How do you get the patients into the ambulance?

[Shishkabob]

First you have to support the weight while the landing gear retracts.

Have to do that with the non-power Strykers, too.

Second, in the field, they can't go to chair mode so pivitoting someone is out of the question.

If they can sit, put them on a stair chair out to the stretcher. If they can't sit, they don't need to be put in chair mode in the first place.

Third, when all the way down, they are still about 6-9 inches off the ground so someone on the ground still needs to be lifted that high.

Going to have to lift them anyhow, whether the stretcher goes flat to the ground or not.

And 4th, when you are in rough terrain, you gotta pick up the cot, and with all of that gear on it it adds at elast 75 lbs if not more.

Doing a year of rural EMS with power stretchers, that really was never an issue. If the terrain was rough enough to preclude strether, we had backboards. Otherwise, you roll it and go with the bumps.

What about a device similar to the Hovermat, but it inflates to a higher level allowing you to slide the patient to the gurney, similar to a bed. (Or airbed)

Oh, it seems they have this already: http://www.hovermatt.com/hoverJack

My agency has a couple matts / jacks, I've used the matt once and it really does make it much easier to move the fat people around like they actually weighed 500 less pounds. The jacks apparently work pretty well too.

 

[Ramis46]

I know there are alot of people that love the power cots, we personally don't have one at our service. What i have heard about them is that people like them. I can't get on board with that, it adds 40-80 extra pounds to your cot. Now for inter-facility transports that is OK, your not doing any of the lifting, so moving in to the ambulance would be great, However, anyone who is/has worked in the field knows that pts are getting heavier, and they don't all move very good when we need to go get them. so now you are having to use a Stair Chair to get them to your cot. That means your moving your Pt 2-3 times, thats not ergonomical. (this is just my opinion on the power cots).

 

[Tigger]

This...
plus the added consideration that anything mechanical can fail, and will always do so at the most inopportune time.

Does my back count as mechanical? Cause that can fail at any time too...

I know there are alot of people that love the power cots, we personally don't have one at our service. What i have heard about them is that people like them. I can't get on board with that, it adds 40-80 extra pounds to your cot. Now for inter-facility transports that is OK, your not doing any of the lifting, so moving in to the ambulance would be great, However, anyone who is/has worked in the field knows that pts are getting heavier, and they don't all move very good when we need to go get them. so now you are having to use a Stair Chair to get them to your cot. That means your moving your Pt 2-3 times, thats not ergonomical. (this is just my opinion on the power cots).

I don't understand how the type of cot affects whether or not the patient gets stairchaired to the cot. The stair chair gets used if the cot would have to be lifted anywhere, regardless of how heavy the cot is (or is not). I have a manual stretcher now and I still refuse to carry it up more than two steps unless I absolutely must.

I dislike the stryker power cots. They are good for IFT, but in the field, they are more trouble than they are worth. First you have to support the weight while the landing gear retracts. Second, in the field, they can't go to chair mode so pivitoting someone is out of the question. Third, when all the way down, they are still about 6-9 inches off the ground so someone on the ground still needs to be lifted that high. And 4th, when you are in rough terrain, you gotta pick up the cot, and with all of that gear on it it adds at elast 75 lbs if not more.

I don't get this whole "power cots work fine for IFT but now 'in the field'" thing. It's not like IFT patients levitate onto the stretcher, they go on the same way as "the streets." My manual stretcher doesn't have the chair feature, it doesn't lower to 0" inches of the ground, and is still heavy as hell to carry over anything significant. The cot is not the only patient transfer device, pick the most effective one.

 

[usalsfyre]

Spent 6 years using power cots for 911 and simply can't say I ever saw the issues described here (yes, I know n=1). This was both the rural and urban setting. The extra weight is offset by the ability to double lift into the truck, and you really shouldn't be carrying your stretcher up and down stairs anyway.

 

[ffemt8978]

Does my back count as mechanical? Cause that can fail at any time too...

Yep, it does and it can. That's why it's important to get as much lifting assistance as you need.

I don't understand how the type of cot affects whether or not the patient gets stairchaired to the cot. The stair chair gets used if the cot would have to be lifted anywhere, regardless of how heavy the cot is (or is not). I have a manual stretcher now and I still refuse to carry it up more than two steps unless I absolutely must.

