# Lifting fat people - I'm not pulling with "all my might"????



## AnonymousEMT

Hi all, I have a very irritating scenario here involving lifting in general. This has happened to me on a few occasions... mainly one where it was just myself and another emt, a female, we had to lift a fat patient off the hospital bed and onto our stretcher. So we got everything aligned, set up, and ready to move the patient. I was on the side of the stretcher, she was on the side of the patient bed. She told me to pull with "all my might" to my side (the stretcher side), I didn't feel confident that I could take all that weight so I didn't think "all my might" would make a friggin difference, I told her maybe we should call for an extra person a nurse or someone, she was like no we can do it. And so we pulled, the patient ended up right in between the bed and stretcher, mind you the bed and stretcher were still close together, but if either were to move she would have fell on the floor in between.

My main point is what the heck is "all my might" consist of? Perhaps everyone has their own lifting prefs., just because you have a EMT certificate, that you gives you super powers to lift any patient of any size regardless of the proper lifting technique? To anyone here who agrees to this, are you really kidding me?

There have been quite a few instances that were similar to this one... actually one involving a patient heavy but not fat like the one mentioned above. We were transferring a patient from the stretcher onto the new bed at destination - I was on the bed side, partner was on stretcher side, the bed was a bit wide as usual so it was more of a stretch for me to pull no matter what the heck i did. The nurse in the room had the nerve to say "I think you need more spinach" and laughed, I'll show her some spinach with a good knock in the face!

Mind you, I'm not a skinny muscleless dude like Shia Lebouf nor am I a diesel built dude like Arnold Schwarzenegger or Sly stallone, I'm more like in between ala Nicholas Cage, guys like that. My point is why the **** do people think just because you are an emt you can lift anyone without any obstacles?


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## Scout

I've always been a fan of telling them move themslefs, if they dont, then its a sliding/lifting device or help.

Always easer to tell someone beep off then have a bad back. I would question a nurse if she told you lift someone on your own, thats just plain not on, and rather than giving smart remarks to get their @$$ over and help.

sounds like a great partner you got there, def a keeper


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## KEVD18

it took me two lifting related injuries on the job before i got smart. now, i never, not once, not ever lift more weight than i am comfortably able and required to lift. anything more than that and we get a second truck, facility staff, an engine company etc etc. i dont risk my livelyhood and personal health for my companies schedule or any one single patient anymore.


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## Sasha

Thats stupid. I always ask a nurse or tech for help if I dont feel comfortable lifting the weight, sometimes they get an attitude, but I remind them they can keep their patient for an extra hour while we wait for a lift assist to come out if they would prefer. Usually works, especially at shift change when they want to go home.

Although as a female, she may be trying to prove herself that she is capable with out asking for help. A lot of people discount females as weak to begin with, especially when they ask for help lifting and moving patients. Ive heard it more than once.


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## firecoins

If I feel I need another person, I get one. My partner may think we can do it but if I doubt it, we get someone.  

We always move the patient in 2 moves.  We move the patient to the edge of the hospital stetcher, Than we do the actual move on to our stretcher.


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## akflightmedic

Agree with above posters.

You are in a hospital with all the help you need at the touch of a button. We have even used janitorial staff before for some rather large patients.

Most facilities have a "slide board" as well. Ask for it, use it, save your back.

All it takes is one time of using "all your might" to cause you to sit at home popping percocets and scheduling surgeries while watching reruns of Emergency and Third Watch.

Be smart, if there is even the slightest doubt in your mind that this is going to be a awkward or difficult transfer, GET ASSISTANCE.

For those of you who do not know me personally, I am a big guy as in tall and fit. I have no issue calling for help, even if my partner is male. I have had fire crews show up and say "What you called us for that lift, they are small". I just smile and say I needed help. No need to take a beating over it, but knowing that you saved your back is priceless.


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## JPINFV

I'm sorry, I refuse to ask permission of my partner to get additional help. If I feel we need help, we're getting help. This is not up for discussion. This is not up for debate. This is not up for my partner's approval. I have only 1 back. Only one, and I don't get a new one. I'll be damned if I'm going to donate that one back to EMS. 


Now a few things. First off, most facilities have a plastic slide board. 







They look like flimsy long back boards. The point is to reduce friction while bridging the gap between the two beds. 

