Lifting, Moving, and Positioning of Patients Chapter 5

Question 1

Define body mechanics.

Answer 1

The use of the body to facilitate lifting and moving to minimize injury.

Question 2

Describe the first step in moving a patient or object.

Answer 2

Plan what you will do and how you will do it.

Question 3

Describe the characteristics of proper body mechanics.

Answer 3

Position your feet properly
Lift with your legs
Avoid leaning to either side
Minimize twisting during a lift
Keep the weight as close to your body as possible
Use appropriate equipment example stair chairs on stairs
Keep eye contact with your partner
Use a spotter when possible when walking downstairs

Question 4

Define power lift.

Answer 4

A technique used to lift a patient who is on a stretcher or cot.

Question 5

Define standard move.

Answer 5

The preferred choice when the situation is not urgent, the patient is stable, and you have adequate time and personnel for a move.

Question 6

Define emergency move.

Answer 6

A patient move that is carried out quickly when the scene is hazardous, care of the patient requires immediate repositioning, or you must reach another patient who needs life-saving care.

Question 7

An emergency move provides protection for the patient’s injuries, true or false?

Answer 7

False - an emergency move rarely provides any protection for patients injuries, and they may even cause the patient tremendous pain. Still, sometimes the need to move the patient to ensure his safety or to provide life-saving care outweighs the risks associated with moving the patient quickly.

Question 8

To avoid the possibility of making a spine injury worse with a patient on the floor or ground, it’s important to make every effort to pull the patient in what direction?

Answer 8

In the direction of the long axis of the body

Question 9

Define clothing drag.

Answer 9

An emergency move in which a rescuer grabs the patient’s clothing near the shoulders and pulls him to safety.

Question 10

Name the five drags.

Answer 10

Clothing or shirt drag
Blanket drag
Shoulder drag
Firefighters drag
Strap drag

Question 11

Name the five one rescuer carries.

Answer 11

One rescuer crutch
Cradle carry
Pack strap carry
Piggyback carry
Firefighters carry

Question 12

What are the 4 rules used when preparing for a standard move.

Answer 12

1. Complete a primary assessment
2. Choose an appropriate number of rescuers
3. Take care to avoid compromising a possible neck or spine injury
4. Consider splinting suspected fractures

Question 13

Define direct ground left.

Answer 13

A standard lift in which three rescuers move a patient from the ground to a bed or structure.

Question 14

A direct ground lift is a standard move, true or false?

Answer 14

True

Question 15

What patients are the direct ground lift not recommended for?

Answer 15

It is not recommended for use on patients with possible neck or spine injuries. Although it can be accomplished by two people, three people are recommended for the safety of all involved.

Question 16

Describe how to perform a direct ground left.

Answer 16

The patient should be lying face up supine, and arms should be placed on the chest. You and your helper should line up on one side of the patient. One rescuer should be at the patient’s head, another at their midsection, and another at the lower legs. Each should drop to the knee closest to the patients feet. The rescue at the head should place one arm under the patient’s neck and grasp the far shoulder to cradle the head. The other arm should be placed under the back, just above the waist. The rescuer at the midsection should place one arm above and one arm below the buttock’s. The rescuer at the patient’s lower legs should place one arm under the patients knees and another arm under the ankles. On the signal of the rescuer at the head, everyone should lift the patient up to the level of their knees. Then, on signal, the rescuers should roll the patient toward their chests. Finally, on signal, everyone should stand while holding the patient. The patient can now be moved, reversing the process when it’s time to place them in a supine position.

Question 17

Define extremity lift.

Answer 17

A move performed by two rescuers, one lifting the patients arms and one lifting the patients legs.

Question 18

When should you avoid when using an extremity lift?

Answer 18

If there is a possibility of head, neck, spine, shoulder, hip, or knee injury or any suspected fractures to the extremities that have not been immobilized.

Question 19

Define direct carry.

Answer 19

A carry performed to move a patient with non-suspected spinal injury from a bed or from the bed level position to a stretcher.

Question 20

Where should the stretcher be placed when using a direct carry method?

Answer 20

It is placed at a 90° angle to the bed, depending on room configuration.

Question 21

How do you prepare the stretcher and position yourself for a direct carry.

Answer 21

Prepare stretcher by lowering the rails, unbuckling straps, and removing other items. Both EMR’s stand between stretcher and bed facing patient.

Question 22

Define draw sheet move.

Answer 22

A method for moving a patient from the bed to the stretcher.

Question 23

What common places use draw sheet moves?

Answer 23

Hospitals and nursing homes

Question 24

What types of common equipment are used to move patients?

Answer 24

Slider board, slider bag, scoop stretcher, long spine board, chair stretchers, extrication devices, baskets, and stretchers

Question 25

What are the common devices used for transporting patients?

Answer 25

Gurney, stretcher, cot, or pram

Question 26

Define recovery position.

Answer 26

The position in which a patient with no suspected spine injuries may be placed, usually on the left side. Also called the lateral recumbent position.

Question 27

Why is it preferable to place a patient on his side?

Answer 27

To help maintain an open and clear airway

Question 28

Describe the steps of placing a patient in the recovery position.

Answer 28

Kneel beside the patient on his left side.
Raise the patient’s left arm straight out above his head.
Cross the patients right arm over his chest, placing his right hand next to his left cheek.
Raise the right knee until it is completely flexed. Place the right hand on the patient’s right shoulder and your left hand on the patient’s flexed right knee. Using the flexed knee as a lever, pull toward you, guiding the patient’s torso in a smooth rolling motion onto his side. The patient’s head will rest on his left arm.
As best as you can, position the patient’s right elbow and knee on the floor so that they act like a kickstand, preventing the patient from rolling completely onto his stomach.
Place the patient’s right hand under the side of his face and allow the head to angle slightly downward for airway drainage.