I don't get this whole "power cots work fine for IFT but now 'in the field'" thing. It's not like IFT patients levitate onto the stretcher, they go on the same way as "the streets."

Except you don't find many of your IFT patients wedged between the toilet and the bathtub, or laying out in the middle of a field.

My manual stretcher doesn't have the chair feature, it doesn't lower to 0" inches of the ground, and is still heavy as hell to carry over anything significant. The cot is not the only patient transfer device, pick the most effective one.

Words to live by there.

 

[Tigger]

Except you don't find many of your IFT patients wedged between the toilet and the bathtub, or laying out in the middle of a field.

Very true, but I (and I hope others, for the sake of their body's) have no intention of carrying a cot of any variety out into a field or bringing it into a bathroom.

 

[Handsome Robb]

What's this fast drop you speak of?

Press the + while also grabbing the manual release it drops the gear faster but the hydraulics still somewhat control it so they don't just slam down into place. Then release the manual handle then the plus button. If you release them in the wrong order the gear won't lock into place.

Mess around with it with an empty gurney before you try it with a pt, I won't be the one responsible for you dropping a pt or hurting yourself

 

[Handsome Robb]

Spent 6 years using power cots for 911 and simply can't say I ever saw the issues described here (yes, I know n=1). This was both the rural and urban setting. The extra weight is offset by the ability to double lift into the truck, and you really shouldn't be carrying your stretcher up and down stairs anyway.

Agreed, so make it n=2 :rofl:

 

[Handsome Robb]

Except you don't find many of your IFT patients wedged between the toilet and the bathtub, or laying out in the middle of a field.

True but in either of those situations it doesn't matter if you have a manual or a power cot, you won't be able to get either close to the patient.

 

[DesertMedic66]

Press the + while also grabbing the manual release it drops the gear faster but the hydraulics still somewhat control it so they don't just slam down into place. Then release the manual handle then the plus button. If you release them in the wrong order the gear won't lock into place.

Mess around with it with an empty gurney before you try it with a pt, I won't be the one responsible for you dropping a pt or hurting yourself

I've tried that before and it doesn't seem to lower the wheels any faster. The thing that it does do is it allows the gurney to be at the right height to unlock it from the safety bar.

 

[Ramis46]

I don't understand how the type of cot affects whether or not the patient gets stairchaired to the cot. The stair chair gets used if the cot would have to be lifted anywhere, regardless of how heavy the cot is (or is not). I have a manual stretcher now and I still refuse to carry it up more than two steps unless I absolutely must.

At our service we take the cot as close to the Pt as possible. We stair chair when we have too. Think about it like this; Using the cot to lift a Pt is the safest lift you will have (Handles, a partner, good lifting technique). So if you get the cot close you can you can (if you have to) lift/move your pt to the cot. Once on the cot you will wheel the pt to the ambulance. That being said if there are multiple steps, then use the Stairchair. Now with only using the stairchair, you need to lift the Pt on to the chair (hopefully the will be able to stand on to it for you but we all know most people, and for the most part we muscle them around). Now either you or your partner will be bending over adjusting the chair as you go to get around cornor, trying not to break all the nic-nac's in peoples homes. Then you are at the stairs which now the stair chair is great. Then Once again we are going to lift/move the pt on to the cot, and usually this lift is a fireman's lift or something along those lines. Now they are on the cot and can be moved to the ambulance.

All I'm saying is, is that I prefer the non power cot with no extra weight becuase at our service we utilize the cot more.

 

[bw2529]

We are lucky enough to have both the newer style stair chair (with tracks) and a power stretcher. I've done the stretcher down stairs and it is not fun, would much prefer using the stair chair when possible. Obviously it won't be in all cases. If we have to backboard or scoop stretcher and carry someone for any significant distance I'm probably going to call for a lift assist from the VFD.

 

[mycrofft]

SO many great wisecracks to this thread's title!......


I was "pre-powered" era. In fact, our litters had a catch release on the passenger's left side as well as at the foot, and not at the head.

So..."Brute force"?

