The Role of the Emergency Medical Technician Lifting and Moving Patients Safely

CHAPTER 6 The Role of the Emergency Medical Technician Lifting and Moving Patients Safely Lifts, Drags, Takedowns, and Carries Transporting Patients Safely Transportation Equipment This chapter focuses on the correct techniques, equipment, and positioning for moving a patient safely and effectively in a variety of situations and locations. 120

Lifting and Moving Patients After completing this chapter, the EMT student will be able to do the following: 1 Define body mechanics. 2 Discuss the importance of safety in lifting or moving a patient. 3 Identify the situations in which an emergency move is indicated. 4 Identify the situations in which a nonemergency move is indicated. 5 Understand the importance of patient positioning, the various types of patient positioning, and the indications for each type. 6 Discuss the importance of patient safety restraints. 7 Discuss the various types of transportation devices used in moving patients in the prehospital environment. 8 Demonstrate the various emergency moves. 9 Demonstrate the various nonemergency moves. 10 Demonstrate patient positioning based on the patient s condition. 11 Discuss the importance of patient safety restraints. 12 Select and demonstrate the use of the various types of equipment used to move patients in the prehospital environment. 6 121

122 EMERGENCY MEDICAL TECHNICIAN How will you get me down those stairs? Louise asked Elizabeth, her voice filled with fear and pain. Elizabeth smiled and patted Louise s hand. You let us worry about that, Mrs. Greenbaum. We have equipment that will help us get you down those stairs safely. Louise had fallen earlier in the day, stumbling over a loose rug in the hallway. Landing on her right side, she could feel her hip pop and a sudden searing pain that went down her right leg. She tried to sit up, but the pain only got worse. The downstairs neighbor heard her calling out for help and called 911 and then helped the ambulance crew enter the apartment by using a key. Once inside, Elizabeth quickly determined that Mrs. Greenbaum apparently has dislocated her right hip during her fall. They would need to extricate the patient down two flights of narrow stairs while the patient had to remain lying flat. Question: Will Mrs. Greenbaum need to be moved urgently? Given the situation, what would you consider using to bring Mrs. Greenbaum safely down the stairs as comfortably as possible? THE ROLE OF THE EMERGENCY MEDICAL TECHNICIAN The goal of emergency medical services intervention is the delivery of the patient to definitive care. Therefore the emergency medical technician (EMT) must possess the knowledge and ability to perform the lifts, moves, carries, and drags necessary to meet this goal. This chapter focuses specifically on emergency moves, nonemergency moves, patient positioning, You and your partner are dispatched to a home for a patient with difficulty breathing. You find the patient, a 60-year-old man who weighs approximately 240 lb (110 kg), sitting on a chair in the tripod position and complaining of shortness of breath that started about 15 minutes ago. You complete your patient s medical history, assessment, and treatment and wish to move the patient to your collapsed wheeled stretcher, which you have placed next to the patient. What technique would you use to move this patient? In what position would you place the patient? Why is patient positioning important? and the equipment used by the EMT in lifting and moving patients. Understanding, practicing, and mastering this miniarsenal of skills will go a long way in protecting the patient and the rescuers from unnecessary additional injuries or worse. LIFTING AND MOVING PATIENTS SAFELY Body Mechanics One of the most common injuries incurred by emergency medical services responders while on the job is back strain. Often such injuries are the result of improper lifting and moving techniques. The safest and most effective way to use your body while lifting or moving a patient is referred to as using body mechanics. Using proper body mechanics and considering a few simple questions can help protect you and your partner when you attempt to move a patient: Is the patient accessible? Can my partner and I lift or move the weight of the patient? Can my partner and I safely overcome the obstacles or terrain while we are moving the patient? If the answer to any of these questions is no, or if the EMT feels unsure, it is always best to get additional help for moving a patient.

