The stair chair

[jakobsmommy2004]

I did a transport today, 63 y/o male, status post CVA w/ left sided deficits. Pt was returning home. There were 29 steps to get Pt into his house. 4 flights of 7 steps. Pt weights 250lbs. I think the safest way for the EMS providers and for the Pt was a 4 man lift with the stair chair. Others believe this to be a waste of a 2nd truck as being able to carry a 250lb person up 28 steps is something that 2 providers should be able to handle. What do you think??? Am I being lazy, or am I right in wanting to do this the safest way possible. Also, does anyknow how big city EMS works... Can you request fire assistance, or is it just you and your partner? The firedepartment refused to help due to us being a private company.

i would have done the same thing why risk any saftey? that is a lot of stairs. its better that you asked for backup than to risk injury to patient or yourself. If you think there is a risk always ask for backup.

 

[emtkrak]

i tried, i tried. when i returned to station my boss told me to pick up my purse and leave... so i did!

 

[fm_emt]

Are you serious, because you work for a private company, FD will not come to help you with a lift assist!! Well hell I don't think that is right!

We've had San Francisco FD assist crews with stairs. Female employee couldn't life diddly squat, so they called FD.

 

[BBFDMedic28]

I have heard plenty of coulda shoulda wouldas in this thread. Could two people do it? Should we call a back up crew?....Heres the reality, Call another truck. Better safe than sorry. Why risk your back, your job, your carrer, and the well being of the pt.? At the first sight of "I think I might not be able to do this" back up needs to be called. If the boss has a problem with this, one thing is obvious...he does not care about the health and well being of his medics. Noone needs to work at a place that does not care about their people.

As for us we have fire first respond, so lift assisstance is already there. On the transport home, we call back up.

 

[BossyCow]

i tried, i tried. when i returned to station my boss told me to pick up my purse and leave... so i did!

Just out of curiosity, how many female EMT's does this agency employ?

 

[RedZone]

Anybody know what Ferno has to say about this?

 

[GoIrishEMT]

The answer to this question entirely depends on what you're comfortable with. Personally, I would not be comfortable 2-manning a 250-lb deadweight patient on a stair chair up 28 steps. I'd definitely hella call for backup. However, if you and your partner are both muscle-bound and comfortable with lifting that much deadweight up all those steps, then go for it.

But, I advise to remember that if things go wrong, there are two possibilities. The first one is that you get the patient up to his home but you hurt your back in the process. Sorry, but if that happens, you're SOL. As Rid said, if you injure your back, you're done (basically). I hope you can find another job that requires less physical exertion.
The second possibility is that you drop the patient and you mess him up. If that happens, well I'm sure you can imagine what kind of lawsuits will occur and the consequences of those lawsuits.

Basically, on a transport (by definition, non-emergency) call, my health, my license, and the patient's safety come before everything else, including the patient's convenience.

 

[joo]

yea i dislike the stairchair myself. i wish we had one of the new strykers with the treads. that way it doesnt actually come off the steps. i'm comfortable with it usually but its ackward being hunched over going backwards upstairs

amazing chairs. i've got one at my fd, but not on my ambualnce at work. I've got the old school. Love the strykers....

have you seen the automatic ones that you use a little remote control to bring down the stairs. Now that's cool!

 

[DisasterMedTech]

Ive never liked stair chairs, even though the are often the only/best way to get a patient from point A to Point B. Here in IL EMS Region 1, we have to be able to lift 150 solo, 250 with assistance (Im pretty sure those are our numbers) Ive often had it go through my head to use a stokes litter with rigging line attached to it and slowly sliding the patient down the stairs. Im sure there is no way its allowed, but it seems in theory like it might work. Works on mountains and for other WEMS settings. Just a thought. Feel free to shoot it full of holes. I can take it.

