# What would you do?



## MMiz (Jul 21, 2004)

Dispatched to a private residence for a non-emergent call.  Have a 200 lb pt up a flight of stairs.

A.  How do you get the patient down the stairs?

- We decide to use the stair-chair, lifting is not my partner's strong point.

B. Your partner can't lift the stair chair.  Pt vitals are getting worse.  What do you do?  There is *no* option for a lift-assist, this area is a ways away from your company's area.

- We call dispatch for assistance.  The city has no police, and FD isn't exactly a tight department.  The city has suffered during the recent economic problems, and PD is now handled by the county.  The FD is there, but really only do emergency calls.

C.  What do you do?

- FD arrives after 45 minutes, one FF helps me get the pt down the stairs with the stair chair.  We transport.

D.  Are you angry with your partner?  This partner almost always has difficulties lifting almost all patients.  


My Response:  I was pissed.  I even got angry on scene after she couldn't get in contact with dispatch.  I go down to the truck, call dispatch, and have no problems.  I'm frustrated, this is not the first time this happened.  Shouldn't there be some expectation for those in EMS that you can lift a patient?

Others have complained about her to the higher-ups, but I wont.  I'm frustrated.


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## ffemt8978 (Jul 21, 2004)

Our stair chairs have tracks on them for going up or down stairs with a patient.  Basically, you use it like a two-wheel hand cart.  I'll see if I can get the info on them and post a link.

As far as your partner goes, something needs to be done.  It's not only unfair to whoever they work with, but it can be dangerous for a patient.

First of all, I would talk to her about her lifting and find out why she has difficulty lifting.  Is it something that she can go to the gym to work on, is it improper technique, or does she just not want to do it?  If it's something that can be fixed, by all means, fix it.  Otherwise, you need to get her out of the field.

I realize that everybody is not the same, and not everybody works out, but I think that if you are in EMS, you should at least be able to provide assistance to your partner when dealing with the average-sized adult patient.  There should be no reason that a two-person EMS team can not carry/lift a 200 lb. patient.

And if all else fails, improvise.  Maybe you could put the patient on a backboard and tie some rope to it so that you can slide them down the stairs.


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## MMiz (Jul 21, 2004)

Good advice.

First, our stair chair is the Stryker STAIR-PRO® Model 6250 .  It has wheels on it, but once we got to the stairs she was lost.

Last week we had a 400 LB patient that she had taken the week before.  The week before she pulled the stretcher wheel release, and couldn't handle the patient.  The patient began a "quick descent to a lower level."  

We then got called back the next week to transfer her again.  It was the exact same situation again.  Let me give you an example:

ATF 400+lb pt on hospital cot.  Pt is stable.

What does she do?  She says "I can't do it" and starts to give me a hard time.  She makes a big deal out of it.  I say "Stop, you need to tell me what part you are unable to handle."  She says she can't lift the patient.  I tell her that we don't have to lift the patient, we can raise the hospital bed to our cot's level, and have the pt slide over.  She rolls her eyes and says "Fine, but I'm not lifting".  This person gives a huge attitude when she feels her skills aren't up to par.

We move her without problem.  I do all the lifting in/out of the ambulance, she does the wheels.  Afterwards I was killing to crack my back, but otherwise I was fine.

In this most recent situation with the 200 lb guy, neither of us thought to use the backboard until we got to the hospital and were in the EMT room doing the paperwork.

I'm by far the most supportive guy you'll ever meet.  I avoid the drama of work, and people like me for it.  I didn't give her a hard time about her lifting today, I told her instead I was angry for something else.

This is going to sound selfish, but I'm scared that her inability to lift will lead to my getting injured.  I really feel as though I need to say something, but I'm not sure how.  She's a very small and larger person, with very short arms.  She just isn't built for EMS.

/ End Vent.


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## ffemt8978 (Jul 21, 2004)

Thanks for posting the link, because we use the Stair Pro Model 6252.



> *What does she do? She says "I can't do it" and starts to give me a hard time. She makes a big deal out of it. I say "Stop, you need to tell me what part you are unable to handle." She says she can't lift the patient. I tell her that we don't have to lift the patient, we can raise the hospital bed to our cot's level, and have the pt slide over. She rolls her eyes and says "Fine, but I'm not lifting". This person gives a huge attitude when she feels her skills aren't up to par*



IMO, this is the scary part of this.  She can't do it AND gives you a hard time about it?  :angry:   What other parts of her job can't she do that she is going to blame you for?  If she's that willing to give up on lifting a patient, what else will she give up on because she "can't do it"?  Assisting ventilations with a BVM?  Chest compressions?  Manual traction or C-spine immobilization?