Principles of Lifting and Moving To protect himself or herself and safely move a patient, the EMT should always follow these guidelines while lifting or moving patients: CHAPTER 6 Lifting and Moving Patients 123 If possible, have backup help available to maneuver a patient through difficult terrain, past obstacles, or up or down stairways. Avoid reaching more than 20 inches in front of you. Avoid reaching for a prolonged amount of time. When possible, push something, rather than pull it. Use your legs and not your back to lift. Bend at the knees and use the stronger muscles of the legs instead of the weaker back muscles (Fig. 6-1). Keep the weight of what you are lifting as close to your body as possible (Fig. 6-2). Move your body as a single unit. When carrying a patient up a flight of stairs, carry the patient head first. While going down stairs, carry the patient feet first. LIFTS, DRAGS, TAKEDOWNS, AND CARRIES Wheeled Stretcher Operations The wheeled stretcher (Fig. 6-3) is the most common means of transporting the patient to definitive care. Hand position plays an important role in controlling the stretcher while hoisting or lowering. The power grip is the most effective way to accomplish this control. To hoist or lower the stretcher, place the hands approximately 10 inches apart, with the palms up and the fingers completely wrapped around the lift bar (Fig. 6-4). Fig. 6-1 Bend at the knees and remember to lift with the leg muscles and not the back muscles. Fig. 6-2 Keep the weight of what you are lifting as close to your body as possible. Fig. 6-3 Wheeled stretchers.

124 EMERGENCY MEDICAL TECHNICIAN The EMT also could encounter situations that are not immediately dangerous to the patient or himself or herself but still require an emergency move to provide adequate care: Fig. 6-4 Power grip for hoisting a stretcher. The power lift is the safest and most effective way to lift a heavy object using proper body mechanics. While performing the power lift, it is important to remember to do the following: Keep your back locked and tighten your abdominal muscles. Feet should be shoulder-width apart and comfortably secure. Keep the lift as vertical as possible to avoid bending at the waist. Skill 6-1 details the step-by-step process of the head and foot method using the power grip and power lift to hoist the stretcher from its down position. Skill 6-2 shows the side-to-side method for lifting a stretcher using the power grip and power lift. This same technique can be used while lifting or lowering a backboard or other similar device. These tools will be discussed later in this chapter. Emergency Moves Just as the name implies, emergency moves are techniques designed to move a patient from an unsafe environment in which additional injury to the patient, or injury to the EMTs, could result. Situations that merit an emergency move include the following: Fire or threat of fire Violence or threat of violence Explosives or the danger of explosion Imminent collapse of a structure Other hazards such as traffic, electrical, or chemical A patient in critical condition in a confined space in which there is not enough room to work. A patient in critical condition positioned in such a way as to prevent effective care. For example, a patient in cardiac arrest sitting in a chair needs to be moved to a hard, flat surface in a supine position. A patient in noncritical condition who must be moved in order to gain access to a patient who is in critical condition. This usually occurs at the scene of a motor vehicle collision. These situations, and possibly others, require the EMT to make quick decisions regarding moving the patient. The EMT must remember that these moves are not designed to protect the patient from injury and may cause additional pain to the patient. Rather, these moves are designed only for situations in which there is a threat to life unless the patient is moved to a safer environment. Drags Emergency drags can be modified for one- or tworescuer use depending on the circumstances. For ex- continued The crew carefully moved Mrs. Greenbaum on the orthopedic stretcher, after padding it with sheets and blankets. It took some time to fit the stretcher around the patient, but because she had stable vital signs and no other major injury that required rapid transport, Elizabeth decided that it was critical to minimize the patient s pain and fears before and during the extrication process. With the final straps in place, the crew prepared to lift Mrs. Greenbaum and maneuver themselves down the stairway. Question: If you were part of the crew, what are some lifting techniques to keep in mind as you move down the stairway?

SKILL 6-1 Power Lift: Head and Foot Method 1. Emergency medical technicians using proper body mechanics and power grip to hoist stretcher. Remember to lift with your LEGS and not your BACK. 2. Simultaneously lift the stretcher until you hear it lock into place. 3. One emergency medical technician pushes the stretcher into the ambulance while the other guides it to the locking mechanism. 125

SKILL 6-2 Power Lift: Side-to-Side Method 1. Some stretchers require the emergency medical technicians to be positioned on the sides of the stretcher instead of the head and foot. 2. Remember to lift with your legs and not your back. 3. While loading the stretcher into the ambulance, use a shuffle step and do not cross one leg over the other because this will cause twisting of the back. 126