 

[Ridryder911]

Ive never liked stair chairs, even though the are often the only/best way to get a patient from point A to Point B. Here in IL EMS Region 1, we have to be able to lift 150 solo, 250 with assistance (Im pretty sure those are our numbers) Ive often had it go through my head to use a stokes litter with rigging line attached to it and slowly sliding the patient down the stairs. Im sure there is no way its allowed, but it seems in theory like it might work. Works on mountains and for other WEMS settings. Just a thought. Feel free to shoot it full of holes. I can take it.

Okay.. Disaster, I am sure your intentions are sincere.. now, take a d-e-e-p
breath of reality. There is vast difference between lifting 150 pounds and 250 pounds assisted. As well, apparently you have not worked with Stokes very often.. they are a pain in the arse; thus the reason they are very rarely used.

Now, a little bit of reality check. Instead of day dreaming about Johnny Rangers high adventure rescue, I much rather have a partner with their head in the game. Assisting, what is in the best interest of the patient, myself and reduction of time, ease, and accessibility.

There is a time of high angle rescue and use of ropes. Removing a patient down a simple stairs is not one of them. Why would one even think of a jeopardizing patients life, and personnel?.. Even, daydreaming about it.
Since you are new to the business, why not get your head into the real event. Do what successful rescuers do. Think of the safest, easiest, way that protects all involved. For example the old saying ... try before pry...

As an old Squad member, I was always impressed with those that used "common sense" and if and only needed.. use ropes and tackle, when necessary.. hint last resort. Definitely, not when simplicity was able to meet the needs.

So instead of "daydreaming" of heroic rescues, do the job and think of safety for all. Practice and prepare using ropes and speciality rescue when and only if needed.. which is very rarely.

R/r 911

 

[ffemt8978]

To all of those that envision using powered/lift-assist cots and stair chairs, I have just one question for you.

What the hell are you going to do when the motor goes out and you have a 300+ lb patient loaded?

Please keep in mind that any powered unit weighs more to start with than it's unpowered counterpart. Also, please keep in mind that using the manual override is not always an easy task.

All mechanical equipment can fail...Murphy's Law just dictates when and with how much severity.

 

[DisasterMedTech]

Rid-

Simmer down. It was just thinking out loud it wasnt a solution or me wanting to get all high speed. So you can put away your scolding hat. I appreciate the advice but Im not a complete idiot, despite the common perception.

 

[Ridryder911]

To all of those that envision using powered/lift-assist cots and stair chairs, I have just one question for you.

What the hell are you going to do when the motor goes out and you have a 300+ lb patient loaded?

Please keep in mind that any powered unit weighs more to start with than it's unpowered counterpart. Also, please keep in mind that using the manual override is not always an easy task.

All mechanical equipment can fail...Murphy's Law just dictates when and with how much severity.

My power motor last longer than the power motor of the medic's back. Simple, we do preventive care, if one is going to manual labor.. if the cot does go out, the same number would be necessary to perform manual. There is not really that much difference.. in fact, I never use the motor in unloading..

Workmen's comp is down in some services 46% .. that's a lot of backs and EMT's career. The additional 36 pounds is worth it. If accessory items such as stair chair, additional personnel, and yes, powered cots may extend the life of EMT's. I am all for it.

Disaster, I am not upset.. but, realistic. Your new to the business and have visions of grandeur.. EMS and Rescue members can detect that. My point is that seasoned members of EMS much rather the KISS method.

R/r 911

 

[DisasterMedTech]

My power motor last longer than the power motor of the medic's back. Simple, we do preventive care, if one is going to manual labor.. if the cot does go out, the same number would be necessary to perform manual. There is not really that much difference.. in fact, I never use the motor in unloading..

Workmen's comp is down in some services 46% .. that's a lot of backs and EMT's career. The additional 36 pounds is worth it. If accessory items such as stair chair, additional personnel, and yes, powered cots may extend the life of EMT's. I am all for it.

Disaster, I am not upset.. but, realistic. Your new to the business and have visions of grandeur.. EMS and Rescue members can detect that. My point is that seasoned members of EMS much rather the KISS method.

