Lift With Your Head

Participate: EMS Magazine's Back Injury Survey

We've all been told to lift with our legs and not our backs. That's good advice, but back injuries in EMS remain all too common. Let's consider a different approach: lifting with our heads.

     This article will look at several aspects of how to move a patient onto an ambulance stretcher and move that stretcher safely, without injury to the EMTs or the patient. It will require you to think outside the box and avoid the "But we've always done it that way!" mind-set. For purposes of this article, a stretcher and an ambulance cot and an ambulance gurney are all that same device in the back of the ambulance upon which the patient is placed.

     Is there an injury problem in EMS? Most certainly! In your own EMS organization, it's a safe bet that there are EMTs who have been out of work due to back injuries, shoulder problems or wrist pain. In my organization, there are three superb paramedics who will likely never work in the field again due to injuries associated with lifting. This is a terrible loss to the community, not to mention a massive disruption to these providers' careers and lives.

     There are other EMTs, though, who just never seem to have back injuries. I've the pleasure to work with an EMT whom I swear could not weigh any more than 100 pounds, yet she has a well-deserved reputation as being able to outlift many of our biggest and huskiest EMTs. You likely have some EMTs like this in your organization. What are they doing differently? Maybe they're lifting with their heads.

Heavy Is Our Burden
     First, let's accept that things have changed in the field. Patients are heavier, and they won't be getting lighter anytime soon. The amount and weight of equipment we carry in the ambulance has increased as well, and we often must carry it into a scene. Ask yourself, "How much training have I had in lifting and moving patients?" The answer is likely to be only a few minutes' worth, despite the fact that it's a major part of our jobs. We need to adapt to the situation at hand and reconsider how we lift.

     First, a quick review of the basics of lifting:

1. Stand close to the object to be lifted, feet shoulder-width apart.
2. Tighten your abdominal muscles before you start the lift (don't talk while lifting; you cannot do both at the same time).
3. Keep your back straight; bend with your knees, hips forward.
4. Lift the weight with your leg muscles, not your arm or back muscles.
5. Do not twist as you lift.
6. Push weights-do not pull them.

Other Input
     We've all been told we should lift with our legs and keep our backs straight, but are we really doing it? Think outside the box. Have a friend take a digital picture of you doing a practice lift and get another EMT to evaluate the picture. What you may think is the proper position could be incorrect. Look at your foot position and how far the weight to be lifted is from your body. Talk to those EMTs who never seem to have back trouble and observe where they put their hands and feet in relation to the patient.

     Have you ever read the owner's manual for the type of stretcher you use? It may instruct you in safe operation. When was the last time you were on the stretcher and had other EMTs load you into the back of the ambulance? You really need to do this to feel the change in anxiety level as you're loaded. It's critical that you realize what the injured or sick patient is thinking as they experience this, especially when their anxiety level might already be through the roof. Before you even load the patient onto the stretcher, you need to explain to them what you're doing. If you don't, you risk startling the patient and causing them to move suddenly, disrupting your balance. It goes without saying that all the straps and rails must be properly secured before you attempt any movement.