Second, if at all possible, a non-ambulatory patient gets moved by draw sheet. Now if I have to put a draw sheet under a patient, then so be it. If at a facility and the patient is in a wheel chair, then I'll "borrow" (heck, the SNF will get a new sheet at the next discharge. Blankets are essentially the same as the "take a penny, leave a penny" jar at the 7/11 (NO, not the cripple children's jar)) a sheet so that at least I can draw sheet at the destination. 

Third, the vast majority of people don't draw sheet correctly. The person on the side opposite of the gurney in general should not be pushing. They should be maintaining tension in the sheet so that the patient is lifted, even slightly, off the bed. Lift=less friction=less work. In general, pushing does add much to the move.


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## WuLabsWuTecH

Agree with the comment of moving twice, once to the side and once to the cot.

I am a tall asian guy which translates into smaller than average american guy.  I have no issue asking for lift assistance when I need it.  Its not anything to be ashamed of.  I don't lift weights daily and I know my limits.  I have never had any problems with people giving me grief about requesting extra help though some nurses won't want to lift.  That's fine, but would you please be able to find me a nurse who doesn't mind doing a bit of work?  Thanks dearie!


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## reaper

To moves and more help. Really simple!






akflightmedic said:


> All it takes is one time of using "all your might" to cause you to sit at home popping percocets and scheduling surgeries while watching reruns of Emergency and Third Watch.



You just described my dream vacation!!


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## Ridryder911

Unfortunately our society is beginning to get bigger and bigger, its a fact of life. As other posts describe use of adjunct equipment is great, yet good knowledge of proper lifting techniques is the best tool. Injury prevention by using such techniques cannot be overstressed. 

One should be able to lift at least >150 pounds to the waist level. Even the NHTSA describes it in the national job description. 

R/r 911


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## mycrofft

*All good points. Mycrofft has to do it sideways as usual.*

Old beds had removable footboards. Swivel the bed to allow the litter to roll the head end up to the foot fo the bed, remove footboard; drawsheet or get a slider under the pt then slide them off the end onto the litter while someone holds the litter in place.
Nowadays...if you can prop the foot of the mattress up into a ramp to/over the footboard of the bed, try that stunt again.
However, loses some benefit if the litter can't be run right up against the bed, but it does eliminate reaching over the bed. Think ahead, and if you need help, remember that sacrolilliac pull a couple years ago, or old football injury?....


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## Outbac1

In addition to all the above suggestions you can usually use gravity to your advantage. The stretcher or bed the pt is going to can almost always be a couple of inches lower than the patient. That way gravity can be on your side.


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## Guardian

AnonymousEMT said:


> Mind you, I'm not a skinny muscleless dude like Shia Lebouf nor am I a diesel built dude like Arnold Schwarzenegger or Sly stallone, I'm more like in between ala Nicholas Cage, guys like that. My point is why the **** do people think just because you are an emt you can lift anyone without any obstacles?




Chuck Norris is short and getting older, what would he do?


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## mycrofft

*He'd call AMR*

He's not stupid!


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## ride2k

I would deffinately have called for a nurse or someone else to help. You don't want to hurt yourself or the patient. 
Was the patient able to reposition herself? What happened?


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## SmokeyBear

I *ALWAYS* ask for help with an morbidly obese patient, even if it means waiting for a lift assist. _*I don't care what my partner says. *_:blush::blush: Better that than ending up with "2" patients.  Dispatch may have the weight ahead of time so you can call for back up if its an emergency. If its an ER--call for a lift assist ahead and try to get family members to help. If there are no family members and the patient is TOO heavy call the fire department, dispatch--anyone that can help you lift. BUT DON'T TRY IT ALONE if you know you will hurt yourself.

I know I may catch flack for this but, Im going to say it anyway--*It's hard in our field to admit weight limitations*.h34r: It is especially hard for women because they are at CONSTANT scrutiny (whether we want to admit it or not) about whether or not they can "lift." So you may often get women who try to "prove" themselves by doing things that are just not possible (men do this as well). But, I cant tell you how many EMT's and Paramedics that I personally know who have ignored their limitations and ended up really hurt. The last guy I know injured out his back, left knee AND shoulder. *He has ENDED HIS CAREER. *You tell your partner "NO"--its that simple and ask for help. I would also recommend a "back brace" for obese patients.  Better that than ending up injured or sued.

