Introduction to Paramedic Practice (Week 3: Manual Handling) Flashcards
(15 cards)
What does the term ‘manual handling’ refer to?
The use of any technique or equipment used to move someone from one place to another
Manual Handling (with no equipment):
moving a patient as a single clinician without equipment…
What is an indication you may be required to do this?
- When you need to move someone immediately and there is no time to retrieve and use manual Handling equipment (most commonly where a person is found in cardiac arrest in a space too small to allow for effective resuscitation or evacuating a person from a dangerous environment such as a burning building)
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Manual Handling (With no equipment)
moving a patient into a recovery position which aims to position the patient on their side allowing vomit or other secretions to drain from their mouth; managing possible risk of aspiration or asphyxiation if patient vomits in a supine position as an unconscious person is unable to maintain their own airway. The recovery position can be used by a single clinician without equipment…**
- What are indications this may be required? What is a contraindication for this method?
- You should aim to use the recovery position when a patient is unconscious and actively vomiting
- Contraindications: You should not use this when the patient has a suspected spinal injury
Manual Handling (with no equipment)
What is the log roll/what does it involve?
Indications/contraindications?
- Log roll: usually requires 3+ clinicians.
- Can be used to examine the spine or back, to help clear secretions from airway/allow positioning of equipment e.g canvas slings, scoop stretchers or spine boards.
- A log roll can be safely performed in a person with a suspected spinal injury provided the head and neck are maintained in neutral alignment
- Indications: Use it to roll a patient onto their side to clear secretions/vomit from the airway, position manual Handling equipment or examine the back/spine
- Contraindications: It requires a minimum of three clinicians to safely log roll a patient with a suspected spinal injury
Manual Handling (With no equipment)
What is a lift assist/what does it involve?
Indications/Contraindications?
- Paramedics are often called to assist people who have fallen without injuring themselves, who require assistance to stand back up.
- The technique can be adapted to assist a person from a chair/bed also.
- This process can be used to assist a person with an injury to one leg provided they are able to weight bare on their other leg.
- This method is unsuitable for a person who is unable to weight bare or who has significant injuries to both legs. A lifting belt can be applied to assist.
Indications: Use it to get someone up and off the floor
Contraindications: Do NOT use it when injury or illness prevents the patient from being able to stand on their own
Manual Handling (without equipment)…
What is a fore and aft lift?
Indications/Contracindications?
- VERY occasionally paramedics need to move someone to the floor or to a stretcher bed immediately.
- If the patient’s condition is time critical there may not be time to retrieve and utilise manual handling equipment.
- A fore and aft lift allows two clinician’s to move a patient from a chair or bed to the floor to begin CPR or to move a critical patient from the floor,bed, chair to stretcher for immediate extrication.
- This method= seldom used because it can place significant strain on lower back.
- This technique should not be used on an agitated or uncooperative patient because any sudden movement by the patient significantly increases the risk of back injury.
-This method should only be used in exceptional circumstances. A patient can be more easily and safely moved using a canvas sling in nearly every presentation. - Indications: Use only in emergencies when patients needs to be moved IMMEDIATELY, and no time for equipment
- Contracindications: There are better means that are safer for moving patients. Usage of canvas sling, spinal board, or scoop stretcher should be used instead wherever possible
Manual Handling - Lifting equipment
What is a lifting belt used for?
Indications/Contraindications?
- A lifting belt wraps snugly around the patients waist and provides handles to help paramedics during a lift assist
- Indications: Use it to provide hand holds during a lift assist from the floor or a chair
- Contraindications: Avoid using a lifting belt in a patient with abdominal or pelvic injuries. A lifting belt may not fit all paediatric or bariatric patients
Manual Handling - Lifting equipment
Canvas sling - Usage, Indications + contraindications?
- Used to allow two or more clinicians to safely lift a patient. Can be placed under a patient in a seated or supine position. Sling has Handles all the way around. Can be used to drag patients along ground if not enough room to carry.
