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Lifting and back problems...
Being based in the UK, we've got rid of our "lift and load" vehicles a few years ago, and now all of our buses have either hydrolic lifts or automatic ramps on them so we don't have to do any of the lifting into and out of the ambulance, howver i've noticed a lot of the North American vehicles seem to still use "rugged" type stretchers and other similar ones that still need to be lifted into the air before loading into your vehicle. Or am i just not seeing enough of any vehicles that might have alternative methods of getting the stretcher into the vehicle ?
I can speak from personal experience and also of of my services general experience, but back problems are quite common, and this moce to ramps and lifts has made a big diference... more so now that our average patient is getting larger.
Any input or comments anyone?
I can speak from personal experience and also of of my services general experience, but back problems are quite common, and this moce to ramps and lifts has made a big diference... more so now that our average patient is getting larger.
Any input or comments anyone?
Replies to This Discussion
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Permalink Reply by Justin Buck on
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we have a ambulance service close to us that us hydrolic lifts. it makes it alot easier for everybody
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Permalink Reply by Tony P on
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I'm fire, not ambulance, but I know that our ambulance service is very concerned about heavy lifts. They must be, the number of times we get turned out to assist them with a lift! I think they have a couple of special vehicles for the really heavy patients, but apart from that it's just the wheeled stretchers with the collapsable frames - get them at about the right height and shove.
Any Victorian Ambos reading that can confirm/correct what I've said?
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Permalink Reply by Joe Stoltz on
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A few of the area ambulance agencies have the newer powered stretchers, which save the backs of those trying to lift larger patients into the rig. We have been looking at them but they are rather pricey.
This solves one of the problems of patient handling. However, we still have to get the stretcher from the bus into the house; the patient from the couch/bed/floor onto the stretcher; and from inside the house (or wherever) to the back of the bus.
I've watched two or three person crews do this - moving stretchers up and down stairs, across driveways, yards, whatever - and I am amazed the back injury rate is not much higher. My department is unique in that we routinely get 6 or more members showing up at EMS calls, so there is generally plenty of help with patient and stretcher moving.
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Permalink Reply by Gareth on
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Sadly here in the City of Manchester (UK), we always respond on our own as a crew (Fire don't back us up or support us anymore). That means that there is only ever the two of us to do all the lifting, moving and carrying thats needed.
The stretchers we use are wheeled (with crappy little wheels like the ones at the local supermarket that go in any direction except the one you want them to go in) with a pump action hydrolic lift. As a rule, we don't take the cots into the address we're gonig in (unless it has the wide doors and no stairs), which means that most patients have to go on a carry chair (the ferno ones). Sadly, this still means we're going to be carrying them downstairs etc, but we can whell them straight into the ambulance with little fuss or strauin on the back. In the event that we do have a large patient we tend to call for a second crew to assist us. Sadly the fire service here now refuse point blank to come out to calls from us for assistance with lifts unless there is an immeadiate risk to life.
I had noticed that with most of the stretchers i've seen in use in the US and Canada they still have to be lifted (with the patient on them) to the level of the bus/rig. Doesn't look like fun... ours used to be like that but thankfully we've gone away from that sort of lift and as a result we have had a drastic drop in back related sickness.
Joe said that they seem a bit pricey ? dare I ask what an empty rig costs over there ? We buy ours in at around £105,000 per unit. ($208,00 USD). Obviously the equipment goes in on top of that cost...
Gareth
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Permalink Reply by kimmieflirts on
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Ive been working paid ems for almost six years and when i stated my company still had some 2 man stretchers not even 1 1/2 man stretchers, and since ive been doing ems Ive have only had the luxury of using a ramp when i was doing critical care transports for nicu incubators. Although there are some voli squads by me that have hydrolic stretchers but at least from the paid perspective its gonna be a long time until we even get those. Besides with those stretchers they have not worked out all the kinks out and one of the chiefs of a local squad who uses them said the batteries died to fast and it just adds so much wait to the stretcher.
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Our stretchers are hydrolic, but it's with a foot plate you pump under the stretcher... They actually work quite well and there are no batteries to break down on you etc...
