Which set of instructions would you give to a new EMT who is preparing to use a squat lift?

Wheeled Stretcher: Two basic types of stretchers are used: the two-person and the one-person. The two-person requires two EMTs to lift and load in the ambulance, whereas, the one-person stretcher has special loading wheels at the head that allows one EMT to load it into the ambulance. Stretchers are usually adjustable to different heights and different angles. Some can be adjusted to elevate the legs (Trendelenberg position). Additional equipment may be attached to the stretchers including oxygen, IV lines, and cardiac monitors or defibrillators.

Guidelines for Moving Stretchers

Stretchers should be handled by two EMTs with both hands on the stretcher. Other personnel or bystanders may be asked to help carry additional equipment if necessary.
Never leave the patient alone on the stretcher.
Load the stretcher with the foot end first or going upstairs.
Position one EMT at the foot and one EMT at the head of the stretcher when rolling it. The EMT at the foot should pull while the EMT at the head should push.
Always maintain a firm grip on the stretcher when rolling to prevent a tipover.
Lower the stretcher and carry end to end if the ground is to rough to roll the stretcher safely.
Use four EMTs, one at each corner, when moving a stretcher across extremely rough terrain.
Turn corners slowly and squarely, avoiding sideways movements that might make the patient dizzy.
Lift the stretcher over rugs, grates, door jams, and other such obstacles on the ground or floor.
Keep the patient secured with belts at all times while on stretcher even if the stretcher is not being moved.

Loading the Ambulance

Place the head end of the two-person stretcher close to the bumper of the ambulance, and make certain it is locked at its lowest level.
The EMTs stand on opposite sides of the stretcher, bend at the knees while keeping their backs straight, and grasp the lowest bar of the stretcher.
Hands are positioned at each end of the lowest bar with both palms facing up.
On signal, both EMTs stand and move toward the rear of the ambulance until the front wheels rest on the floor at the back of the ambulance.
Roll the stretcher forward and guide it into the front of the stretcher catch. Then the foot end of the stretcher is locked into place.
NOTE: Load hanging and portable stretchers before the wheeled stretcher. Obstetrics patients may be loaded feet first so that it is easier to manage an impending delivery. Make sure that all patients and stretchers are secure before moving the ambulance.

Unloading the Ambulance

Unlock the latch at the foot end of the stretcher catch and pull the stretcher until the rear wheels are at the lowest end of the floor.
Grasp the lowest bar on each side of the stretcher with palms facing upwards as it is rolled out.
Once the head end of the stretcher is clear of the ambulance, keep the stretcher level and lower it to the ground by bending at the knees while keeping the back straight. The stretcher may then be raised by triggering the appropriate release handle.
Alternative. Once the head end of the stretcher is level and clear of the ambulance, the driver's side EMT may trigger the handle release and allow the base of the stretcher to slide down the legs of the EMTs. This method avoids the extra lift from the ground but requires the use of the main stretcher bar for lifting and simultaneous release of the handle.
Portable stretchers, or "folding stretchers" weigh 8-15 pounds and can carry a patient up to 350 pounds. They are more easy to use when carrying patients down stairs, down hill, or over rough terrain. It can be suspended from the ceiling with special brackets, placed on the floor, or secured to the squad bench.

Stair Chair

These are designed for patients that can sit up while being carried. They are useful for taking patients up or down stairs, or through narrow passageways. The patient must be transferred to the stretcher once back at the ambulance.

The extremity lift is used to place the patient in the stair chair. All belts and straps must be secured before moving patient. The patients wrists may be loosely tied to prevent grabbing onto fixtures and causing loss of balancewhen moving them. The chair is tilted slightly backwards to allow movement with the wheels on the chair.

Long Backboard

There are several styles of backboards:

Ohio is coffin-shaped to fit easily into a basket stretcher or helicopter.
Farrington is rectangular with rounded corners.
Aluminum are usually foldable but they can be uncomfortable in cold weather and prevent x-rays from being taken.
Miller is made of molded plastic and is strong and buoyant.
Vacuum molds to the patient once they are positioned in it.

The importance of a backboard is in spinal immobilization and moving the patient, especially during rapid extrication, and providing secondary support when using a short spineboard.