- Patient may be left on canvas sling during transportation
- Can be used to assist moving a patient from ambulance stretcher to a hospital bed
- Indications: Moving patient from seated/supine position, with two or more clinicians
- Contraindications: Not suitable for patients with suspected spinal injury, May not be appropriate for bariatric patients.
Manual Handling - Lifting Equipment
What is a scoop stretcher? Usage
Indications + Contraindications?
- Scoop stretcher is used to move someone from the floor to a stretcher. This is the preferred method for anyone with a suspected spinal injury. S. stretcher can be split in half lengthways. Is positioned to either side of patient and pressed together. This allows for two or more clinicians to lift a patient from a supine position without needing to roll them
- Indications: Use it to lift a person from the floor to a stretcher. This is the preferred method for anyone with a suspected spinal injury.
- Contraindications: A scoop stretcher needs a reasonable amount of space to apply. It may not be appropriate in cramped or confined spaces.
Manual Handling - Lifting Equipment
What is a spine board/usage?
Indications/contraindications?
- A spine board is used to move a person from the floor to a stretcher. This device requires at least four clinicians to use because three clinicians will log roll the patient while the fourth slides the board under them. Spine boards are older technology and a scoop stretcher is preferred for any patient suspected of having a spinal injury.
- Indications: Use it to move someone from the floor to the stretcher
- Contraindications: Don’t use it if you suspect a spinal injury, use a scoop stretcher instead
Manual Handling - Lifting equipment
What is a slide board/usage?
Indications/contraindications?
- A slide board is used to transfer a non-ambulatory patient from one bed to another or from an ambulance stretcher to a hospital bed. This item is not carried on the ambulance but is readily available in hospitals and aged care facilities.
- Indications: Use it to transfer from the ambulance stretcher to a hospital bed and back again.
- Contraindications: This tool can only be used to transfer from one bed to another.
Manual Handling - Lifting equipment
Carry chair: NOTES
A carry chair is a collapsible wheelchair that can be folded up and stored in the ambulance.
This device is used to extricate patients from places where a stretcher would be impractical. For example a stair chair is regularly used to carry patients up or down a flight of stairs.
It is important to keep your passenger informed of your plan when moving them in a stair chair. Being carried down a staircase can be a frightening experience for some people. This can motivate some individuals to reach out and grab onto things (like handrails) in an attempt to steady themselves. This must be avoided as movements like this can unbalance the chair greatly increasing the risk of injury to both the patients and staff. We often wrap patients in a blanket or a sheet when using the stair chair to prevent this from happening.
Indications/Contracindications:
Indications: Use it to extricate a non-ambulatory patient, particularly from places a stretcher cannot go
Contraindications: This device is unsuitable for anyone who needs to remain supine such as profoundly hypotensive patients and most major trauma patients
Manual Handling - Lecture Questions:
What does manual handling define?
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- The activity requiring the use of force exerted by a person to lift, lower, push, pull, carry or otherwise move, hold or restrain a person.
Manual Handling - Lecture Questions:
What is a dynamic risk assessment?
What does the acryonym READ stand for?
- A dynamic risk assessment is the process of identifying hazards and assessing the risks, taking action to eliminate or reduce risks, monitoring and reviewing in rapidly changing circumstances of an operational incident.
- The aim is to reduce risk of injury in paramedics, patients, and the public
- READ: (risks, equipment, action plan, discuss)
Manual Handling: Lecture slides Questions:
When you have to manually handle loads what should you consider (LITE)?
LITE: load, individual, task, environment
- Load: patient characteristics, heavier at one end, diagnosis, comprehension of oral language, neurological status?
- Individual: Knowledge, training, experience, general health, fatigue
- Task: How often, is their associated bending or twisting, assessment and strategies employed.
- Environment: hot, cold, uneven surface, slopes, wind stairs, space.
