The Ideal Procedure For Moving An Injured Patient

The Ideal Procedure for Moving an Injured Patient

Moving an injured patient requires a delicate balance of speed, safety, and proper technique. Improper handling can exacerbate existing injuries, causing further pain and potentially long-term complications. This comprehensive guide details the ideal procedure, emphasizing patient safety and best practices for various injury scenarios and environments.

Assessing the Scene and the Patient

Before initiating any movement, thorough assessment is paramount. This involves:

1. Scene Safety:

• Identify potential hazards: This includes traffic, unstable structures, downed power lines, hazardous materials, and other environmental dangers. Secure the scene before approaching the patient.
• Ensure personal safety: Wear appropriate personal protective equipment (PPE) such as gloves, eye protection, and potentially a mask, depending on the situation.
• Consider the need for additional resources: If the situation is complex or the patient's injuries are severe, call for emergency medical services (EMS) immediately. Don't attempt to move the patient unless absolutely necessary.

2. Patient Assessment:

• ABCs: Check for airway, breathing, and circulation. Address any immediate life threats before moving the patient. This might involve opening the airway, administering CPR, or controlling bleeding.
• Level of consciousness: Assess the patient's responsiveness using the AVPU scale (Alert, Verbal, Pain, Unresponsive). This helps determine the urgency of the situation and the appropriate moving technique.
• Nature and extent of injuries: Identify visible injuries such as fractures, bleeding, or deformities. Consider potential hidden injuries based on the mechanism of injury.
• Spinal immobilization: If there's a suspicion of spinal injury (head trauma, significant mechanism of injury), prioritize spinal stabilization before any movement. This typically involves using a cervical collar and a backboard.
• Patient communication: If the patient is conscious and able to communicate, speak to them calmly and reassuringly. Obtain information about their medical history, allergies, and the events leading up to the injury.

Choosing the Right Moving Technique

The choice of moving technique depends heavily on the patient's condition, the nature of their injuries, and the available resources. Several methods exist, each with its own advantages and limitations.

1. Emergency Moves:

These are used when there's an immediate threat to the patient's life, such as a fire or an unstable environment. Speed is paramount, but safety should still be considered.

• One-person drag: Used for quickly moving a conscious or unconscious patient a short distance. This involves grasping the patient's clothing under the armpits and dragging them. Only use this for extremely short distances.
• Two-person drag: Two rescuers can perform a more controlled drag, minimizing the risk of further injury.
• Clothes drag: Grabbing the patient's clothing to pull them. Use caution to avoid any further injury or damage to clothing.

Important Note: Emergency moves should only be used as a last resort for immediate life-threatening situations. They can potentially cause further injury.

2. Non-Emergency Moves:

These are used when there's no immediate threat to life and the patient can be moved safely without causing further harm.

• Direct lift: This method is used for patients who are conscious and can assist with the movement. Two or more rescuers lift the patient simultaneously. This is appropriate for patients with minor injuries and sufficient strength. Requires good communication and synchronization between rescuers.
• Draw-sheet method: A sheet is placed under the patient, allowing for coordinated lifting and moving. This is a gentler method and helps to minimize strain on the patient and the rescuers. Good for patients who are unable to assist.
• Log roll: This is used for suspected spinal injuries. The patient is moved as a single unit, maintaining spinal alignment. Multiple rescuers are required and must work in a coordinated manner.
• Scoop stretcher: This stretcher allows for moving patients who are lying down from a prone position. It is particularly useful in confined spaces and when spinal immobilization is required.
• Stair chair: Used to move patients up or down stairs. It provides support and stability, particularly useful for those with lower-extremity injuries or decreased mobility.

3. Using Equipment:

Proper equipment can significantly improve safety and efficiency.

• Backboards (Spine Boards): Essential for suspected spinal injuries. Provides rigid support for the entire spine.
• Stretcher: A common device for transporting patients, offering a stable and comfortable surface. Various types of stretchers exist, designed for different patient needs and environments.
• Cervical collars: Used to immobilize the neck and prevent further spinal cord injury.
• Head blocks: Provide additional support for the head and neck during transportation.
• Vacuum mattresses: These conform to the patient's body, providing comfortable support and minimizing pressure points.

Post-Move Considerations

After moving the patient, continuous assessment and monitoring are crucial.

• Reassess ABCs: Check again for airway, breathing, and circulation.
• Monitor vital signs: Continuously monitor heart rate, respiratory rate, blood pressure, and oxygen saturation.
• Document actions: Record all actions taken, including the type of move used, the patient's response, and any changes in their condition.
• Hand-off report: Provide a clear and concise report to EMS or hospital staff upon arrival. This should include the patient's history, assessment findings, injuries, and interventions performed.

Specific Injury Considerations

Moving patients with specific injuries requires extra care and specialized techniques.

• Head injuries: Maintain spinal alignment at all times. Use a cervical collar and backboard. Minimize movement and avoid unnecessary manipulation.
• Fractures: Support the injured limb to prevent further damage and pain. Use splints or other immobilization devices when appropriate.
• Spinal injuries: Always suspect spinal injury in the case of significant trauma. Use log roll and backboard for transfer.
• Chest injuries: Support breathing and prevent further injury to the chest cavity. Handle with care to avoid exacerbating the injury.
• Abdominal injuries: Handle with care to minimize pressure on the abdomen. Avoid unnecessary jostling.
• Pelvic injuries: Stabilize the pelvis using appropriate devices to prevent further displacement or damage. Consider a pelvic binder.
• Burns: Protect the burn wound from further damage during transportation. Avoid rubbing or applying pressure to the burned areas.

Training and Teamwork

Safe and efficient patient movement relies heavily on proper training and teamwork. All personnel involved should receive adequate training in moving techniques, equipment usage, and emergency procedures. Effective communication and coordination between team members are crucial for a successful transfer. Regular practice and drills can enhance efficiency and reduce the risk of errors. Knowing limitations and seeking assistance when needed is also an essential aspect of safety.

Conclusion

Moving an injured patient is a complex procedure requiring careful assessment, appropriate technique, and a focus on patient safety. This guide provides a framework for best practices, emphasizing the importance of scene safety, proper assessment, choosing the correct moving method based on the patient's condition, utilizing appropriate equipment, and post-move monitoring. Remember, prioritizing patient safety and receiving proper training are paramount in minimizing risks and ensuring successful patient transfers. Always prioritize the safety of both the patient and the rescuers. If in doubt, call for professional medical assistance.