Okay, when I say routinely calling for lift assists, I'm not talking about picking someone up from a bathtub, navigating through a hoarding environment, getting someone over a motorized stair lift, or using a Reeves down winding stairs, wet/icy terrain, etc. I'm sure that everyone can come up with a few examples of difficult lifts to prove a point about requesting a lift assist. What I'm talking about is typically calling for anyone 200# or so that can't stand and pivot, that needs to be sheet transferred to the cot, or lifted up on a board or Reeves from the floor. I've been called to lift a 200# person from the bed to the stair chair, for example. We typically should not be asking for help to get someone 200# from the floor to a chair or cot, or from a bed to a chair or a cot, or to load that same cot into the ambulance. I've worked with people (not talking about females only) that have made it a habit to call frequently for each of these scenarios. I've had situations where we have a patient rapidly decompensating, interventions on board, that don't have the time to wait for another crew to help them get into the ambulance.
National EMS Education Standards, page 5, "Directions and Commands" 3 of 3 says this:
"Adults often weigh 120-220 lb. Two EMT's should be able to safely lift this weight. If patient weighs over 250 lb, use four rescuers. Place strongest EMT at the head":
https://code1.us/cow/10eppt/Chapter35.pdf
That sounds about in-line with typical hiring requirements of lifting 150# unassisted (basically a deadlift), and 250# with assistance. In the field, when lifting a patient off of the floor, the one at the head will have more weight, so with a 200# pt, the person at the head will be lifting as if it were a 250# patient with load even distributed between the two crew members. That's why I was being lenient and saying to not automatically call for any 200# patient that needs to be lifted, and not a 250# person.
You shouldn't need more than two people for a stair chair job in most cases for a 200# person. I've had real problems working with weak people when the chair is treadless or we can't use the treads for some reason (going up the stairs for example) - the weak person will insist on taking the bottom, and refuse to take the top lift. What then occurs is that the bottom person holds the handles with fully extended arms, which makes the top person have to lean forward, which puts tremendous pressure on the L-spine. I've maintained a 445# - 495# DL for the last 20 years, and I would've surely blown my back out in that scenario had I been any weaker. A strong person can grab the bottom handles, pull their elbows backwards and upwards to lift the chair as they carry, which lets the top person stay mostly upright, which is much easier on the back, and much safer. I've refused to work with certain partners that play those stair chair shenanigans, and who always have an excuse as to why I should load/unload the cot instead of them. Yes, I may be more capable, but it's reasonable to spread out lifting duties. The stronger person shouldn't be penalized for being more physically capable by being made to do the lion's share of the lifting. All of these lifts add up over time. Two person sheet transfers where I'm obviously doing 85% of the pulling is bad for the patient, and bad for me as well. This species of person that must take the bottom of the stair chair, never loads/unloads the cot, will also ensure that they're positioned at the cot, "lifting" the patient away from them towards the bed, letting their partner do most of the work. This oftentimes makes the transfer a 3 step process.
We all know a few of these people at every EMS job. Again, if you cannot lift a 200# patient with assistance under normal, uncomplicated circumstances, you need to reevaluate whether you belong in EMS from a physical standpoint. Being fit for duty in EMS is one part KSA's, one part physical preparedness, and one part psychological health. All three
must be present. Or, if you have little regard for your partners and your patients, and feel that you have a right to be on the job regardless, then do whatever.