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Permalink Reply by FETC on
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Gareth,
We have always had the stryker EMS manual lift cots in our 3 Fire Department based ALS ambulances. We had suffered a few back related workmens compensation injuries over the last couple of years. We initially worked with our provider and did training which did put us in a better situation from a training standpoint. We also run 3 personnel on the ambulance all the time regardless of the call coding. This has provided the ambulance crew with an officer and two attendants on every run to assist with patient handling.
We looked at studies and made some operational changes. First we never bring the cot into the house if we have to lift it more than 2 steps up. NEVER. The weight of the new 600 lbs rated cots plus the weight of the patient is just too much to carry without injuring the crew. We purchased the newer Stryker Stairchairs with 4 wheels and the tractor friction tracks to reduce carrying the load down any stairs. So all upright seated patients get the chair and any supine patients will get either the scoop or LBB per policy. Those carries may require additional manpower in the form of an engine company, but for the most part the 3 handle most of the calls in a single unit response.
We still suffered an additional injury with lifting the patient and cot into the ambulance. Manual lift / straight up with a single end loading operation to load or unload the patient into the ambulance. So we then purchased the new Stryker Electric / Hydraulic lift cot and have had great success (so far, knock on wood)
The cot weighs more than the other manual one, so more justification to leave it outside the house and not carry it upstairs, but the training aspect is required to reduce the chance of a back injury while loading the cot in and out of the bus. We now have a two person / single end lift while raising the wheels hydraulically to load and unload all patients.
BTW: The new hydraulic cots are a little pricey but the average comp claim in my state for a back injury is 60K per claim. And we have been told we are now the LOWEST claim per department in our state. They tell us we are also the only service in our state (municipal or private) that runs 3 on the bus for every call...
Training, proper form and body mechanics is key along with a common sense thought process to live a long and healthy career. Especially lifting heavies...
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Kimmie,
IF it is a stryker stretcher using a DeWalt battery, ask the chief if they have the vehicle mounted battery charger. I have seen that everytime the ambulance is started, the battery charger cycles on and off thus re-starts the battery charging cycle. The batteries will form a memory and they also have a certain number of charges total for the service life.
I would recommend that they place the battery charger unit in the ambulance bay on house power.
This will reduce unneccessary overcharging of the batteries. The stretchers have a red/green indicator light to display the battery's power level. I have also seen squads change the battery out at the start of each shift or the end of every run. This can dramtaically shorten the working time of the battery.
When the cot battery light displays RED, I have worked 5 or 6 additional calls with multiple lifts before the battery actually went dead. The cot can be still used manually when the battery is dead so running out of battery power should not be an issue.
Lastly, the comment about "wait" to the stretcher, are you talking about overall weight? If used properly with a newer thought on lifting and carrying the cot/patient, the weight is actually less per EMS attendant if you use two people to remove the cot from the ambulance when un-loading.
If it was for additional time to "wait" for the wheels to come down when unloading the cot from the ambulance, then they should be pulling the cot using the fastest method to lower the wheels.
That can be achieved by one of the two attenants pulling the manual drop red handle and alos pressing the "extend" button. The wheels will extend faster than dropping the wheels manually on the old stretcher without the load and jarring BANG we are used to.
We have the hydraulic cots and our backs just LOVE EM.
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Permalink Reply by Kimberly A Bownas on
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We still have to llift the patient into the ambulance in both my vollie squad and paid job.
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Permalink Reply by Dina Lynn on
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I work for American Ambulance in Fort Lauderdale Florida, and our company purchased the hydraulic stretchers. They are beneficial to help back injuries, but even without a patient on it, they are heavy. But I prefer them over the regular stretchers.
Dina
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Dina,
You are right, the cot weighs more than the older manual ones. But you have reduced your number of times of lifting the cot/patient dramatically. No more raising it up to get it to ambualnce height.
Focus on leaving the heavy cot outside the house and not carry it upstairs. We focused on training everybody on how to reduce the overall weight while loading the cot in and out of the bus. As you know, using two people to lift the end while the wheels hydraulically retract or extend is actually lighter than lifting the old cot by yourself while your partner raises the wheels manually.
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