R/r 911

You are making alot of assumptions. You dont know my training, background or experience. Remember what happens when you ***-u-me

 

[reaper]

You are making alot of assumptions. You dont know my training, background or experience. Remember what happens when you ***-u-me

Training doesn't matter. Background ain't showing and experience, we can figure that one!:glare:

Two weeks ago you posting about how to blouse boots. That thread sounded much like a newbie question. This shows that the experience ain't that deep. Instead of acting like rescue randy, why don't you learn from people here and gain some of that experience. No one will rag you, if you are really wanting to learn. But, don't come here and fight with guys that were doing the job when you were in diapers.

 

[triemal04]

Ive never liked stair chairs, even though the are often the only/best way to get a patient from point A to Point B. Here in IL EMS Region 1, we have to be able to lift 150 solo, 250 with assistance (Im pretty sure those are our numbers) Ive often had it go through my head to use a stokes litter with rigging line attached to it and slowly sliding the patient down the stairs. Im sure there is no way its allowed, but it seems in theory like it might work. Works on mountains and for other WEMS settings. Just a thought. Feel free to shoot it full of holes. I can take it.

Now that's on interesting concept. I am curious where you are going to rig your system though. Because at the bare bones minimum you need a tensionless anchor with enough wraps to create enough friction to control the descent. When you really should have a real bomb proof anchor attached to a rescue-rated rope using a brake rack to control the descent. For your main-line. Then there is the safety line to think of. And where you're going to put your litter attendants. And how you'll attach them to the litter. Just whatever you do don't think that you can hold onto the end of the rope and control how fast the stokes goes down. That is an accident (and major lawsuit...and probably the loss of your cert and job) waiting to happen. And this is to say nothing of how rough a ride it'll be. Or how long it'll take to set up. Or that most ambulances don't carry stokes. Fire engines either.

Thinking outside the box is fine. Great in fact, but over thinking something is a real good way to take a simple task and make it next to impossible. And technical rescue techniques in situations where they are not needed is not appropriate.

Use the stairchair. Or a longboard, long as it'll take the weight, but then you have to worry about the tight corners, the pt rolling, the added difficulty, keeping the head raised...use the stairchair.

 

[Ridryder911]

You are making alot of assumptions. You dont know my training, background or experience. Remember what happens when you ***-u-me

You are correct. Again per communication and what is written and described is what people are basing their assumptions on. This is why and others have developed such opinions.

You described thinking of using more difficult and possibly dangerous situations to patients, staff and way out of reason and logic. Like others described thinking outside the box is great, but let's keep it within reason, scope and practical. Would you think of using a telesquirt on a trash can fire?

Part of EMS is deciding to use the best, easiest and safest maneuvers that produce the best outcome. All of this has to occur in rapid amount of time, from split seconds to few minutes. While doing this making and deciding upon multiple tasks and maneuvers, for this is part of the job of being an EMT.. the new categorization as it is referred to as critical thinking skills.

The reason, I make and made such statements is because I do hear ludicrous and non-rationale similar statements on calls and discussions by newer EMT's; like yourself. Usually, it is written off by veteran commanders and supervisors on the scene as inexperienced, lack of common sense, attempting to impress others and themselves.

Now, please remember that some Chief's and leaders do pay attention of your thinking process on scenes. Would one want to promote or place trust upon someone not even thinking rationally or one that would attempt to develop a true and working plan for the immediate situation? For example using immediate resources on hand, or possibly bringing in resources that would decrease the risks or dangers to both the patient and staff.

So the only assumptions I am making, is solely being based upon your responses and replies, as it appears everyone else is making the same opinion. If it is wrong, then it is up to you that need to clarify and make appropriate responses for us not to make those wrong assumptions .