CHAPTER 6 Lifting and Moving Patients 127 ample, in the event of multiple patients, each EMT may be required to move a patient on his or her own, whereas a single patient could be moved by two EMTs. In either case, it is important to stabilize the head and neck of the patient as much as possible during the drag. Time may prohibit the use of a cervical collar and long backboard. Thus the EMT must remember to move the body as a single unit as much as possible. While moving the patient, the EMT also must remember to move along the long axis (length) of the patient. Skill 6-3 demonstrates several emergency drags one or two EMTs could use. Carries A carry, as the name implies, involves supporting part or all of the patient s weight while moving him or her. For this reason, it is recommended that two rescuers carry the patient. Granted, a patient could be carried by a single rescuer, provided that rescuer could support the weight of the patient adequately and safely while moving. Skill 6-4 demonstrates a variety of one- and two-person carries. Standing Backboard Techniques The standing backboard techniques can be qualified as emergency moves and as nonemergency moves, depending on the presenting situation. For example, a patient found standing in the middle of an area that just sustained an explosion needs to be removed quickly while protecting the patient s spine. This qualifies as an emergency move. However, the patient found out of his or her vehicle, walking around the scene of a motor vehicle collision but complaining of head and neck pain, would not fall necessarily into the category of a true emergency move. In this instance, the patient may have sustained a spinal injury. To have the patient sit or lie on the wheeled stretcher when he or she is found standing is inappropriate. Asking a patient to sit or lie changes the patient s center of gravity and could transform a minor injury into a major one. For this reason, any patient found standing after a motor vehicle collision and complaining of head, neck, or back pain or with signs of a position mechanism of injury should be placed on a backboard while standing. The concept and skills of complete spinal immobilization will be covered later in this text. In the context of this chapter, however, when simply moving the patient from one point to another, the EMT must remember that his or her primary consideration is to remove the patient from the dangerous environment first and then to immobilize the patient completely once he or she is in a safe area. The EMT must realize that the skills shown in this chapter only minimally protect the integrity of the spine. The technique for applying a backboard to a patient who is standing is demonstrated in Chapter 29. Rapid Extrication Occasionally, the EMT is faced with having to care for a patient in critical condition in a confined space (e.g., inside a vehicle). The extrication devices, shown later in this chapter, are time-consuming to apply and should be used only on a stable patient. When faced with an unstable patient when time is critical, when a safe scene is becoming unsafe, or when a stable patient must be moved to attend to a more seriously injured patient, the EMT should rely on rapid extrication. Rapid extrication is the quick but safe manner to remove a patient from an area to provide meaningful intervention. Rapid extrication can be performed with two or more rescuers. The technique for three-person rapid extrication is shown in Chapter 29. Nonemergency Moves Nonemergency moves are performed when there is no immediate threat to the patient s life or the safety of the patient and the rescuers. Nonemergency moves are those used most often by EMTs in the course of their work. These moves include transferring a patient from his or her own bed to the stretcher, from the ground to the stretcher or backboard, and from the wheeled stretcher to the hospital gurney. The decision of which move to use, once again, depends on the presenting situation. If the EMTs feel that the patient s spine has not been compromised, then the direct ground lift or logroll without spinal precautions should be used, depending on whether the patient is prone or supine. Skills 6-5, 6-6, 6-7, and 6-8 demonstrate the various nonemergency moves. If the potential for spinal involvement exists, then the logroll using spinal precautions should be used. See Chapter 29 for additional skills involving spinal precautions. TRANSPORTING PATIENTS SAFELY Once definitive prehospital care has been given, the next goal of emergency medical services is the safe delivery of the patient to an appropriate facility. Not only should the EMT be aware of the medical needs

SKILL 6-3 One- and Two-Rescuer Emergency Drags One-person clothing drag. Two-person clothing drag. One-person blanket drag. Two-person blanket drag. 128

SKILL 6-3 One- and Two-Rescuer Emergency Drags continued One-person upper extremity drag. One-person modified upper extremity drag. Incline drag. Firefighter s drag. 129

SKILL 6-4 One- and Two-Person Carries Pack strap carry. The emergency medical technician grasps the patient s arms around his or her neck and pulls the patient onto his or her back. One-person cradle carry. This carry should be used on children and lighter adults. Piggyback carry. Firefighter carry. 130

SKILL 6-4 One- and Two-Person Carries continued One-person assist. Support and steady the patient by grasping the patient s hand and supporting the patient with the emergency medical technician s other arm. Two-person cradle carry. Not only can this carry be used to move a patient to safety, but also it can be used to move a patient from a sitting position. Two-person assist. Each emergency medical technician must have a firm grasp of the patient s wrist. Two-person extremity carry. In an emergency situation, a patient can be carried down a flight of stairs or an incline. Remember to carry the patient feet first. 131

