Other methods of moving the patient

To relieve the transportation of the patient in the medical facility we can use a number of devices: crutches, canes, walkers, support belt.

Walkers improve coordination, allow you to keep balance and reduce the load on the lower limbs.

There are walking and non-walking model of a walkers. Non-walking model is hard design, operating as a unit. Walking model in pipes, fastening the left and right side of the walker, have hinges that allow you to flip the side of the walker in relation to each other, which allows the patient during moving forward of one part of walker to rely on the second side.

The height of the walker is adjusted depending on the height of the patient. The hands of the patient lying on the holders for the hands of the walker should be bent at an angle from 20 to 30° at elbows. Patients should wear reliable, well-fitted shoes. Remember that all types of walkers unsafe at ascending and descending the stairs. In addition, they are bulky and inconvenient to use in a limited space and can get stuck in doorways (Fig. 21).

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а b

Figure 21.

Moving with a walker

а – rolling, b - transportable

For reliable fixing of moving debilitated patient or patient with impaired coordination, or other threat of falling assistant can use a wide sturdy belt that is worn to the patient over the clothes and is fixed by lock (Fig. 22).

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Figure 22.

Support belt

During moving the patient clenches the assistant's neck by one hand, and assistant supports the patient by one or two hands for the belt. This belt allows an assistant to apply much less effort at moving the patient and to reliably control the situation.

In the absence of means to transport the patient you can transport in other ways. The method of transportation of the patient depends on the nature and severity of the injury, condition and weight of the victim, the number of people able to help and their physical abilities, the presence of improvised means.

Transportation of patients by non-specialists should be only done when you know exactly that the doctors or rescue professionals will not be able to arrive at a reasonable time, or the patient is no longer able to stay in life-threatening conditions.

Transportation of the patients for long distances is greatly relieved by the use of straps, which reduce strain on the wrists.

Transportation of a victim with the help of straps

One porter can move the victim, using the strap, folded by eight or end. Porter spoofing strap for his height, puts it on the legs of the victim, puts the patient on the healthy side, and clinging to victim’s back, puts on a strap on himself, so that its cross fell on the chest. Then gradually rising, getting on all fours, firstly on one knee, then to his full height. The victim clings to the shoulders of a porter. Folded as a ring strap also needs to be adjusted for your height. The strap should be worn on the thumbs of one outstretched arm and the other, then to bent at the elbow at a right angle (Fig. 23).

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Figure 23.

Moving a victim with the help of straps:

а — adjustment of straps; b — putting on straps; c — the position of the strap and hand on the stretcher of front porter; d — the position of the strap and hand of back porter; e — moving by one porter; f — moving by two porters.

Adjusting the strap of the victim, put on the patient on healthy side, stretcher strap, folded in the form of end is adjusted so that one half of the strap was under the buttocks, and the other, passed under the armpit, on the back; the free end of the strap should lie on the ground. Thus, on each side of the patient there are loops, in which the carrier extends his hands and tightens the strap on his shoulders, putting the victim on back. Then gradually rises. The victim sits on the strap pressed to the carrier.

In the presence of 2 carriers, the victim can be moved using the shoulder strap, folded by eight. The strap is put on so that the intersection of belt is between them at the level of the hip joints, and the loop is through the right shoulder of first porter, and the other is over the left shoulder of the second porter. The carriers approach the victim from behind, turn face to face to each other and go down on one knee (the one goes down on the right knee, another one goes down on the left knee, lifting the victim, they put him on locked knees, then offer to take by mouth, underlay the strap under the buttocks of the victim and stand on their feet.

The transfer of the victim by one rescuer is carrying out on the shoulder, arms or back.

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Figure. 24.

Moving a victim by one porter:

a — on hands; b — on back; c — on shoulder.

For transportation for a short distance porter, kneeling on one knee at the side of the victim, picks him up by one hand under the buttocks, the other is under the blades; the victim grabs the neck of the porter. Porter rises and transports the victim. In this case, the part of load is transferred from the hands of the rescuer on his torso (Fig. 24 a).

For longer distances victim is moved on the back. The victim is sat on the height, porter goes down on one knee between his legs, by back to him, grabs the thigh of the victim, and the patient grabs porter for the upper part of the chest. Then the porter gets up and moves the victim (Fig. 24 b).