 

[Sasha]

Yep, it does and it can. That's why it's important to get as much lifting assistance as you need.



Except you don't find many of your IFT patients wedged between the toilet and the bathtub, or laying out in the middle of a field.


Words to live by there.

And for the rare times you do find them between the toilet and wall, you let the SNF staff get them out per their fall protocol.

We have power stretchers. I have never had a problem with them. Even when we had the fernos they never went all the way to the ground, there was still a few inches. You still have to support the weight with the manuals but with the power ones you can two point it.

I stand and pivot patients every shift with no problem. Even the biggens.

The main problem with the power ones is if your battery dies and your employers are too retarded to give the trucks a charger and make them charge at the station. They are a bee then, especially fighting the hydraulics lifting the wheels.

I find those who don't like the power stretchers are ones who don't like anything new

 

[Sasha]

We also have hover mats for bari calls. I don't like them simply because my employer seems to think they take the place of a lift assist on a bari call. Our bari stretcher is manual and the real problem is getting the stretcher up and into the truck.

If they were used as an adjunct to the lift assist instead of in place of, I would love them

 

[Tigger]

At our service we take the cot as close to the Pt as possible. We stair chair when we have too. Think about it like this; Using the cot to lift a Pt is the safest lift you will have (Handles, a partner, good lifting technique). So if you get the cot close you can you can (if you have to) lift/move your pt to the cot. Once on the cot you will wheel the pt to the ambulance. That being said if there are multiple steps, then use the Stairchair. Now with only using the stairchair, you need to lift the Pt on to the chair (hopefully the will be able to stand on to it for you but we all know most people, and for the most part we muscle them around). Now either you or your partner will be bending over adjusting the chair as you go to get around cornor, trying not to break all the nic-nac's in peoples homes. Then you are at the stairs which now the stair chair is great. Then Once again we are going to lift/move the pt on to the cot, and usually this lift is a fireman's lift or something along those lines. Now they are on the cot and can be moved to the ambulance.

All I'm saying is, is that I prefer the non power cot with no extra weight becuase at our service we utilize the cot more.

If the house is congested enough to make maneuvering the stairchair difficult, the cot is not even going to fit into the house. I don't use the stairchair unless a) there are more than two stairs and b) the cot won't fit. Any other time I just wheel the cot in, and in that case the cot could way 500 pounds and it wouldn't make a difference since I'm not carrying it around.

 

[Tigger]

We also have hover mats for bari calls. I don't like them simply because my employer seems to think they take the place of a lift assist on a bari call. Our bari stretcher is manual and the real problem is getting the stretcher up and into the truck.

If they were used as an adjunct to the lift assist instead of in place of, I would love them

One of my partner's refuses to use the hover mat because "we won't be able to use them on the street." Arggh no $h!t we won't, but I doubt the patient will be found in a hospital bed either!

Our bari stretcher is manual as well yet the new rule is that patient contact must be made before requesting a lift assist. What do they excpect, that the obese person is not going to be heavy? Apparently some crews have been able to muscle 350 pounders in alone, so now we all have to "try." I think those crews should be talked to and not the ones calling for lift assists "prematurely" cause they're the ones that are going to get hurt, while the rest of us wait for 40 minutes for another truck.

 

[Oculuck]

We just use the standard cot for our ambulances, both ALS and BLS.. our cabs have a lift for wheelchair patients though.

 

[downunderwunda]

Always follow your ABC's.

Ambulate Before Carrying......

 

[DesertMedic66]

We use the mega mover for our heavy patients or the fire departments "carry all". Everyone calls these whale movers. They are just heavy duty tarps with 4-8 handles on them. We run on 2 males often that weigh over 350lbs. Our gurneys hold up to 660lbs. So we are like UPS "if it fits it ships". Our Bari unit could take up to 2 hours to get to us.

On one of the guys who weighs 378lbs (last weigh in) we easily loaded him into the ambulance with a manual gurney with no lift assist. We did a dual person lift and had the patients family member move the wheels up to the frame.

We have a lift test in order to start working where we have to lift 150lbs from the ground and place it on a box that is the height of the gurneys. So each person should be able to safely lift 150lbs at a minimum (hence why staying fit should be mandatory).