Question 29

Define Fowlers position.

Answer 29

A position in which a patient is placed fully upright in a seated position, creating a 90° angle.

Question 30

When should Fowlers position be used?

Answer 30

When patients have no suspected spine injuries.
Use as a position of comfort or allowing for more effective care of particular conditions. This may be used on patients with medical complaints such as chest pain, nausea, or difficulty breathing.

Question 31

Define semi Fowler’s position.

Answer 31

A Semi-seated position in which the patient reclines at a 45° angle.

Question 32

When should Semi-Fowler’s position be used?

Answer 32

When patients have no suspected spine injuries. Use as a position of comfort or allowing for more effective care of particular conditions. This may be used on patients with medical complaints such as chest pain, nausea, or difficulty breathing.

Question 33

Define Trendelenburg position.

Answer 33

A position in which the patient is placed flat on his back with legs and feet raised.

Question 34

When should Trendelenburg position being used?

Answer 34

For patients you suspect may be suffering from shock

Question 35

Define shock position.

Answer 35

Elevation of the feet of a supine patient 6 to 12 inches

Question 36

When should the shock position be used?

Answer 36

When a patient is suspected of having non-injury shock. This position should only be used for patients exhibiting signs of shock with no evidence of trauma or injury.

Question 37

Define log roll.

Answer 37

A method used to move a patient with a suspected spine injury from the prone position to the supine position

Question 38

Describe the steps in completing a log roll.

Answer 38

Manually stabilize the patient’s head and neck as you place the board parallel to the patient. Maintained manual stabilization throughout the log roll.
Kneel at the patient side opposite the board.
Reach across the patient and position your hands. Inspect the patients back.
On command from the rescuer at the head, as a unit roll the patient toward you.
Then move the spine board into place.
Lower the patient onto the spine board at the command of the rescuer at the head.
Center the patient on the board.

Question 39

Define restraint.

Answer 39

The process of securing a combative patient’s body and extremities to prevent injury to himself or others.

Question 40

When should a patient be restrained?

Answer 40

Only when necessary to secure a combative patient who is a danger to himself or others. In a perfect world, you would leave the job of restraining a patient to law-enforcement personnel, but it is not always possible. Whenever possible, be sure to have law-enforcement present when attempting to restrain a patient. It is very important to follow local protocol.

Question 41

What are the two types of restraints?

Answer 41

Physical and mechanical

Question 42

Define positional asphyxia.

Answer 42

Refers to death resulting from the securing of a person in the prone position, limiting his ability to breathe adequately. Also called restraint asphyxia.

Question 43

Is positional asphyxia preventable?

Answer 43

Yes, in all cases by using proper techniques in restraining patients.

Question 44

What considerations should be made when placing a patient in restraints to avoid positional asphyxia?

Answer 44

Always ensure an open airway, make sure the chin is not held tightly to the chest or in a manner that does not allow for full expansion of the chest and lungs.

Question 45

Proper body mechanics is best defined as:
A. properly using your body to facilitate a lift or move
B. using a minimum of three people for any lift
C. contracting the body’s muscles to lift and move things
D. lifting with your back and not your legs

Answer 45

A. properly using your body to facilitate a lift or move

Question 46

An emergency medical responder should immediately move a patient EXCEPT when the patient:
A. has a blocked airway
B. is bleeding severely
C. has mild shortness of breath
D. is in cardiac arrest

Answer 46

C. has mild shortness of breath

Question 47

When lifting a patient, your feet should be placed:
A. one in front of the other
B. shoulder width apart
C. a comfortable distance apart
D. as close together as possible

Answer 47

C. a comfortable distance apart

Question 48

Good body mechanics means keeping your back what and bending at the knees when lifting a patient or large object.
A. at a 45° angle
B. straight
C. curved
D. slightly twisted

Answer 48

B. straight

Question 49

The load of your back is minimized if you can keep the weight you are carrying:
A. as close to your body is possible
B. at least 6 inches in front of you
C. at least 18 inches in front of you
D. as low as possible

Answer 49

A. as close to your body is possible

Question 50

What type of move is used when there is no immediate threat to the patient's life?
A. emergency
B. standard
C. rapid
D. non-rapid

Answer 50

B. standard

Question 51

Which one of the following would be the best choice for a stable patient with a suspected spine injury?
A. one rescuer assist
B. cradle carry
C. two rescue assist
D. shoulder drag

Answer 51

D. shoulder drag

Question 52

Which one of the following patients would best be served by being placed in the recovery position?
A. a child who is unresponsive following a seizure
B. an adult and cardiac arrest and in need of CPR
C. a child who is facedown and unresponsive in a pool
D. an adult victim of the vehicle collision

Answer 52

A. a child who is unresponsive following a seizure

Question 53

Before restraining a combative patient, the EMR should obtain what approval?
A. law-enforcement
B. medical direction
C. ALS
D. supervisor

Answer 53

A. law-enforcement

Question 54

Which one of the following devices would be best suited to carry a responsive patient with no suspected spine injury down a flight of stairs?
A. flexible stretcher
B. wheeled stretcher
C. scoop stretcher
D. stair chair

Answer 54

D. stair chair