On the shoulder we transfer the unconscious victim in the absence of contraindications to such movement (Fig. 24 c).

The transfer of the victim by two rescuers on hands

Moving a victim by two porters is carried out in two ways:

1) One of the porters raises the upper part of the patient's torso, bends forearms at the elbows on his body and covers his forearms by "monkey grip", and the second, standing between the legs of victim and by back towards him, picks up his feet a little below the knee. Then both straighten and transfer the patient. At fracture of limbs and injuries of spine this method is not applicable (Fig. 25 a).

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а б в

Figure 46

Moving a victim by two porters:

а — the way “one by one”; b — "lock" of three hands;

c — "lock" of four hands.

2) One of the best ways of transportation is considered the "manual lock". This method is used when the casualty is conscious and can hold the neck of the rescuers. Porters can move directly supporting the victim by free hands (Fig. 25 b).

Transportation on the lock - seat of the two hands (Fig. 26).

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Figure 26.

"Manual lock":

1 - "lock" of the three hands; 2 - "lock" of four hands.

Most often ”lock” is done, combining four hands; for what each of porters captures by the right hand his left hand (at wrist), and captures by left - right hand of another porter (also at the wrist). If the victim has light weight or if he needs support during transportation we use “lock” of two hands (one hand of one porter and another arm of another porter) or of three hands (two hands of one porter and one hand of another porter).

Moving the patient from position "lying on side" to position of “sitting with bowed legs " (performed by one nurse)

Procedure:

· To stand in front of the patient: to bring the left hand under the shoulders, right hand is under knees, covering them from above. Bend your knees. Do not bend over!

· To raise the patient, putting his feet down and simultaneously turning him on the bed in a horizontal plane at an angle of 90°.

· Seat the patient, holding by one hand over his shoulder, and holding by other hand his body.

· Ensure that the patient is sitting steadily and surely. Put the focus for back.

· Put slippers on the patient, if his feet touch the floor, or put the bench under the feet, if they don't touch the floor (Fig. 27).

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Figure 27.

Moving the patient from position "lying on side" to position of "sitting with bowed legs"

Moving a patient from a bed to a chair by the method of "raising the shoulder" (performed by two people)

Procedure:

· Put a chair next to the bed

· Move the patient and sit him in a position with free hanging legs

· Stand on both sides of the patient by face to him

· Approach nearest hand to the patient under his thigh

· Support the patient's hips as close as possible to the buttocks

· Lean shoulders in the armpit of the patient, and the patient puts his hands on the backs of workers

· Use a free hand bent at the elbow, as a support, basing it on the bed behind the buttocks of the patient

· On the count of "3" straighten the knees and elbow, while nurses will not stand up straight.

· Move the patient to the chair, supporting his back with his free hand.

· Place the retaining hand on the armrest or seat of the chair.

· Lower the patient on a chair, bending the knees and elbow (Fig. 28).

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Figure 28

Moving a patient from a bed to a chair by the method of "raising the shoulder"

The method of “lifting by a shoulder in bed” (Australian lifting) (performed by two people)

· Procedure:

· Help the patient to sit: one nurse supports the patient, and the other puts a pillow to the head (or raises the head of the bed)

· Stand on both sides close to the bed facing each other

· The shoulders of the nurses are at the level of a patient's back, legs apart, back should be straight, legs are bent at the knees, leg, closest to the headboard, is deployed in the direction of motion

· Lean shoulder closer to the patient in the axilla and body of the patient. Wrist of this hand is brought under the hip of a patient. The patient puts his hands on the back of the sisters.

· Lean by one hand on the headboard (elbow is bent), the other hand is below the hips, take an assistant’s wrist (“double carpal capture”)

· Straighten the leg which is located at the feet of the patient, and shifting the weight of your body on the other leg which is located closer to the head, then lift the patient. Elbow, providing emphasis is unfold.

· Fully raise the patient above the bed, move him for a short distance and lower again to the bed, bending the leg which is located closer to the head and the hand, providing support

· Move the patient to the desired distance (Fig. 29).

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Figure 29

The method of “raising by shoulder” in bed

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