Short Backboard

This is used when a spinal injury is suspected and the patient is in a seated position. They made be made from wood, aluminum, or plastic. A vest type is also used when a patient is found inside a small car or place. It wraps around the patient and has all the straps attached or enclosed.

Scoop (Orthopedic) Stretcher

This is designed to easily lift supine patients. The stretcher is made of a rectangular aluminum tube with V-shaped lifts to "scoop" patients from the floor or ground without changing their position. Its greatest advantage is that it can be used in confined spaces where other stretchers cannot fit.

The scoop may be used to initially lift the patient with a suspected spine injury. The patient should then be placed immediately on a long backboard for immobilization. If no spine injury is suspected, the scoop can then be placed with patient onto the stretcher for transport.

The following steps are used with the scoop stretcher:

Adjust the length of the scoop stretcher on the ground beside the patient to accommodate the patient.
Separate the stretcher halves and place one half on each side of the patient. Do not lift equipment over patient.
Slightly lift the clothing on one side of the patient while another EMT slides one half of the scoop under the patient's side. Repeat on the other side. If a spine injury is suspected, another EMT must maintain cervical spine support at all times.
Lock the head end of the scoop in place, then bring the foot end together until the assembly is locked. If any resistance is met, have an EMT gently lift one side of the patient. This move prevents the patient's clothing from being caught or their skin from being pinched.
Attach the padded head strap. Use at least three straps to secure the patient to the scoop stretcher before lifting.

Flexible Stretcher

Do not use the flexible, or "pole" stretcher if spine injury is suspected. It is designed for the following uses:

limited access space
on stairs or around cramped corners
when other equipment is not available

Patient Positioning

EMTs should consider not only the best equipment to use but the position of the patient. The following general rules apply:

Unresponsive patients without suspected spine injury should be placed in the recovery position on their left side.
Patients with chest pain or difficulty breathing should NOT be walked to the ambulance.
Patients with suspected spine injury should be fully immobilized on a long backboard.
Patients with signs and symptoms of shock should have their legs elevated 8-12 inches.
Place the pregnant patient with hypotension on her left side.
Load the pregnant patient whose delivery is imminent feet first into the ambulance to allow for more room to work.
An infant's own car seat should be used if possible. It can be secured to the stretcher with the straps. It can also serve as an immobilization device with padding and taping.
Patients with head injury and no suspected spine injury should be transported in a semi-sitting position at about a 45 degree angle. This reduces pressure inside the skull and risk for increased bleeding.
Trauma patients with multiple injuries should always be transported on the long backboard to provide full body immobilization.
Use discretion when moving and positioning a disabled patient. Increased communication is necessary with visually or hearing impaired patients. Take extra care when securing patients with physical deformities. Use pillows, rolled towels, or other supports and padding to create a more comfortable position.
Elderly patients should be placed in a position that will be as comfortable as possible for their condition. Extra time and care with patients with conditions such as arthritis, osteoporosis, or other conditions is important to reduce risk of further injuries.

When lifting or moving any patient, the EMT must remember to primarily use the muscles of his or her:A) arms. B) back. C) legs.

D) hips.

You are caring for a young male patient who has overdosed on an unknown medication and has a decreased level of consciousness. When positioning the patient on the stretcher, what instructions will you give to the Emergency Medical Responders?A) "He will need to be positioned flat on his back when on the stretcher."B) "When you put him on the stretcher, elevate his head and chest."C) "Place him in a supine position and then carefully elevate his feet."

D) "When you move him to the stretcher, put him on his left side."

You are moving a critically injured patient to a helicopter for rapid transport to a trauma center. The rotors are spinning so that the aircraft can immediately take off. As team leader, what instruction would you provide?A) "Let's get many people around the backboard so we can safely load him into the aircraft."B) "I need someone to hold the IV bag in the air while we load so he continues to get IV fluids."C) "Will someone please securely cover the patient's eyes so that they are not struck with flying dirt?"

D) "Will someone please lay the O2 tank on the patient's legs so he continues to get oxygen as we load?"

C) "Will someone please securely cover the patient's eyes so that they are not struck with flying dirt?"