SKILL 6-5 Direct Ground Lift * 1. Two or three providers line up on one side of the patient. Providers kneel on one knee (preferably the same for all providers). 2. The provider at the head places one arm under the patient s neck and shoulder and cradles the patient s head while placing the other arm under the patient s lower back. The second provider places one arm under the patient s knees and the other under the patient s lower legs. The third provider places arms above and below the waist. 3. On signal, the rescuers lift the patient to their knees and roll the patient in toward their chests. 4. On signal the rescuers stand and move the patient. 5. To lower the patient, the steps are reversed. * NOTE: The direct ground lift should be used only on lighter patients who have no suspected spinal injury. A minimum of three providers is necessary. 132

SKILL 6-6 Extremity Lift 1. One provider kneels at the patient s head and another kneels at the patient s side by the knees. The provider at the head places one hand under each of the patient s shoulders and grasps the patient s wrists. The provider at the foot slips his or her hands under the patient s knees. Both providers move up to a crouching position. 2. The providers stand up simultaneously and move with the patient. 133

SKILL 6-7 Draw Sheet Transfer 1. Two emergency medical technicians positioned on each side of the patient roll the edges of the sheet. 2. Lifting together on a three count, the technicians lift and move the patient to the adjacent bed or stretcher. 3. The patient is lowered gently onto the adjacent bed or stretcher. 134

SKILL 6-8 Logroll with No Suspected Spine Injury 1. The three providers line up on the same side of the patient and are down on one or two knees. The provider at the head grasps the patient s arms and shoulders. The middle provider grasps the patient s torso and upper leg while the provider at the feet grasps the patient s feet and hips. 2. On the count of the person at the head, the providers roll the patient as a single unit toward themselves. From this position the patient s anterior can be assessed or the patient can be rolled completely over to a supine position. 135

136 EMERGENCY MEDICAL TECHNICIAN of the patient, but also he or she should be aware of the patient s need for comfort and safety during the transport phase of the call. Patient positioning, depending on the patient s particular needs, and the use of safety restraint devices fulfill those needs. Patient Positioning The position in which a patient is found, the patient s level of consciousness, the type of mechanism of illness or injury, and how the patient feels most comfortable will determine how the EMTs will transport the patient. The EMT must know how to position a patient for transport because it is an important part of the documentation record on the narrative portion of the patient run sheet. For example, Transported the patient in the position of comfort, tells the nurse or physician that the patient not only was cared for properly but also was made as comfortable as possible during transport. Position of Comfort Unless a patient has a specific condition that warrants transporting in a particular way (e.g., an immobilized patient), the best way to transport a conscious patient is in the position of comfort. The EMT must possess effective communication skills in order to assist the patient in finding that most comfortable position. Fig. 6-5 shows a patient with an isolated wrist injury that has been splinted, and the patient is being transported in the position of comfort. Recovery Position When treating an unconscious patient, protecting the patient s airway is of primary concern because the patient is not capable of protecting it. The recovery position (Fig. 6-6) is the best method for the EMT to accomplish this protection. The recovery position allows the EMT access to the patient s airway and will assist in removing possible obstructions, such as blood or vomit. Fowler s and Semi-Fowler Positions Patients in respiratory distress, nauseated or vomiting patients, or patients experiencing dizziness or other medical problems are most often comfortable sitting upright in varying degrees while being treated and transported. For patients being treated and transported in the Fowler s position, the head of the wheeled stretcher is elevated to 45 to 60 degrees. This is the most common position for transporting patients in respiratory distress. Fig. 6-7 shows a patient being transported in the Fowler s position. The semi-fowler position is for those patients who wish the head of the stretcher to be lower for increased comfort. In this position, the head of the wheeled stretcher is raised to 30 degrees. Fig. 6-8 shows a patient in the semi-fowler position. Fig. 6-6 Recovery position. 60 45 Fig. 6-5 Placing a patient in the position of comfort may make an unpleasant situation more tolerable and less painful. Fig. 6-7 Fowler s position.

