# unconscious patients and stairs



## leonardo pistachio (Apr 26, 2011)

I am looking for any suggestions on how to bring down that dreaded, 200+ pound unresponsive patient, down three flights of stairs. Unfortunately, our private service does not provide stair chairs. I am looking for a more efficient way to do so, because this whole backboard thing is getting old quick...


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## 18G (Apr 26, 2011)

Use a Reeves stretcher. It has six hand holds, semi-flexible, holds a lot of weight, and has straps incorporated into it to secure the patient. They are slightly easier to get around corners too. 

You wouldn't really put a 200lb unconscious on a stair chair even if your company did have them would you? lol.


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## leonardo pistachio (Apr 26, 2011)

My apologies, I really have no experience with a stair chair, so I do not know what would be contraindicated. I am just curious, as to how large urban services, take these patients down multiple flights of stairs. I suppose FD assistance and good 'ol sweat and tears is the norm?


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## MrBrown (Apr 26, 2011)

Scoop stretcher or Fire Service with stokes basket


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## Akulahawk (Apr 26, 2011)

Ready bed or a litter of some sort... with the patient WELL secured. Not to mention possibly calling the FD for manpower assistance.


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## DrParasite (Apr 26, 2011)

leonardo pistachio said:


> My apologies, I really have no experience with a stair chair, so I do not know what would be contraindicated. I am just curious, as to how large urban services, take these patients down multiple flights of stairs. I suppose FD assistance and good 'ol sweat and tears is the norm?


wasn't carrying devices covered in your EMT class???  stairchairs are usually required equipment (but apparently not in texas)

If you have a carry down an unconscious person, Reeves stretchers usually work the best  http://www.reevesems.com/Products/StretchersImobilization.aspx?ProductID=31

if you have a possibly spinal injury, Reeves sleeves work awesomely.  they are pricey, but awesome. http://www.reevesems.com/Products/StretchersImobilization.aspx?ProductID=39  my agency has one on every ambulance and one of our heavy rescue

200 lbs isn't two bad for 2 people, 275+ is def time to consider extra help.

you can use a backboard, if you secure the person well, but a Reeves stretcher works significantly better.


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## leonardo pistachio (Apr 26, 2011)

Yes of course it was covered, and it was refreshed in Paramedic school, no reason to be a smart***. Here in south Texas buildings sprawl outwards rather than upwards, so a stair chair would be an unnecessary luxury for us here as we rarely encounter a staircase. I was curious as to how some of you fellow EMS providers out there that routinely "extricate" patients from third or fourth floor walk- ups, do so without blowing out your back in the process.


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## JPINFV (Apr 26, 2011)

This comes down to anything that works. This would be a situation where a backboard would be useful, especially if there is plenty of room on the landings. If the stairs are a straight shot, consider using an extraction basket or backboard as a sled. Similarly, if need be, rest the backboard on the railing to help pivot it around the landing. The more is definitely the merrier, but more people does not always solve all problems.


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## BEorP (Apr 26, 2011)

Is it common in the United States to not have stair chairs on ambulances?


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## rescue99 (Apr 26, 2011)

leonardo pistachio said:


> I am looking for any suggestions on how to bring down that dreaded, 200+ pound unresponsive patient, down three flights of stairs. Unfortunately, our private service does not provide stair chairs. I am looking for a more efficient way to do so, because this whole backboard thing is getting old quick...



Pole stretchers...


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## rescue99 (Apr 26, 2011)

BEorP said:


> Is it common in the United States to not have stair chairs on ambulances?



Yes....easiest answer all day


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## mycrofft (Apr 26, 2011)

*Tempting to say "Elevator?".*

Lots of hands, and NOT on the full-on ambulance litter. Other than that, it's a matter of shopping for the device you want.


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## Sasha (Apr 26, 2011)

Firefighters.  At least that's what I do when the patient is too heavy for us to negotiate them (for me it's usually up stairs) or down a long narrow hallway.