After immobilizing an elderly female patient who fell in her bathroom, you prepare to carry her down a flight of stairs on a backboard. Which of the following instructions would be most appropriate to give to your partner?A) "Make sure to hold the board 6 inches from your body so that you get maximum stabilization."B) "It is best if we do not talk so that we can concentrate on safely moving her down the stairs."C) "Why don't I take the head and then we can carry her down the stairs feet first."

D) "Let's have the patient hold onto the stair railing to prevent the board from getting off balance."

C) "Why don't I take the head and then we can carry her down the stairs feet first."

A patient has developed chest pain while working in his wood shop. After assessing and providing care to the patient, the chest pain remains, although his vital signs are normal. To get him to the ambulance, the EMTs must first go up a short flight of stairs from the basement to the first floor, where the front door is located. Which one of the following would be the safest for both the patient and crew?A) The patient carefully walks up the stairs under the watchful assistance of the EMTs.B) The patient is carried up the stairs on the stair chair feet first.C) The stronger of the EMTs takes the head of the portable stretcher.

D) The two EMTs grasp the sides of the portable stretcher and move the patient up the stairs.

C) The stronger of the EMTs takes the head of the portable stretcher.

Which one of the following instructions would you give to a new EMT who is preparing to use a squat lift to raise a patient secured to a stretcher?A) "Make sure to place your weaker leg slightly back."B) "Try not to use a power grip when performing the squat lift."C) "Support yourself with your stronger leg and push up with your weaker one."

D) "Make sure that you push yourself up with your stronger leg."

You are correctly using the blanket drag to move a patient when you:A) secure the patient in a blanket and drag him headfirst toward you.B) place the patient in the blanket in a prone position and drag him toward you.C) secure the patient in a supine position and drag him feet first along the ground.

D) place the patient in a blanket and drag him by grasping his forearms.

A) secure the patient in a blanket and drag him headfirst toward you.

Which one of the following positions would be most appropriate for an alert and oriented patient complaining of shortness of breath?A) Side lying B) Supine with feet elevated C) Prone

D) Position of comfort

You are trying to convince the equipment committee to purchase a hydraulic power stretcher. When discussing advantages over a more traditional stretcher, what would you emphasize?A) It is much lighter, more durable, and easier to maneuver. B) It enables one EMT to safely move the stretcher, freeing another for patient care.C) It is considered much safer for transporting a child car seat

D) It will be easier to lift and lower when it is loaded with a patient.

You have been called to assist a pediatric physician, a pediatric nurse, and a respiratory therapist in the transfer of a 2-week-old baby who is very sick. The baby is to be transferred in an isolette to a large metropolitan teaching hospital in a nearby city, where specialized care can be provided. The isolette is secured to the stretcher, and the stretcher is loaded into the ambulance. The physician, nurse, and respiratory therapist will provide all patient care. Prior to departing the hospital, it is essential that you:A) mix and prepare the medications needed for transport. B) make sure the stretcher is secured in the ambulance. C) disinfect the outside of the isolette.

D) advise the family of the baby's critical condition.

B) make sure the stretcher is secured in the ambulance.

You and your partner are preparing to move a trauma patient down a flight of stairs using a portable stretcher. As you begin the move, a third EMT shows up and asks to help. Which one of the following instructions would be most appropriate to ensure a safe move for both the patient and crew?A) "Come up and help me with the head end, since most of the weight is here."B) "Stand behind us at the top of the stairs and let us know if you see any obstacles."C) "Please stand behind the EMT at the foot end and count steps for her."

D) "You can help by grasping the right side of the stretcher to keep it balanced."

C) "Please stand behind the EMT at the foot end and count steps for her."

A large female patient has fallen in a parking lot between two cars. She must be moved on the backboard to the waiting stretcher which is located approximately 200 feet from your location. Four rescuers are present. How would they best be used to promote the safest movement of the patient?A) Two at the head, two at the feet, with all rescuers using their right hand to carry the backboardB) One at the head, one at the feet, and the other two on opposite sides on the backboardC) One at the head, two at the feet, and the fourth to act as a spotter during the move

D) The strongest person at the head, and the other three at the foot end

B) One at the head, one at the feet, and the other two on opposite sides on the backboard

Which of the following would be considered an appropriate position for transport?A) An alert 67-year-old female with nausea in a sitting position B) A critically injured 18-month-old in a car seat C) A 23-year-old pregnant woman in a supine position

D) A hypotensive 48-year-old male in a position of comfort

A) An alert 67-year-old female with nausea in a sitting position

When reaching to perform a logroll, the EMT must:A) keep his back flexed. B) reach no more than 30 inches. C) lean from the waist.

