Researchers from the Ohio State University and the University of Illinois at Chicago have recently published a series of studies comparing different methods for performing lateral transfers and transporting patients down stairs. A summary of the methods and results are presented below.
Note: Each experiment was conducted with eleven, two-person teams of firefighters/paramedics from Chicago’s suburbs. In place of an actual patient, a 75-kg (165-lb) dummy was used.
Performing Lateral Transfers
EMS runs can begin with and almost always end with a lateral transfer: from the patient’s bed to a stretcher and from the stretcher to a hospital gurney. In this study, a variety of transfer methods were evaluated and compared to completing the transfer by lifting a patient using a bed sheet only.
- Use of a pair of collapsible rods as handles, rolled into the bed sheet, with one worker positioned on the bed and one on the far side of the stretcher. This method did not show an improvement over using a bed sheet.
- Use of a single collapsible rod, rolled into the bed sheet, with both workers positioned on the far side of the stretcher. This method changes the task from lifting into pulling, reducing the level of activity in the low back. To compensate for the new task a different set of muscles were used at a greater level, but this effect was eliminated when combining the single rod with the plastic bridgeboard.
- Use of a plastic bridgeboard between the bed and stretcher, with one worker positioned on the bed and one on the far side of the stretcher. This method reduced the level of activity in the low back, especially for the worker positioned on the far side of the stretcher.
The researchers concluded that using a single collapsible rod in combination with a plastic bridgeboard would have the greatest effect.
Transporting Patients Down Stairs
Once the patient is placed on a stretcher, EMS workers may have to transport patients down stairs. In this study, a variety of interventions were evaluated and compared to transporting patients down stairs on a traditional backboard.
- Use of a foot strap attached to the backboard to prevent patient sliding toward the first worker down the stairs. This method reduced the level of low back muscle activity for the worker leading the backboard down the stairs.
- Use of a backboard wheeler (a hand truck type device) to roll the patient and backboard down the stairs. This method reduced the low back muscle activity for the worker leading and following the patient down the stairs.
- Use of a descent control system (DCS—a tank tread like attachment) to roll a stretcher down the stairs. This method reduced the low back muscle activity for both workers, but increased the level of muscle activity in another group of muscles for the following worker.
The researchers concluded that the additional foot strap is easily implemented with commonly available EMS materials and adds little time to the current process of securing the patient. The researchers also concluded that the DCS and backboard wheeler would be even more beneficial to reducing back injuries, by transforming the carrying task into a pushing and pulling task.
Lavender, S., Conrad, K., et al, 2007. Designing ergonomic interventions for EMS workers. Applied Ergonomics 38 (1), 71-81. Applied Ergonomics 38 (2), 227-236. Applied Ergonomics 38 (5), 581-589.