You will be injured because of her unless this situation is corrected.  THIS IS JUST A MATTER OF TIME.  You can only lift so much without hurting yourself or your patient.



> *This is going to sound selfish, but I'm scared that her inability to lift will lead to my getting injured. I really feel as though I need to say something, but I'm not sure how. She's a very small and larger person, with very short arms. She just isn't built for EMS.*



I would probably speak to a supervisor about this.  I wouldn't present it as a complaint about her job performance, but rather a request for assistance in figuring out what the problem is and how it can be corrected.  Maybe something along the lines of "tricks of the trade" they learned for lifting patients.

Okay, I'm done with this topic for now so that some others can post their thoughts about the subject.


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## SafetyPro2 (Jul 21, 2004)

Does your company have a pre-employmeny physical evaluation? I know several companies in this area, including AMR, require a series of lifting tests before they'll hire an EMT or Medic. I went through a similar test when joining the FD. Might be something to suggest...doesn't necessarily help with this individual, but might help in the future.

Your absolutely right in that if your partner can't handle her part of a lift, it could very easily lead to you getting hurt. Strength's part of it, but it's technique as well. It's nothing sexist...I got a talking to from my Captain about how I carried a gurney down stairs back when I first started and have improved my technique since then.

If it continues to be an issue, I wouldn't hesitate to talk to a supervisor. After all, if you're aware of an unsafe situation, you need to take action to correct it.


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## TKO (Jul 21, 2004)

> *D. Are you angry with your partner? This partner almost always has difficulties lifting almost all patients. *



I think I would be a little ticked off expecially since this happens alot for you. Being that this pt is 200lbs that should not really be a problem for a 2 person crew to carry down a flight of stairs on a stair chair. 



> *I realize that everybody is not the same, and not everybody works out, but I think that if you are in EMS, you should at least be able to provide assistance to your partner when dealing with the average-sized adult patient. There should be no reason that a two-person EMS team can not carry/lift a 200 lb. patient.*




My past experience with lifting is also quite difficult. I am vertically challenged (5'0) so raising a stretcher to the full height is a challenge with hefty pts and usually I am on my tippy toes. But still being petite I have lifted pts with my partner up to 350+lbs on our stretcher. I know there really is no way for me to get over my height challenge but to make things easier for me I usually lift the foot end which controls the wheels and grip on the lowest bar so I can lift higher. My partners are usually very understanding with this.

I agree with ffemt's statement on talking to a supervisor. You had mentioned you don't want to complain but really in the end someone is bound to get hurt . You by doing "too much" of the lifting to compensate for you partners strength. Your partner by perhaps lifting wrong. Or your pt by getting dropped or something bad like that.

I totally agree with pre-employment fitness tests. Going through several highering processes in the past each one had a evaluation which was same for male and female. Some of them were pretty hard. I would say this one was the hardest one since it included heart rate , endurance and strength. I made it to the very last step in which I had to carry the 125lb weighted barbell backwards up the flight of stairs . By that time I had already carried it upforward, downforwards and downbackwards. My muscles were so fatigued I couldnt even get a good grip and didnt make it. http://www.mdambulance.com/company/kineticmain.htm

Check out this link and I would actually like to know what you all think about this test? What would you change , like and dislike?


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## rescuecpt (Jul 21, 2004)

> _Originally posted by MMiz_@Jul 20 2004, 11:46 PM
> * This is going to sound selfish, but I'm scared that her inability to lift will lead to my getting injured. *


 It's not selfish at all.  I have a broken back thanks to someone who couldn't carry a stair chair.  I've been fighting with the Fire Dept's insurance company for almost 9 months now so that I can have an operation to fuse my L-5 back together.  There is a 9 millimeter movement between the two pieces of bone when I move.