/PS also unless its a "shut in" many morbidly obese can "scoot" on their own onto the stretcher (most of these guys are already in bed) but *will not do it* unless pushed. Why? Its LITERALLY too much effort for them (especially if they are pushing over 400) but MAKE them. Seriously.
//some may even be able to ambulate with help--ASK them. Because trust me they* wont do it otherwise.*
///use Gravity to your advantage--place the stretcher slightly lower than where these guys are seated (the couch or bed)
///slide boards do wonders--if your agency doesnt have one I would spend the extra cash and declare it on your taxes--better that than a broken back


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## Hal9000

I'm a small guy.  I can lift a lot more than people think and my coworkers appreciate that fact.  However, there are people that I can't lift.  Those people will stay where they are until more help comes.  I won't hurt myself or the patient if it can be avoided, and that's in any situation, of course. 

Oh, and I recently heard some new wankers talking about how they could lift so much, and the veterans were letting them take the lifting because they were the only ones strong enough...I laughed out loud.  I wish I had people like that every time I got a call.  I'd rarely do any lifting.


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## fortsmithman

I have no problem whatsoever in calling for assistance.  Also as the town ambulance service coordinator says heavy patients is what the fire fighters are for.


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## SmokeyBear

AnonymousEMT said:


> My point is why the **** do people think just because you are an emt you can lift anyone without any obstacles?




I've wondered that for years. Seriously.


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## BossyCow

This is such a hugely subjective topic. Like pain, we are all highly individualized in what we feel we can comfortably handle. I've done a lot of lifting in my checkered careers and was taught good ergonomics and body mechanics early. So I am pretty comfortable in lifting most pts, safely for both me and them. But there are always those times when the pt is in an odd position and you have to really think about your plan, almost like an extrication. 

The danger I most encounter has been when lifting as a team and one person either drops or slips and the weight shifts to the rest of us. I would ask that if you don't feel comfortable lifting a particular pt or at the placement on the backboard, gurney, sheet during a transfer to a bed.. speak up early instead of waiting until halfway through the lift to announce that its too much for you.


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## Medic9

Good grief! Always always always get help with the Biggins! If they are stable and you can stay and play while you wait for help then do it! I wish I could describe a couple of calls I had with the same patient but I am from a small community and I don't dare risk it. 
Slider boards are great in the hospital or nursing home setting, so are Hoyer lifts. I will never ever risk my back again. 

24/7 has a lesson plan for bariatric patients. I am thinking about getting it and doing that class for the agency I work for.


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## KEVD18

Medic9 said:


> Good grief! Always always always get help with the Biggins! If they are stable and you can stay and play while you wait for help then do it! I wish I could describe a couple of calls I had with the same patient but I am from a small community and I don't dare risk it.
> Slider boards are great in the hospital or nursing home setting, so are Hoyer lifts. I will never ever risk my back again.
> 
> 24/7 has a lesson plan for bariatric patients. I am thinking about getting it and doing that class for the agency I work for.




a proper bariatric program involves much more than a class. you need a bariatric stretcher, ramps, winch, the whole shooting match. proper body mechanics only takes you so far.


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## medicdan

One of the ERs/hospitals in Boston just instituted a bariatric team-- not only bariatric beds, and slide boards but specially trained staff and support. Ambulance crews now need to call ahead to "mobilize" the team when bringing in a bariatric patient. 
From what I understand, more and more hospitals are forming these teams-- the number of workers comp claims has shot up recently-- and there have been patients hurt from these poor moves. 
OP, pulling "with all your might" is only one piece of the puzzle... you also need the tools and training to make the move successful. 
As well, if you are having trouble with the sheet carry try moving to the "push" side not the "pull side" until you feel comfortable with it. 

Good Luck!

Dan


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## Medic9

KEVD18 said:


> a proper bariatric program involves much more than a class. you need a bariatric stretcher, ramps, winch, the whole shooting match. proper body mechanics only takes you so far.



I have talked about getting a bariatric rig for the county, having it centrally located and for any departments use. The problem is funding and training. So if we start with the classroom training and get some eyes to open and see the need maybe we can move forward with all the other stuff.


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## johnrsemt

Using a garbage bag (clean); or a plastic laundry bag;  tucked under the patient's draw sheet helps tremendously in reducing friction if there is no slide board available.  But still GET HELP!!!


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## rhan101277

Well when I get my certification, I hope to have super-powers myself. :glare:


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