This is a guest post by EMS Safety Expert Jim Love. If you want to guest post on this blog, check out the guidelines here.

I am typing this from my hotel in the Town of Tullamore in Ireland.  Yesterday I had the opportunity to visit an Irish ambulance builder and converter.  I saw things I have never seen before in over 35 years of EMS experience in the US.  Things like a Fiat ambulance.  How about a stick shift full-sized ambulance?  I can’t imagine driving a stick shift ambulance. One thing I saw, and I’ve seen in pictures from Europe, are patient loading ramps.

Powered loading ramps, hydraulic loading systems, and winch powered systems

It seems in Europe there is an aversion to EMTs and Medics doing much patient  lifting.  Imagine just rolling a stretcher onto a ramp, pushing a button and there you are able to roll the cot in and lock it down.  No muss, no fuss-no lifting.

In the US we look to powered cots to ease the burden we carry – to reduce the number of repeated heavy and sometimes awkward lifts.  There are plusses and minuses to these cots. One minus is the added weight we must lift when the cot needs to be carried and or lifted.  I look forward to the time when there is a powered solution that is light, quick and versatile.

Injury Prevention Tips

Until then there are some rules and Tips to follow to help prevent injury.

• Exercise: your job is not an exercise program
• Manage your weight: the heavier you are the more prone you are to musculoskeletal injury.
• Get plenty of rest:  fatigue is a sure-fire way to assure injury.
• Don’t smoke: smoking restricts blood flow, decrease oxygen and nutrient flow to muscles and other tissues.

Lifting Rules

• Know your limits
• Back straight
• Head up- eyes forward
• Knees bent- lift with your legs
• Tighten your abdominal muscles as you lift
• Communicate and time your lift with your partner

Jim Love began his EMS career in 1974. Jim was the National Director of Safety and Risk for AMR. Jim is currently enjoying consulting on EMS safety. He maintains an EMS Safety site and blog, Emsafety.net, and can be contacted at drjlove007@gmail.com.

Read related posts and tips:

1. Continuing Education Opportunity: Ambulance Safety Solutions Read the Ambulance Safety Solutions supplement from the October issue...
2. Video: Ambulance Safety Tips In this video, recorded at EMS World Expo 2010, Justin...
3. 3 Eye Safety Tips For EMS Providers Nearly 2000 eye injuries occur everyday in the United States....

Three of my favorite EMS sounds:

1. An infant patient crying.
2. My partner’s seatbelt clicking.
3. An unresponsive patient breathing.

What are your favorite EMS sounds?

Three of my least favorite EMS sounds:

1. Sirens.
2. I’ll find his/her nurse.
3. Flatulence as a patient is being lifted as it is rarely only a noise.

What are your least favorite EMS sounds?

Read related posts and tips:

1. Essential Elements of a Hand-Off Report EMS professionals deliver two reports for every patient – the...
2. Hot Summer Posts from Outside the Service Area July has been a hot one for me. First a...
3. Patient Pit Care Crew My son’s favorite part of watching auto racing is the...

A bullet point in the National Standard Curriculum section on patient lifting and moving suggested using a “Power Grip” when lifting the cot. I have never been totally clear on what was meant by the Power Grip so I asked my EMS contacts on Twitter for an explanation and photo. Paramedic, photographer and blogger Joel Neild (see more from Joel at his photography site) sent me these photos of an underhand and power grip.

Underhand Grip

Power Grip

Do you use the Power Grip? Is it more effective for you?

Read related posts and tips:

1. Alternate Posting Location: Green Circle Trail I had a short piece with photos published today at...
2. New York City Marathon: 1 Word Race Recap FINISHER!...
3. Marathon Running: 3 Lists of 3 Part 5 The food and fluids edition. Favorite Gu/Gel Flavors 1. Vanilla...

In central Wisconsin, the ice and snow season logically leads to an increase in the number of “elderly patient has fallen, possible broken hip” calls. When responding to patients with a suspected broken hip, remember these tips:

1. The patient is often already in a relative position of comfort. Wait to move the patient until you have a plan and resources to make the move. This will also minimize your risk of injury.

2. Geriatric patients have decreased thermoregulatory responses. The patient is likely conducting heat into a cold floor. Covering the patient does not stop the downward conductive heat loss. Move the patient on to a warm blanket(s) and/or padded backboard to minimize the heat loss.

3. If authorized, follow your local protocols to begin pharmacological pain management before moving the patient. If IV access is difficult due to the patient’s position on the ground or cramped quarters consider IM administration.

4. Minimize movement of the patient’s injured leg and hip by using available materials like pillows and draw sheets to buddy splint the patient’s legs together.

5. When it is time to move the patient, assign one person to focus on stabilizing the injured hip and not participate in the lift.

What do you do to minimize pain and improve comfort for a patient with an unstable hip injury from a fall?

Do you see an increase in fall during the winter?

How is your service involved in fall prevention programs?

Read related posts and tips:

1. Moving Patients I like to use a kitchen chair as an intermediary...
2. Tips for Rapidly Rising Number of Disabled Adult Patients A Centers of Disease Control and Prevention study shows that...
3. 5 Heat Injury Prevention Tips for EMTs The summer months mark a time of increased run volume...

A Centers of Disease Control and Prevention study shows that the number of American adults reporting a disability is rapidly increasing. 47.5 million adults report a disability – as shown in this graph.

As EMS providers you know the growing limitations of patients – inability to stand without support, not being able to walk short distances, or not being able to communicate medical history or present illness. And many patients have several of these disability causes.

Even if disability rates hold steady EMS providers will be challenged to safely and effectively interact with a large population of disabled adults. Is your service ready? Are you ready?

Apply these Everyday EMS Tips to be prepared for adult patients with disabilities.

1. Assume you will need to lift and carry the patient from their location (i.e. bedroom or living room) to the ambulance. Have alternative carrying devices and tools ready for the patient’s specific situation.

2. Maintain your physical fitness so you can assist patients with sitting, standing, or walking. As well as the inevitable lifting and carrying many patients will require.

3. Pain is a component of many of these disability types. Assess and manage every patient’s pain with non-pharmacological and pharmacological pain management tools.

4. Be prepared to rephrase or restate SAMPLE questions so patients can understand the question. Give patients time to respond to the question.

5. Acknowledge your patient’s disability while offering comfort and reassurance. Since we are all likely to live longer than the generation before ours we are all likely to encounter temporary or permanent disability. Treat the patient you will want to be treated.

Read related posts and tips:

1. 5 Tips for Moving Patients with a Hip Injury In central Wisconsin, the ice and snow season logically leads...
2. Quick Tip: Scald Burn Assessment in Geriatric Patients This statement in a recent CDC MMWR caught my eye,...
3. 6 Assessment Tips for Deaf and Hard of Hearing Patients How would you learn the SAMPLE history of a patient...

I like to use a kitchen chair as an intermediary resting place before moving non-injured patients from the floor back into a recliner, bed or patient cot.

Read the full Everyday EMS Tip at EMS1.com

Read related posts and tips:

1. 5 Tips for Moving Patients with a Hip Injury In central Wisconsin, the ice and snow season logically leads...
2. 6 Assessment Tips for Deaf and Hard of Hearing Patients How would you learn the SAMPLE history of a patient...
3. Patient Pit Care Crew My son’s favorite part of watching auto racing is the...