I am not supposed to lift, because if something goes wrong the broken bone will rub against my nerves and even worse, could rub against my spinal cord.  The crews that I ride with all know this - it is the first thing I tell them if they don't already know.  We have the luxury of usually having more than 2 people on a crew (usually 3), and PD also shows up 9 times out of 10, so they help out a lot.  I can carry equipment and in a pinch I can lift and carry a patient - but I'd rather not push it if I don't have to.

I do a good job treating my patients and it would be a shame to hurt myself worse and not be able to continue treating them.

*Take it from someone who knows, DONT TAKE CHANCES - Tell her she needs to beef it up or request a new partner.*

You could also offer to practice with her when you're not on calls - load all the equipment on the stretcher and work on lifting and lowering... although she sounds like she might not be very receptive to that.  Good luck.


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## PArescueEMT (Nov 12, 2004)

PA has a requirement that in order to keep your cert, you have to be able to lift a minimum of 150 lbs on your own. 99% of the people I work with (myself included) can't do this fom a normal standing position. but that may be something you want to look into. I understand that it may not be something you want to resort to, but she may hurt a Pt. or worse, YOU!!!


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## DonQ (Nov 13, 2004)

Wow, I just can't imagine having to lift one person on my own down a flight of stairs.  I'd be angry too!


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## lindsayn2 (Dec 8, 2004)

Did she not have to take a physical agility test before she was hired.  At our service that is a must.  And is that one of the key functions in her job description???  EMS is not a profession that you can come to work and expect not to mess your hair up and break a nail, you have to be able to take whatever is thrown at you, given it is a reasonable task.


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## Margaritaville (Dec 8, 2004)

MMiz,

How about just taking those large patients and throwing them down the steps. Problem solved and you get a few extra skills out of it.  OK. Just kidding, but you know you all have thought of it at least once!!

On a serious note. This provider has issues. There are certain requirements in our job, and lifting is one of them. Over the years with the different kinds of stretchers and stair chairs I have found that practicing with them helps me to be more comfortable. It also reassures my partner that I am doing this for him, as well as myself and the patient.  

I would strongly suggest that you document the various incidents where lifting has been an issue, and when you finally get a belly full - you have some documentation to back you up when you speak to the supervisor. I am sure you have done it, but ask her if there is a reason she won't lift or can't. Maybe she is scared. Another good resource for her is to talk to a physical therapist. Mine taught me how to lift with my legs to save me from a back injury. They usually have some good advise.

Now most important - MMiz - protect yourself. Do not hurt yourself. You need your job too. Remember, it is not natural for a person to lift 400 pounds of anything on thier own. 20 years from now, your back, shoulders, and knees will remember what you have done.

Take care and be safe my friend! B)


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## MMiz (Dec 10, 2004)

Great points everyone!

It hasn't been an issue since I originally posted, so we'll see


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## Luno (Dec 12, 2004)

Yeah, margaritaville, 





> *Remember, it is not natural for a person to lift 400 pounds of anything on thier own.*


 Hehehe, you need to come and work out with me  B)  Just kidding, for most people it is an unreasonable request, but some people do it for fun, hmmmm does that make us unnatural?   :huh:   Yes, a rhetorical question, just playing with ya.  Oh, wait, I just looked at your profile, hmmm paramedic, well where I'm from they don't lift at all (usually including the lifepak and drug box, well sometimes the drug box).


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## rescuecpt (Dec 12, 2004)

> _Originally posted by Luno_@Dec 12 2004, 05:58 PM
> *Oh, wait, I just looked at your profile, hmmm paramedic, well where I'm from they don't lift at all (usually including the lifepak and drug box, well sometimes the drug box). *


Yeah, Luno... since I've been ALS I don't do much of anything except ECG's, tubes, IV's, and meds.    Unless I have a small crew, then I have to try to remember what it was like before I became a goddess....  wait, I um, I uh... didn't mean that.  Yeah.... that's it...

Matt - I'm glad to hear things have gotten better for you!


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## ffemt8978 (Dec 13, 2004)

> _Originally posted by rescuecpt+Dec 12 2004, 04:14 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (rescuecpt @ Dec 12 2004, 04:14 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-Luno_@Dec 12 2004, 05:58 PM
> *Oh, wait, I just looked at your profile, hmmm paramedic, well where I'm from they don't lift at all (usually including the lifepak and drug box, well sometimes the drug box). *


Yeah, Luno... since I've been ALS I don't do much of anything except ECG's, tubes, IV's, and meds.    Unless I have a small crew, then I have to try to remember what it was like before I became a goddess....  wait, I um, I uh... didn't mean that.  Yeah.... that's it...