R/r 911

 

[DisasterMedTech]

You guys are ones for the books. I mentioned it as something I had thought of and wondered about. My thinking was to apply appropriately rated line to the stokes, lay them down on the stokes on the stairs, and with the appropriate amount of muscle slowly lowered to where the stokes could be picked up and carried. I dont know where you work, but all of our ambulances companies here carry stokes and are trained in their useage. I have used the technique I described with a 50' roll of 550 cord doubled up on itself numbers of times . to drag someone on a stokes with the assistance of one other rescuer during a SAR operation the SW desert of the US. The person was too big for us to lift, but she drug quite nicely in a stokes lined with a blanket across the desert floor. We transported her for two miles to evac LZ this way. I was simply wondering if this might work with getting a patient down the stairs. The problem with "noobs" as you say is inexperience. The problem with old timers often is that there experience often is old, they stick to only what has worked in the past. You seem to not have a very good grasp of the notion of technical rescue since tying a rope or cord to a stokes and easing someone down a flight of stairs hardly qualifies I am currently undergoing training in tech rescue which is what made me think to ask the question. Maybe I think too far outside the box. Perhaps you have been locked in it too long. What I suggest may not work or be feasible, But Ive been on crews with guys like you stand around and scratch their heads (or butts as the case may be) and try to figure out what to do and the "noobs" stand around, afraid that challenging conventional wisdom might cost them their jobs. If you dont listen with the idea that you mind can be changed, you just aint listening. And from what Ive read of your posts, you seem to be mired in the grand old days of EMS/rescue. People need saving and they dont care how it gets done as long as it saves the life. Do you know that what I have suggested wont work? Have you tested it? Can you prove me wrong without a shadow of a doubt? No, you cant. But you rest assured that I will be testing the operation I simply theorized about and Ill let you know. I respect you, but when you start telling me what I can and cannot say and to whom I can and cannot say it, youre over the line. I know you see yourself as the guardian of the holy grail of EMS/rescue. I have no such delusions. I just want to help people. Have you been in service so long that youve forgotten thats what its about. What did you think of the I/O drill when it was first introduced? Or the AED. Im guessing you didnt like them much. You are owed respect because you have earned it with experience. I am owed respect because I am willing to work to get the experience and because I care enough to get out of bed each morning and try to help. Its a shame that this site has become a refuge for all the old timers at EMTCity who had belched their "back in the day" bilge all over people who had heard enough of it and let you know it. Ive looked you up over there, Rid, an am surprised at some of the non-sense you've spewed. You dont get respect because your old. You get it because you give it. I wont be a part of that sight simply because of people like you. While there are others there who seem willing to slap down nubies, they also seem like they might perk up when someone besides themselves has a feasible plan.

 

[Flight-LP]

Well, lets see. Most ambulances do not carry stokes baskets so that would be problem #1. Problem # 2 would be on how to secure the line as previously written. Its not really feasible especially since most EMT's and Medics are not trained in any form of rope rescue And to finish it off, why make it more difficult than it has to be? Oh, thats right to save that life that we do on every call.

You seriously need to step back and take a look at what you actually writing. We are not locked up in the box. In actuality, we are at the opposite end of the spectrum as to newer modalities and cutting edge technology. You ask us not assume, you need to do the same.

Now your just humerous, especially if you think someone in their early 40's is old...............

 

[DisasterMedTech]

Fine. Im humorous. But Ive seen my share of CCPs stand around not knowing what to do when some fire fighter or basic comes up with the ideas. As for being trained in technology that is cutting edge, I spend at least one weekend a month training with such technology. Technology breaks. Last time I was working with a CCP he was standing around with everyone else trying to figure out out to get a 400 pound patient out of her bed when the back board was rated for 350 and broke on two pieces. It was a fireman with a halligan that figured out the solid core bedroom door would work. He didnt fly around in helos, or you multi-million dollar pieces of equipment...just his noodle and some imagination. But I guess thats not allowed...especially if youre new. Im not going to argue with you or folks like you anymore. And exactly what does having to blouse boots for the first time have to do with knowledge or training or experience. Now you are a little humorous.