CHAPTER 6 Lifting and Moving Patients 137 Laterally Recumbent Position Certain medical conditions, discussed later in this text, require a patient to be transported on his or her side, with the head of the stretcher flat. Often patients also will feel more comfortable while lying on their side, often with their knees bent upward. This position of transport is called the laterally recumbent position. This position is documented by the side on which a patient is lying: left laterally recumbent or right laterally recumbent. Fig. 6-9 shows a patient being transported in the left laterally recumbent position. Patient Safety Restraints Most states require some form of safety restraint device while transporting adult and pediatric patients, whether they are on the wheeled stretcher or the bench seat of the ambulance. Wheeled stretchers should have three restraint straps: one for the chest that should be secure but not so tight as to prevent adequate expansion of the patient s chest, one at the waist, and one at the legs (Fig. 6-10). Pediatric patients should be transported in an approved child restraint seat (Fig. 6-11). If a child is found in a restraint seat (e.g., at the scene of a motor vehicle collision), it is appropriate for the EMT to remove the seat from the vehicle with the child in it to transport him or her, provided the seat is not damaged. Fig. 6-10 A patient safely secured for transport. 30 Fig. 6-11 Approved child restraint seat. Fig. 6-8 Semi-Fowler position. Pediatric Consideration Fig. 6-9 Left laterally recumbent position. In most states, child restraint laws do not exclude ambulances. When transporting a child who falls within the scope of the law, the child must be in an approved car seat unless the child cannot be seated because of treatment or immobilization issues. A car seat can be belted onto the stretcher or the attendant seat. Many ambulances carry an inflatable car seat for this purpose, or you also can use a car seat the child s family may have in their car.

138 EMERGENCY MEDICAL TECHNICIAN Whenever possible, first place an open blanket in the stair chair, and then place the patient onto the chair. Wrap the blanket around the patient with the patient s arms under the blanket before strapping the patient in the chair. This will prevent the patient from helping you by grabbing the railing and also will help you lift the patient from the chair to your stretcher. Fig. 6-13 Scoop stretcher. When moving patients who are immobilized, remember to cover and protect their face from rain, snow, and bright sun. Fig. 6-14 Portable stretcher. Fig. 6-12 Wheeled stretcher. TRANSPORTATION DEVICES Emergency medical technicians have a variety of equipment available to them to assist in lifting and moving patients. Local protocol generally dictates what equipment is available and in what situations the equipment can be used. The EMT should become familiar with the operation and use of all the Fig. 6-15 Basket stretcher.

CHAPTER 6 Lifting and Moving Patients 139 conclusion Inside the ambulance, Mrs. Greenbaum relaxed noticeably. Although her hip still hurt, it was better than before and she realized that the crew worked hard at making her feel as comfortable and safe as possible while being carried down the stairs. The crew even made sure that the apartment was locked and let the neighbor know to which hospital she was being transported. Fig. 6-16 Stair chair. Fig. 6-17 Long backboard and straps. Teamwork is essential in the lifting and moving of patients. Whether a single patient is being transported by two EMTs or multiple patients are being transported by several ambulances, even from different agencies, working together is critical in maintaining the safety of the rescuers and the patients. Assistance from fire or police personnel, or even bystanders on the street, could greatly aid the EMTs responding to a situation. The responding EMTs must remember, though, that they are responsible for the patient s care. Therefore they should exercise due caution in assigning roles to anyone who is not trained to their level. Fig. 6-18 Short backboard and straps and vest-type extrication devices. equipment available, not only during the initial training but also once the EMT has been in the field for a time. Frequent review and training with equipment will increase the confidence of the EMT in using the equipment. Review and training also will ensure that the patient receives the best possible care during transport in times of need. Figs. 6-12 to 6-18 show common equipment. During the skills labs associated with the EMT training, the instructor will demonstrate the use of each piece of equipment.