Matt - I'm glad to hear things have gotten better for you! [/b][/quote]
 I thought that's what ALS stood for - Ain't Lifting S***!

Of course, we all know that BLS stands for Be Lifting S***.


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## Margaritaville (Dec 13, 2004)

OK kids question for ya,

Where do you all work that you don't lift? In my dep. we are all FF/Paramedics. If there is a fire call, you are either engineer or interior and if it is an EMS call there are only two of us - we carry everything (drug box, O2 bag, lifepack 12, stretcher) and the patient. 

Some of the residences in our area have very small spiral staircases that a patient cannot be brought down all 4 flights safely - so we can call for a Tower if needed. But that is pretty rare. The rest of the time we are on our own.

BTW Luno, I would love to work out with you! I know I couldn't match you - but I'd try to give you a run for your money! LOL.

ffemt8978 - that acronym is hilarious!

rescuecpt - goddess is GOOD!!! Personnally I am reffered to as "Princess". Can't post why though.

Be safe ya'll.


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## rescuecpt (Dec 13, 2004)

My crew at the ambulance corps normally has 4 people.  Two drivers (both EMTs), myself (ALS), and a probie.  Once our probie gets certified, we'll be able to run two full crews, one ALS, one BLS.  (If by full you figure 2 people is our minimum to run a call).

But for right now, we run with all four of us if needed, usually 3 of us, once we're settled one driver goes back to base incase we get toned out for another call.  Because my crew knows about my back, they always reach to lift before I'm anywhere near it.  I'm not saying I don't lift - I just don't lift if I don't have to.  And the young cops we have in our area seem to LOVE to show off their muscles to this starstruck little blonde girl...   

At the fire department I actually resigned from interior duties as of the end of this year.  It's not fair to me and it's not fair to my brothers to count on my back to be able to do things that I'm not sure it can.  I haven't actually done any interior work for most of the year.  One day when my back is better (if the FD's insurance company ever pays for my surgery), I'll get back into it.  I am (was) the only female FF in my department.  On ambulance calls - we roll the ambulance and then the rescue truck full of rough, tough, helping FF hands.


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## PArescueEMT (Dec 13, 2004)

> _Originally posted by ffemt8978_@Dec 13 2004, 01:05 AM
> * I thought that's what ALS stood for - Ain't Lifting S***!
> 
> Of course, we all know that BLS stands for Be Lifting S***.
> ...


 ya know... I thought BLS stood for Basic Lifting Service.


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## TTLWHKR (Dec 14, 2004)

Well, your safety is number one.

Would you ruin your career to get someone down a flight of stairs?

Don't you have a reeves? You could slide the patient down.

You know what happens when you lift more than you can handle safely, even if you do lift properly?

Herniated discs, abdominal hernias...

I have three herniated discs, L4, L5, S1. We had to lift a patient, there was no alternative. Now I can't lift at all, and they can't operate to fix the problem. Even if they could, they define it as a high risk surgery and even the top neuro and ortho surgeons in the State of Pa & Ny have turned me down.

It's not worth it, if you can't lift, don't. It's not your fault the patient is obese, don't be the one to pay for that persons lifetime of mistakes. I know 200lbs is not obese, I was just making a point. 

But if you like to sit around all day, not able to stand up w/ out severe pain; then all the power to ya!


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## Luno (Dec 18, 2004)

Margaritaville, okay, well, drop me a line if you're going to be in seattle, we'll work out, then drink  :blink: .  Seriously, I'm not on the rigs anymore, having just left to pursue a different career path, but the medics are King County Medic One.  Good people, mostly.

Rescue, rescue, rescue, when will you stop using the cops for your lifting, you know they're not bright enough to see what you're doing..........  But in all seriousness, I've been known to help a cute winking blond EMT myself.   <_<  That doesn't make it right though.      And goddess?  Someone's let that paragod t-shirt go to her head.  

But on a different note, you should always lift properly, no matter how much you "can lift" or work out, or are a Paraninja, etc... Because accidents do happen, and you don't want it to happen to you.  Weightlifting just gives you a little bit more of a buffer zone, but doesn't prevent them.  It can ruin a career.
Luke


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