Litters and pt movement class...thoughts?

[mycrofft]

I have a 110 page PowerPoint presentation prepared (45 min), I have hands-on prepared (1 hour).

I'm teaching volunteer non-EMS enthusiasts who posted a Youtube video of themselves hoisting a hefty, live volunteer, strapped onto a LSBoard, onto an ambulance litter then whisking him away, fully raised, across a rough tarmac parking lot. Three of them.

OTHER than training safety and basic mechanics and types of litters (including ad hoc), any points your experience would suggest I add?

 

[mycrofft]

I'll take that as a "no".

:glare:.....

 

[JPINFV]

What sort of "enthusiasts" are we talking about? If it was EMTs, I'd include draw sheets, wheel chair to bed one man lifts, GS style moves. If it's non-EMS providers, I would include things like three man supine carry and the 4 handed seat carry.

 

[AlphaButch]

When the patient should stay put and wait for EMS vs. when they need rapid transport.

Maintaining c-spine during rapid extraction (i.e. from a car seat).

Basic scene safety and hazard identification.

Have them experience what it's like being bounced around on a litter (especially over rough terrain).



I would love to see your finished ppt.

 

[systemet]

Just a thought - if you haven't given this presentation before, check how long it takes. 110 slides in 45 minutes is really fast. I find I usually present at ~ 1 slide / minute.

 

[Steam Engine]

Maybe add some "special scenarios" during the practical portion. In one of my courses, we practiced moving a patient out of a rolled vehicle (basically had him inverted in the space between two filing cabinets), a ship's engine room (pt. partially inside the shower of a cluttered office restroom that was being renovated), and in an office building immediately following an earthquake (interior stairwell and landing of same office building, with lots of scattered cardboard and construction debris).

An exercise like that will get them thinking about how to apply the principles they just learned in the real world, and will make it challenging and fun.

 

[mycrofft]

Hey, thanks for coming by!!

Honestly, thanks!
These are CERT volunteers, none of whom are professionals in EMS, some are graduates of various EMT programs but all are graduates of our Brady book version of medical first responder.

Systemt, the powerpoint is just a written "soundbite" version of my talk, a text reinforcer for "text learners". Most slides are extremely short. A few need me to slow down. Good point, though, I will rehearse it as my old demon is "too much material in one class". And that will be in 60 min, not 45. Unless we finish early! (Yeah, right). Volunteers will be called to the front; and we are all volunteers (heh heh).

JPINV, since these CERT's might be tasked to assist moving people in a triage or treatment facility, I'm going to touch on transfers and wheelchairs. They should not be doing complicated extrications, but they have to know something about them to interface with FD in a disaster, so I may have a class put on by the FD (our sponsors) or do one myself if that isn't a good deal.

AlphaButch, good points and some are in it already, especially the "Should I Stay Or Should I Go?" deal (apologies to "The Clash" there). Accent, as it should be in all CERT training, will be first what NOT to do and WHEN NOT to do it, size up and plan are a separate class by another department. In a non-disaster role our folks furnish basic first aid at events with regular EMS about ten minutes out.

Since our vollies are mainly not physically exercised, don't do this on a regular basis, and many are retirees, SAFETY is the watchword. I saw the ambulance litter YOUTUBE and wrote two emails strongly urging the FD not to allow this sort of disaster waiting to happen to occur again. MAYBE we will let a vollie or two experience a simple lift and excursion in a classroom, but I'm using sandbags and/or weighted and balanced rescue manikins otherwise.

I will have them go over a low barrier or two, set it down quickly ( the "I'm losing my grip!!" deal), switch places and pick it back up under their leader's organization; I will stress drags and effective improvised litters. (If they're good and we luck out, I'll take them over the new BMX track with a stopwatch, a stretcher, and a plastic wine glass 1/2 full of water taped to the litter). NO more than ten students per evolution and go go go go.

 

[mycrofft]

OK rehearsed the Powerpoint

About 50 minutes. WIll shave it a bit more. I appreciate the feedback.

 

[vamike]

What sort of "enthusiasts" are we talking about? If it was EMTs, I'd include draw sheets, wheel chair to bed one man lifts, GS style moves. If it's non-EMS providers, I would include things like three man supine carry and the 4 handed seat carry.

A couple questions... how do you do wheel chair to bed one man? Also what is GS style? Thanks.

 

[JPINFV]

Wheelchair to bed:

The patient needs to be able to have some sort of ability to support themselves and shuffle. Not a lot, but some.

This is how I learned to do it with three major differences.

1. I'd have a much better grip on the patient's shoulder blade, almost cupping them with my hands.
2. I'd be closer. The patient's knees and your knees are basically interdigitated.
3. The patient would be holding onto my shoulders for additional support.

Also, while not clearly mentioned in the video, make sure the bed and chair is locked. For a gurney, this might mean making sure that the gurney is against a wall or someone is holding the gurney.

This is one of those maneuvers where there is no such thing as personal space.

[youtube]http://www.youtube.com/watch?v=UWSPIHGiuFs&feature=related[/youtube]

You can follow it by putting one hand between the patient's shoulder blades and the other arm under the patient's knees and pivoting them into a laying position if need be. Both this pivot and the video works in reverse to go from bed to wheel chair.

"GS" also known as "Georgia Street" maneuver (I have no idea why it's named that).

Person 1 stands at the head and comes under the arm pits and then interdigitates his hands across the patient's chest.

Person 2 stands at the feet and grabs the patients knees.

Works wonders, but move slowly. This isn't Olympic weight lifting where you need to do a clean and jerk with the patient.

 

[MSDeltaFlt]

Most people I see lift pts do not use proper techniques. The vast majority of the ones I see fail to remember that you're not supposed to look at your pt as you lift. You're supposed to be looking where your body is going: up. Where the head goes the body follows. Which is why I have met only one medic who doesn't have a bad back.

 

[mycrofft]

MS Delta, good one!

Thanks

 

[systemet]

About 50 minutes. WIll shave it a bit more. I appreciate the feedback.

Remember to think about whether that time will change if you get nervous. I've found I tend to go slower when something/someone's distracting me, or I'm feeling uncomfortable.

Good luck!