EMS providers with an option when confronted with a patient who requires extrication from a tight space, such as a narrow hallway or small elevator. It has a dolly-style fold-down footrest that enables the EMS provider to raise the head of the board anywhere between 0 and 90 degrees.
When raised, the board’s attached 3-inch wheels allow EMS providers to negotiate situations like removing a patient from a residential bathroom; descending or climbing narrow stair cases; or moving the patient through a crowd or other constricted area.
The Reeves EMS Company is still making the “old standby” of my youth, the 101 Flexible Stretcher, along with a whole line of litters, carries and chairs. The 101 is pretty much the same as the Reeves I used as a young EMT, but the high-visibility orange is much better looking than the battleship grey of the older model.
How has the Reeves been able to stand the test of time? What you see is what you get; it’s all there:
- Five removable hardwood slats positioned between two layers of fabric provide strength and rigidity.
- Three, polypropylene (2-inch width) web patient security straps with plastic buckles located to provide maximum immobilization.
- Six ergonomically placed handles, constructed of polypropylene webbing with foam inserts.
Their current flagship product is the Reeves Sleeve Dragable Stretcher, which can be used to immobilize those with spine and neck injuries and lift patients out of tight spaces.
In addition, its heavy-duty construction — along with a plastic bottom — enables rescuers to use it to drag patients across a variety of terrains. It also has one vertical lift point and four horizontal lift points making it capable of being hoisted by a helicopter or crane.
Is there any patient extrication situation more difficult than seating at a football stadium, in a movie theatre or on a commercial airliner?
The Reeves Stadium Stretchair gives EMS providers a new tool for just those situations. It is constructed of 18-ounce vinyl-coated polyester making it washable with soap and water, highly resistant to acids and alkali, and impervious to most liquids.
The Stetchair features hardwood slats positioned between two layers of fabric for strength and rigidity, four ergonomically placed carrying handles, and two adjustable polypropylene web straps with plastic buckles to secure the patient.
The Rigid Mesh Decon Litter is designed for patient transport during the decontamination process or multiple casualty incidents. Its 18-ounce vinyl-coated nylon mesh design allows contaminated run-off to pass through during decontamination procedures, thus preventing water from pooling under the patient and minimizing exposure to harmful substances.
The Wheeled Litter Carrier (litter not included) will transport a large number of injured people over almost any terrain not accessible by vehicles. Some of the unit’s features include:
- Pole stretchers or litters with a width of 19 to 22 inches.
- A weight capacity of 500 pounds.
- The ability to fold to compact footprint for transport and storage.
- Wide wheel base for stability while transporting a patient.
- Snap-down clamps allow a litter to be quickly attached to and detached from the carrier.
Looks like EMS providers are not the only ones who are constantly looking for the next big thing, does it? The equipment manufacturers have been pretty busy too.
Battalion Chief Robert Avsec (Ret.) served with the Chesterfield (Va.) Fire & EMS Department for 26 years. He was an active instructor for fire, EMS, and hazardous materials courses at the local, state, and federal levels, which included more than 10 years with the National Fire Academy. Chief Avsec earned his bachelor of science degree from the University of Cincinnati and his master of science degree in executive fire service leadership from Grand Canyon University. He is a 2001 graduate of the National Fire Academy’s Executive Fire Officer Program. Since his retirement in 2007, he has continued to be a life-long learner working in both the private and public sectors to further develop his “management sciences mechanic” credentials. He makes his home in Alexandria, Virginia.