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## Cawolf86 (Apr 26, 2011)

I vote for a break-away flat or just carrying them with the Engine.


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## abckidsmom (Apr 26, 2011)

And without a reeve's stretcher or a stair chair, there's always the good old 2-person carry.  I've been surprised a couple of times recently that my partners were not familiar with how to reach under the patient's arms, grab their wrists and hold them to their chests while the other partner gets the legs.

Quick, easy and works without extra equipment.  Several breaks would be involved with 3 flights of stairs, though.


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## Archymomma (Apr 26, 2011)

Call for fire assist. 

Unconscious pt's we generally use a backboard. We have moved a pt downstairs on one with just the two of us (medic and myself) but they were smaller people and it was a straight/easy stairway. For anything else we call for fire assist.


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## skivail (Apr 26, 2011)

Our service also has the Ferno Rescue Aid.  Basically a big strong tarp with handles.


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## BedpanCommando (Apr 26, 2011)

That’s what Firemen are for.  That and opponents for HALO


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## NomadicMedic (Apr 26, 2011)

As everyone else has said, there are a ton of options.

Scoop Stretcher (or "clamshell") 






MegaMover (the "whale tarp")





The Reeves





The Reeves Sleeve





Backboard Wheels





Breakaway flat





...or the good ol' fashioned Chair carry.





Frankly, moving an unconscious 200 pounder on a backboard seems like the right choice to me. After all, how many times a month are you lugging an unconscious patinet down three flights of stairs?

However, if your service won't supply you with the right tools to do your job, you need to start making some noise.


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## medicsb (Apr 26, 2011)

Ask your employers to compare the cost to stock all ambulances with stair-chairs versus the cost of one lawsuit from an employee injured while moving a patient down stairs without the proper equipment.


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## DesertMedic66 (Apr 26, 2011)

A flat or a mega mover. Fire responds to all EMS calls here so no need to call for a lift assist.


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## leonardo pistachio (Apr 27, 2011)

thank you everyone for the input and answers, i am seeking a job in NYC, and am just trying to learn as much as i can about the way "ya'll" do things


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## DesertMedic66 (Apr 27, 2011)

leonardo pistachio said:


> thank you everyone for the input and answers, i am seeking a job in NYC, and am just trying to learn as much as i can about the way "ya'll" do things



That makes sence why you were asking about stairs lol.


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## small-town-EMT (Apr 27, 2011)

Can anyone tell me why lift assist is always there when you dont need them but never availible for the 500 pounder??


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## DesertMedic66 (Apr 27, 2011)

small-town-EMT said:


> Can anyone tell me why lift assist is always there when you dont need them but never availible for the 500 pounder??



All depends on your area. Fire responds to all EMS calls so if we need an assist they are already there. And if we don't need an assist then we cancel them.


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## small-town-EMT (Apr 27, 2011)

unfortuantaely we dont always have that luxery with being on a volunteer dept we cant always get a full engine crew, i mean its a great day if we get 3 to a squad


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## DrParasite (Apr 27, 2011)

small-town-EMT said:


> Can anyone tell me why lift assist is always there when you dont need them but never availible for the 500 pounder??


a lift assist is ALWAYS available, you just have to be patient.  call the FD, if they are not available, request a mutual aid company.  Call another EMS unit to assist, if you can't get a second crew, request a mutual aid crew.  as the cops if they can send 3 or 4 guys over to assist.

you might have to be patient, but it isn't worth hurting yourself over it.


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## DesertMedic66 (Apr 27, 2011)

DrParasite said:


> a lift assist is ALWAYS available, you just have to be patient.  call the FD, if they are not available, request a mutual aid company.  Call another EMS unit to assist, if you can't get a second crew, request a mutual aid crew.  as the cops if they can send 3 or 4 guys over to assist.
> 
> you might have to be patient, but it isn't worth hurting yourself over it.



+1. There are alot of different people that you can use to help. If you need to move the person bad enough and no mutual aid is there get some civilians to help.


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