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- 1. Tie the patient's wrists together if you have something quickly available. If nothing is available, tuck the hands into the waist band to prevent them from being pulled upwards.
- 2. Clutch the patient's clothing on both sides of the neck to provide a support for the head.
- 3. Pull the patient towards you as you back up, watching the patient at all times. The pulling force should be concentrated under the armpits and NOT the neck.
Sheet or towel Drag?
- 1. Fold or twist a sheet or large towel lengthwise.
- 2. Place the narrowed sheet across the chest at the level of the armpits.
- 3. Tuck the sheet ends under the armpits and behind the patient's head.
- 4. Grasp the two ends behind the head to form a support and a means for pulling.
- 5. Pull the patient toward you while observing the patient at all times.
- 1. Lay a blanket lengthwise beside the patient.
- 2. Kneel on the opposite side of the patient and roll the patient toward you.
- 3. As the patient lies on their side while resting against you, reach across and grab the blanket.
- 4. Tightly tuck half of the blanket lengthwise under the patient and leave the other half lying flat.
- 5. Gently roll the patient onto their back.
- 6. Pull the tucked portion of the blanket out from under the patient and wrap it around the body.
- 7. Grasp the blanket under the patient's head to form a support and means for pulling.
- 8. Pull while backing up and while observing the patient at all times.
Bent Arm Drag?
- 1. Reach under the patient's armpits from behind and grasp the forearms or wrists.
- 2. Use your arms as a cradle for the patient's head and keep the arms locked in a bent position by your grasp.
- 3. Drag the patient towards you as you walk backwards, observing the patient at all times.
Direct Ground Lift?
- 2-3 EMTs line up on the same side of a supine Pt.
- The EMTs all kneel on one knee.
- Cross the Pt's arms on the chest if injuries don't prevent it.
- The EMT at the head places one arm under the Pt's head and shoulders, cradling the head. The other arm is placed under the Pt's lower back.
- 2nd EMT places one arm directly below the first EMT's arm in the small of the Pt's back. The second arm is placed under the Pt's knees.
- 3rd EMT (if available) slides both arms under the Pt's waist. The other EMTs adjust their arms accordingly.
- On signal, the EMTs lift the Pt to their knees and roll the Pt in toward their chests.
- On signal, the EMTs stand and move the Pt to the stretcher.
- On signal, the Pt is lowered onto the stretcher, which has been positioned at waist level.
- This is only used when a spinal injury is not suspected.
- Best used for short distances.
- One EMT kneels at the Pt's head and the other EMT kneels at the Pt's side by the knees.
- The EMT at the head reaches under the Pt arms at the shoulders and grasps the Pt's wrists. If the Pt is unresponsive or uncooperative, the other EMT may assist by lifting the Pt's wrists to within the reach of the partner. To improve stability, the Pt's left wrist may be grasped by your right hand and their right wrist by your left hand. This crosses the Pt's arms over their chest creating a more secure hold with less give.
- 2nd EMT reaches under both knees with one arm and under the buttocks with the other arm.
- The EMT's rise to a crouching position, then simultaneously stand and move with the Pt to the stretcher.
- Position the stretcher at a right angle to the Pt's bed with the head end of the stretcher at the foot of the bed.
- Prepare the stretcher by unbuckling the straps, removing other items, and lowering the closest railing.
- Both EMTs stand between the stretcher and the bed, facing the Pt.
- The EMT at the head end of the stretcher slides one arm under the Pt's neck and shoulders, cupping the far shoulder with his or her hand and cradling the head.
- 2nd EMT slides one arm under the small of the Pt's back, slides the arm under the buttocks and lifts slightly to allow the first EMT to slide an arm under the waist.
- 2nd EMT reaches under the Pt's lower legs.
- Pt is pulled to the edge of the bed, then lifted and curled toward the EMT's chest.
- The EMTs rotate to be in line with the stretcher, then place the Pt gently on to it.
Draw Sheet Method?
- Loosen the bottom sheet on Pt's bed.
- Adjust stretcher to height of bed, unbuckle straps, lower both rails, and remove all items from stretcher.
- Place the stretcher against the side of the bed.
- Both EMTs reach across the stretcher and grasp the sheet firmly beside the Pt's head, chest, hips and knees.
- Slide the Pt gently across and onto the stretcher. If enough personnel are available, the Pt may be lifted by grasping the sheet on both sides of the Pt at the chest and hip simultanously.
Rapid Extrication Technique?
- 1st EMT provides in-line manual support of the head and cervical spine.
- 2nd EMT gives commands, applies a cervical collar, and performs initial assessment.
- 2nd EMT supports the torso. 3rd EMT frees the patient’s legs from the pedals and moves the legs together, without moving the pelvis or spine.
- 2nd & 3d EMTs rotate the patient as a unit in several short, coordinated moves. 1st EMT (relieved by 4th EMT or bystander as needed) supports the head and neck during rotation (and later steps).
- 1st (or 4th) EMT places the backboard on the seat against the patient’s buttocks.
- 3rd EMT moves to an effective position for sliding the patient. 2nd & 3rd EMTs slide the patient along the backboard in coordinated, 8” to 12” moves until the hips rest on the backboard.
- 3rd EMT exits the vehicle, moves to the backboard opposite 2nd EMT & they continue to slide the patient until patient is fully on the board.
- 1st (or 4th) EMT continues to stabilize the head and neck while 2nd & 3rd EMTs carry the patient away from the vehicle.