D) use his shoulder muscles.

Your coworkers would like to purchase a scoop (orthopedic) stretcher with some grant money. Before the purchase can be authorized, you have been asked to inform the purchasing committee of how this piece of equipment will benefit the service as well as enhance patient care. Your response would be:A) "The scoop stretcher does not require straps to secure the patient."B) "The scoop stretcher is much more comfortable than a wheeled stretcher."C) "The scoop stretcher is good for moving patients from confined areas."

D) "The scoop stretcher is considered the best device for patients with a possible spinal injury."

C) "The scoop stretcher is good for moving patients from confined areas."

When you must push an object, it is important to:A) keep your elbows straight and locked. B) push with your arms away from your body. C) push using muscles between your waist and shoulders.

D) push from an overhead position.

C) push using muscles between your waist and shoulders.

You and two other EMTs are preparing to move a patient down several flights of stairs using a stair chair. After assigning one rescuer to hold the chair at the head and another to hold the chair at the foot facing the patient, you should:A) assist the EMT at the patient's head. B) "spot" by standing behind the EMT at the feet.C) direct movement from behind the EMT at the head.

D) assist the EMT at the patient's feet.

B) "spot" by standing behind the EMT at the feet.

An elderly patient is being taken care of at home by family members and lies in a hospital-type bed in the living room. After providing necessary care, you prepare to move her from the bed to the stretcher. There is no mechanism that suggests a head, neck, or spinal injury. Which one of the following methods would be most appropriate in this situation?A) Direct lift B) Direct carry method C) Extremity lift

D) Draw sheet method

When transferring a patient from a bed to a wheeled stretcher, an EMT uses proper body mechanics when he or she:A) transfers the patient to the stretcher all at once, not in stages.B) keeps his arms locked and the patient away from his body during the transfer.C) aligns his shoulder, hips, and feet when moving the patient.

D) primarily uses the muscles of his back to move the patient.

C) aligns his shoulder, hips, and feet when moving the patient.

To improve your physical fitness and decrease the risk of injury when lifting and moving patients, you should combine proper body mechanics with:A) proper nutrition. B) vitamin supplements. C) caffeine substitutes.

D) protein drinks.

Which observation demonstrates that the EMTs and EMRs are correctly using the stair chair?A) The stair chair is carried down the stairs with the chair tilted forward.B) The patient is carried down the stairs feet first. C) The wheels of the stair chair touch each and every step.

D) The stair chair slides down the stairs while tilted forward.

B) The patient is carried down the stairs feet first.

A small car and tanker truck loaded with gasoline have collided. The car is lodged under the tanker, from which gasoline is leaking from a ruptured valve. The car engine is smoking and the threat of fire and explosion is great. Assessment reveals your patient to be unresponsive with a patent airway, but breathing with difficulty at 8 times a minute. In caring for this patient, your immediate action should be to:A) immediately start positive pressure ventilation and place a vest immobilization device for extrication.B) promptly open the airway and suction prior to moving the patient.C) rapidly extricate the patient and provide care away from the wreckage.

D) quickly obtain vital signs and then extricate the patient from the car.

C) rapidly extricate the patient and provide care away from the wreckage.

When an EMT places his palm and all fingers in contact with the object being lifted, he is using the:A) power grip. B) squat grip. C) lock grip.

D power lift.

You have been charged with writing a policy regarding reaching for equipment. In that policy, you indicate that the maximum distance an EMT should reach is no more than:A) 10 to 12 inches in front of her body. B) one arm's length in front of her body. C) 30 inches while bending at the waist.

D) 15 to 20 inches in front of her body.

When carrying equipment in the right hand, the EMT would:A) bend backward for counter balance. B) keep his or her back straight and locked. C) lean to the left side for compensation.

D) tilt his body to the right side.

B) keep his or her back straight and locked.