Critical Points Think before you move! Ask yourself, Is the scene safe? What is the patient s condition? Critical? Noncritical? Can my partner and I safely and effectively move this patient by ourselves? If so, how should we move the patient? The ultimate goal of emergency medical services is to deliver the patient safely, stabilized to the best of the EMTs abilities, to an appropriate facility. As such, the EMT has many responsibilities in caring for patients. Knowing if, when, and how to move a patient and deliver him or her to appropriate care is an integral part of the overall outcome of the patient. The EMT must be able to answer these questions and use the appropriate methods and equipment to accomplish this goal. Learning Checklist The EMT must be able to identify whether a scene is safe for entry. An accurate initial assessment is crucial in determining whether the patient is critical or noncritical. A patient in critical condition must be moved in a more expeditious manner than one in a noncritical condition. Knowledge of proper body mechanics is essential in order to protect the EMT from injuring himself or herself while on a call. The most frequently used piece of transportation equipment is the wheeled stretcher. The EMT must be familiar with whatever product he or she is using. The EMT must know how to raise and lower the stretcher. In addition to the operation of the stretcher, the EMT must know how to use proper body mechanics in operating it. The EMT can choose from a variety of lifts, carries, and drags. The EMT must be able to determine which one to use and how to execute each one effectively and safely. The decision of which one to use is based on the situation. The EMT must decide whether an emergency move is indicated, or if there is no imminent danger, whether a nonemergency move should be used. The EMT also must decide whether the patient should be extricated rapidly from the vehicle. The EMT must 140 be able to make those determinations and execute the appropriate corresponding actions. To transport the patient safely and effectively, the EMT must know the position in which to transport the patient and how to secure the patient safely before transport. The EMT must be familiar with and proficiently use all the transportation equipment available to him or her. The EMT must know which device to use and its indications and contraindications. Key Terms Body mechanics The most effective way to use your body to lift or move a patient. Carry Supporting all or part of the patient s weight while moving him or her. Contraindication A reason or factor that prohibits administration of a drug or use of a method of treatment or transportation. Emergency drags Using the patient s clothing or extremities to pull him or her along the floor or ground in a critical situation. Emergency moves Any lift, drag, or carry to remove a patient from a potentially dangerous environment. Fowler s position Placing a patient on a wheeled stretcher with the head of the stretcher raised to 45 to 60 degrees. Head and foot method Hoisting or lowering a transportation device where one emergency medical technician is at the patient s head while the other is at the patient s feet. Indication Conditions in which administering a specific drug or using a specific treatment or mode of transportation may benefit the patient. Laterally recumbent position Placing the patient on his or her side. A patient lying on his or her left side is said to be left laterally recumbent. Nonemergency moves Any lift, drag, or carry used when the scene is safe or the patient is not in critical condition. Position of comfort Placing the patient in his or her most comfortable position when there is no need for emergency procedures such as immobilization.

Power grip The correct hand placement for hoisting or lowering a transportation device. For hoisting, the hands should be spaced approximately 10 inches apart, with the fingers facing up. For lowering, the hands should be spaced the same distance apart, with the fingers facing down. Power lift The most effective way to lift a heavy object. Rapid extrication The rapid removal of a patient in critical condition from a vehicle. Recovery position Placing an unresponsive, breathing, nontrauma victim on his or her side to allow access to the airway to keep it open. Semi-Fowler position An inclined position with the upper half of the body raised by elevating the head or the stretcher about 30 degrees. Side-to-side method Hoisting or lowering a transportation device where the emergency medical technicians are on either side of the device. Standing backboard techniques Placing a standing patient with a suspected neck or spinal injury onto a long backboard, while the patient remains standing. These are twoor three-person techniques. Transportation device Any equipment, such as stretchers, stair chair, long backboards, or vacuum backboards, used to move a patient from one location to another. National Standard Curriculum Objectives Cognitive Objectives After completing this lesson, the EMT student will be able to do the following: Define body mechanics. Discuss the guidelines and safety precautions that need to be followed when lifting a patient. Describe the safe manner to lift a cot or stretcher. Describe the guidelines and safety precautions for carrying patients or equipment. Discuss one-handed carrying techniques. Describe the safe carrying procedure on stairs. Discuss the guidelines and applications for reaching. Describe correct procedures and reaching for logrolls. State the guidelines for pushing and pulling. Discuss the general considerations for moving patients. State three situations that may require an emergency move. Identify the following transportation devices: Wheeled ambulance stretcher Portable ambulance stretcher Stair chair Scoop stretcher Long backboard Basket stretcher Flexible stretcher Affective Objective After completing this lesson, the EMT student will be able to do the following: Explain the rationale for properly lifting and moving patients. Psychomotor Objectives After completing this lesson, the EMT student will be able to do the following: Working with a partner, prepare each of the following devices for use, transfer a patient to the device, position and secure the patient for transport, and load the patient into the ambulance: Wheeled stretcher Portable stretcher Stair chair Scoop stretcher Long backboard Basket stretcher Flexible stretcher Working with a partner, demonstrate proper techniques to move a patient from the wheeled stretcher to the hospital bed. 141