Obstacle Course Teaches Stretcher Operations Right the First Time

Situational training challenges providers to stay safe


As a part of NAEMT’s efforts to reduce the number and severity of injuries suffered by EMS practitioners, the course is designed to increase  awareness and understanding of EMS safety standards and practices, and develop the ability to implement these practices in the street. The one-day program is designed for EMS practitioners at all levels, as well as EMS supervisors and administrators. For more information, go to www.naemt.org and click on “EMS Safety,” or call 800/34NAEMT.

It’s difficult to understand the concept of safe stretcher handling just by watching a video or reading a policy. There are many more components of safe patient handling such as a review of proper body mechanics, choosing the right equipment, lifting techniques and employee wellness that must be covered first.

It is the responsibility of an agency to teach employees how to stay off the injured list, while doing no harm to their patients. However, in most organizations, hands-on training usually consists of watching a video, lifting the stretcher up and down and pressing the buttons.

Situational training takes hands-on training to a new level. It puts EMS providers through many of the challenging scenarios they may encounter when moving a patient.

At Sunstar Paramedics, our training starts with a 180-pound manikin that is lying on the ground. Two recruits work together to determine the best way to move the “patient” to the stretcher using a variety of devices such as slide mats, friction-reducing devices, backboards and scoop stretchers. Next, they must demonstrate the ability to lift the “patient” and stretcher using good body mechanics. If they use unacceptable or dangerous techniques, the recruits are remediated in real time.

We then have them maneuver through a stretcher obstacle course that takes them to an ambulance. The stretcher course is an area designed to have multiple surfaces and grades. We planned the course so that the stretcher must travel over gravel, dirt, sand, grass, mud and hard-packed surfaces like cement and asphalt. We also place obstacles for them to maneuver around and to lift over. A piece of plywood that doubles as a wheelchair ramp and an uneven grade is added to evaluate their problem-solving skills.

As they maneuver the stretcher through the course, the trainer watches for any safety problems that may occur such as not keeping two hands on the stretcher. As they change surfaces, they are questioned about what problems might arise and how they may compensate to keep their patient and themselves safe.

The recruit uses critical thinking skills rather than just being told solutions. When the stretcher is on an uneven surface, we surprise them by pushing on the side of the stretcher to show how easily it is tipped if the stretcher is not being supported with two hands on each end.

As they approach the ambulance we demonstrate how reaching to open the back doors while the stretcher is still in motion can affect the gravitational forces of the stretcher. We listen to how they interact with each other and the patient and advise them on the most common mistake that most recruits make, which is assuming rather than verbally communicating with each other.

We have found that training for situational awareness and critical thinking is the most important aspect of patient handling and safety.

Charlene Cobb is an NAEMT Safety Committee Member and education coordinator for Sunstar Paramedics in Pinellas County, FL.