Which of the following statements accurately describes the concept of body mechanics?A) "Body mechanics describes the personal maintenance of a proper weight and posture so that on-the-job injuries are minimized."B) "Body mechanics refers to methods that promote using your body in the safest and most efficient way when moving objects or patients."C) "Body mechanics describes a program of back exercises that decreases the chance of incurring a back injury when moving a patient."

D) "Body mechanics refers to an exercise program designed to increase strength and prevent injuries when lifting or moving patients."

B) "Body mechanics refers to methods that promote using your body in the safest and most efficient way when moving objects or patients."

The EMT recognizes that an advantage of using the wheeled stretcher is that it:A) cannot become unbalanced. B) can be adjusted to different positions. C) can be safely moved by one EMT.

D) rolls smoothly over rough terrain.

B) can be adjusted to different positions.

The EMT would perform an urgent move when the:A) patient is suffering from an immediate threat to life. B)patient is stable but suffering from pain. C)patient exhibits no problems with the airway, breathing, or circulation.

D)scene contains an immediate threat to the patient and EMT.

A) patient is suffering from an immediate threat to life.

A patient involved in a motor vehicle collision has critical injuries and must be immediately removed from the car for lifesaving care and transport to the hospital. Prior to removing the patient from the vehicle, which one of the following must be done?A) Application of a vest-type immobilization device B) Completion of the primary assessment and vital signs C) Application of a cervical-spine immobilization collar

D) Completion of the primary and secondary exams

C) Application of a cervical-spine immobilization collar

A patient must be removed immediately from a structure that is on the verge of collapse following an explosion. He is lying on the ground and dressed in shorts and a T-shirt. You are by yourself and have no other supplies or equipment. What type of move would be most appropriate in this situation?A) The armpit-forearm drag B) The shirt drag C) The blanket drag

D) The extremity lift

A) The armpit-forearm drag

A patient has fallen in his upstairs bathroom and is lying on the floor. Assessment indicates no life threats to the airway, breathing, or circulation; however, he does have pain, deformity, and bruising to his right hip. In this situation, the EMT should recognize the need for what type of move?A) Urgent B) Aggressive C) Emergency

D) Non-urgent

When lifting the stretcher with a patient secured to it, the EMT must avoid which of the following?A) Contracting the abdominal muscles B) Bending at the waist C) Maintaining a straight back

D) Lifting with the thigh muscles

In preparing the schedule, you have been instructed to pair EMTs in a way that decreases the chance of injury when lifting and moving patients. Given this directive, who would make the best partner for a tall and very strong EMT?A) A short and weaker EMT B) A tall and very strong EMT C) A short and very strong EMT

D) A tall and weaker EMT

B) A tall and very strong EMT

Kyphosis is best described as:A) a pronounced lateral curvature of the thoracic spine. B) the exaggerated curvature of the lumbar spine. C) an exaggerated forward curvature of the thoracic spine.

D) a distinct lateral curvature of the cervical spine.

C) an exaggerated forward curvature of the thoracic spine.

A large patient has been placed on the stretcher, and you and your partner are preparing to raise the stretcher using the power lift. Which one of the following observations of your partner would cause you to stop the lift in order to correct his technique?A) Both feet are turned slightly outward. B) Both feet are flat on the ground. C) His feet are positioned closely together.

D) His hands are approximately 10 inches apart.

C) His feet are positioned closely together.

An obese patient cannot ambulate and must be carried down several flights of stairs. The patient exceeds your physical capabilities; however, your partner is very strong and physically fit. Which of the following statements, made by you, indicates the best means to safely lift and move the patient as well as minimize your opportunity of suffering an injury?A) "When we move him, let's go slowly down the stairs."B) "We will have to call for assistance to get him from his house."C) "To be safe, let's move him quickly and at one time down the stairs."

D) "As long as I lean backward when moving him, we will be okay."

B) "We will have to call for assistance to get him from his house."

You have been asked to present a continuing education session on body mechanics and posture. In your presentation, you would advise the participants that proper posture is achieved when your:A) ears, shoulders, and hips are vertically aligned when standing.B) body weight is evenly distributed over the thoracic spine when sitting.C) abdomen and buttocks are positioned slightly to the posterior when standing.

D) ears, shoulders, and feet are vertically aligned when sitting.

A) ears, shoulders, and hips are vertically aligned when standing.