Proper Draw Sheet method?

[leftysoftball]

I searched here w/o any luck. What is the "proper" execution of the Draw Sheet Method of moving a patient from bed to cot or vise versa?

Every partner I have ran with has done it where EMT1 (positioned with the cot between them and the patient bed) pulls toward the cot and EMT2 on the other side of the bed lifts up slightly or stands on the bed even.

I was taught both EMTs on the same side, cot between us and the patient bed, squat slightly and gently pull pt. toward me with a straight back. I would also like advice on how to correct improper tech. company wide w/o being a tattle-tale new guy.

Thanks

 

[EMSLaw]

If you don't have someone on the far side, the patient may roll right off the sheet. So, while reaching and lifting is supposed to be something we don't do, there's no way to avoid it in this case.

My preferred method is one person (or more, depending on the patient size) on each side. The person on the side you're moving to pulls the sheet towards him. The person on the other side just lifts up. Magically, the patient is transferred.

 

[JJR512]

If you're both on the same side, you run the risk of pulling the sheet right out from under the patient. Also, all you're doing is dragging the patient across the bed. Ideally, the two providers would be on opposite sides, and there should be some lifting going on as well. You don't necessarily need to lift the patient up into the air, but by providing some upwards force, you reduce the effect of gravity and make it easier to slide the patient.

 

[STXmedic]

I don't think there's any way around it. One of those "textbook v real world" situations. If you can get the staff to help, that'll take some of the stress off of you. Sometimes, if it's a small bed or you can position effectively, I like to use the head-toe method; it keeps the pt closer to your center. If you didn't want to destroy your back, you should've gone into nursing

 

[fortsmithman]

With my service we use 2 people on both sides minimum 2 attendants and 2 RNs. A few other times we've had 3 on both sides or 2 on both side and 1 at the head t vairies based on how heavy the pt is.

 

[xnuralratiugx]

I usually try to do one emt per side and get a cna/rn to help w the feet. Gurney goes a couple inches lower than the bed so you have gravity working with you. Person gurney side pulls while the bed side person ensures the patient doesnt slam down to the gurney. Just a slight lift so they have a smooth transfer. One of those situations where you just need to get the job done.

 

[EMSLaw]

I was going to comment that there is usually some upper limit on the number of people you can have around the patient to move him or her. I've been in hospital rooms where the bed and stretcher barely fit at the same time, and we had to push chairs, the rolling table thingy, and the various linen/garbage/biohazard bins out into the hallway.

Then I remembered the time I brought in a 700 lbs+ patient. There was, indeed, a limit, but it was large, and we stood shoulder to shoulder around the stretcher and bed (which had been wheeled out almost to the parking lot) to move him. In my now-wiser days, I probably would have left him on the floor and called for a bariatric rig, since he wasn't in any immediate danger (He was "suffering" from "general weakness". Incidentally, I had to listen to the famous, "You brought him here for that?" when we arrived at the ED.)

The number of people can change, but the technique remains the same. One side up, other side over. You'll be surprised how well it works. Things go pear shaped when the people on the "up" side don't lift.

 

[JPINFV]

If you're both on the same side, you run the risk of pulling the sheet right out from under the patient.

[sarcasm]
Funny, every time I try that trick with a table cloth and a table set with a 3 course meal, all I do is make a mess.

 

[JJR512]

I was going to comment that there is usually some upper limit on the number of people you can have around the patient to move him or her. I've been in hospital rooms where the bed and stretcher barely fit at the same time, and we had to push chairs, the rolling table thingy, and the various linen/garbage/biohazard bins out into the hallway.

Washington Adventist Hospital in Takoma Park, MD (right outside of Washington, DC) has many rooms like this. Some of the rooms—and I'm not talking about in the ER, I'm talking about in the hospital itself—are actually two bed-witdths wide by 1.5 bed-lengths long.

 

[JPINFV]

In regards to a draw sheet, I'm going with the opposite sides crowd. At a minium, one on the side without the gurney and one with the opposite side of the gurney. If the patient weighs too much, add more people. Also, depending on the height of the patient and the size of the draw sheet, add one person to help with the feet and/or a person to help with the head.

Now if the patient isn't on a sheet that can be used as a draw sheet, if they're wearing proper clothing (in contrast to a gown), you can use the clothing as a poor man's draw sheet. Similarly, non-fitted sheets and some fitted sheets can be used. Finally, remember that even if the patient isn't currently on a draw sheet, you can always place a draw sheet on your gurney and then move the patient onto the draw sheet on your gurney. Now when you arrive at the hosptial, the patient can be draw sheeted from the gurney to the hospital bed.

 

[JPINFV]

Washington Adventist Hospital in Takoma Park, MD (right outside of Washington, DC) has many rooms like this. Some of the rooms—and I'm not talking about in the ER, I'm talking about in the hospital itself—are actually two bed-witdths wide by 1.5 bed-lengths long.

That's why you need multiple methods of moving patients. Depending on the totality of the situation (including but not limited to, patient's status, number of helpers, material resources, size of the room, etc), they can walk, walk with assistance, be transferred to a wheel chair, wheeled into the room, then transferred from the wheelchair to the bed, be moved via a "taco wrap" (draw sheet with a person at the head and person at the feet), draw sheet (with extra help and/or slide board), or various other lifts (e.g. "Georgia Street" (GS) lift). Anyone who relies only on one method or refuses to consider all options will eventually be unable to complete the job.

 

[JJR512]

The worst thing about being on the non-gurney side of the bed is moving the patient onto the gurney and then discovering that he or she had incontinence, the results of which you have just smeared your arms through during the move.

 

[JJR512]

That's why you need multiple methods of moving patients. Depending on the totality of the situation (including but not limited to, patient's status, number of helpers, material resources, size of the room, etc), they can walk, walk with assistance, be transferred to a wheel chair, wheeled into the room, then transferred from the wheelchair to the bed, be moved via a "taco wrap" (draw sheet with a person at the head and person at the feet), draw sheet (with extra help and/or slide board), or various other lifts (e.g. "Georgia Street" (GS) lift). Anyone who relies only on one method or refuses to consider all options will eventually be unable to complete the job.

Don't forget that if the patient's bed got into the room, it can come out of the room. Sometimes there's more room in the hallway than in the room.

 

[EMSLaw]

That's why you need multiple methods of moving patients. Depending on the totality of the situation (including but not limited to, patient's status, number of helpers, material resources, size of the room, etc), they can walk, walk with assistance, be transferred to a wheel chair, wheeled into the room, then transferred from the wheelchair to the bed, be moved via a "taco wrap" (draw sheet with a person at the head and person at the feet), draw sheet (with extra help and/or slide board), or various other lifts (e.g. "Georgia Street" (GS) lift). Anyone who relies only on one method or refuses to consider all options will eventually be unable to complete the job.

As we are all well aware, a goodly number of people transported by ambulance are quite capable of walking into the ER (indeed, they were probably quite capable of driving themselves to the hospital, or to the doctor's office in the morning). While protocol generally requires us to stretcher, or at least wheelchair, these people in, I have no qualms about politely requesting that they do the cot-bed shuffle under their own power.

 

[Sam Adams]

I was taught both EMTs on the same side, cot between us and the patient bed, squat slightly and gently pull pt. toward me with a straight back.

If you can find someone to do this with you, by all means! Give me a buzz before hand though, I want to video tape it.....