Patient Moving - Part 1
One of the constants of EMS is now and will always be that we have a need to get patients from one place to another. In EMS we find patients in all sorts of environments and circumstances. In the best of cases they are easily accessible for our stretchers and even able to stand up and place themselves on the stretcher for us. However, often the patient may be a distance away from where we can wheel the stretcher to and they need to be carried. This can include stairs or other obstacles. In still other situations there may be a need to rapidly remove someone from a hostile or otherwise undesirable location. In these cases EMS professionals may deviate from more conventional moving methods in favor of expediency. In all patient moving circumstances, the availability of appropriate resources – people and equipment – will factor into decision making when it comes to determining how best to get your patient from where they are to where you want them to be.
When it comes to moving people, increasingly what we have always known to be “best practices” are being challenged. A prominent example of this is backboard use. Based on evidence and studies that suggest we may be doing more harm than good, backboards are being increasingly reserved for a very limited patient population. Similarly, we are also recognizing that physically lifting and moving patients with our hands and arms, even just from the floor to a chair, without some adjunct isn’t a safe practice for the patient or the EMS provider.
To this end, let’s consider a specific scenario and look at potentially better options. Here’s a common one: your patient is a 200lb male found in a second or third floor bedroom. The patient is unconscious or even worse, in cardiac arrest. Since the patient is unconscious a stair chair isn't going to work, so now you’re thinking stokes basket or backboard, right? Both will allow you to secure your patient using straps and with enough help, safely move him to the stretcher at the bottom of the stairs. But what about those corners and landings? Yes, we can “stand” the patient up or pass him over the railings, but this takes time, a lot of muscle and places the patient and the EMS providers at risk. Besides, we’re not using these devices because we need to immobilize, only move. In these situations you can consider the use of a non-rigid or semi-rigid patient mover. An excellent example of this type of device is B2 Products' Rapid Patient Mover (RPM).
The Rapid Patient Mover (RPM) is a semi-rigid people moving device that is designed for flexibility with both patient and EMS provider safety in mind. At first glance it may appear to be just another tarp with handles, but it really is much more. Made with ballistic nylon and heavy duty nylon web handles and attachment points, the RPM can be dragged or carried and is far more durable than most similar-looking devices on the market. What makes the RPM substantially different and more functional than other soft litters and patient carriers is the embedded plastic plates that protect the patient and provide just enough rigidity, but at the same time are placed in a way that allows the entire device to bend with the patient. Using the RPM in the example above, a crew could secure the patient snugly into the RPM, drag him down the hall and then drag or carry around landing corners and down the stairs without a lot of strain to the EMS providers. When the patient safely reaches the stretcher he can be left right on the RPM for easy transfer off at the hospital.
About the author: Josh Beaulieu, co-founder of B2 Products LLC, has been a licensed practicing paramedic for 20 years and currently leads EMS for a small city fire department in CT.