advice on keeping the stretcher from tipping over

[emt seeking first job]

Thank god it has not yet happened.

Any pointers from you veterans on keeping it that way.

I get uneasy, especially when it is fully raised. One guy told me each person should be diagonally opposite.

We were taking my mentors 95 year old grandmother home from the hospital one night, and I just freaked out, I had visions of the thing tilting so I begged her to pull it out.

So please post your tips and tricks to keep it from happening for the benefit of all, especially the good people we transport.

Thank you.

 

[bigbaldguy]

Never push it drunk I'm finding that planning ahead is very important when pushing the stretcher. Map out your route visually and pay attention to roots, cracks in sidewalks Ect.

 

[adamjh3]

Communication. That's the biggest part of it.

Make sure both you and your partner know exactly what's happening when.

When hitting ramps, or on hills, take them straight on.

When putting the gurney on the scales at a dialysis center, go one wheel at a time.

When going up stairs, have the strongest person be the lowest person on the stairs.

Rough terrain? Drop it down a few clicks to lower the center of gravity.

Super fat guy on the gurney? Keep it low.

 

[emt seeking first job]

My service was buffing a call.

I jumped in to help the paramedic unit with the stair chair. Three story walk up (or down). Marble steps, rainy night. It worked out well.

One small victory is the next time we crossed paths, he politely told his own organizations EMTs that (blah name of vollie unit blah) is here and we can help them. He then picked me to ride with him (out of 2 other dudes) to assist. It was a person who had ROSC with an implanted AED. She was vomitting. I jumped in to clean it all up without being asked.

I have been only at this for about three months or so. Its really critical that nothing goes wrong.

Thank you, though, I do already do that. Thank you for re-inforcement. I glance back at all hazzards. I just don't want to dump anyone......most of our 'customers' are elderly.

 

[46Young]

The lower the cot sits, the lower the center of gravity, and the less of a chance of tipping over. If you have a third person, have them back you up if you're coming down the stairs. When you're loading the cot into the bus, your partner is going to left the legs. When this happens, the cot will tend to tip to one side. Be ready to compensate with some force in the other direction. When you unload the cot, always be sure that someone is holding the legs, and letting them down slowly. Besides the undue wear and tear, the shock from the legs rapidly extending can hurt the pt. If you're moving the pt on a stair chair, just continue to do so until you get to the bus, to minimize the chance of a mishap with the cot.

 

[MSDeltaFlt]

Keep both hands on the stretcher, both of you.

Lift as one unit. Always.

Slow and steady; and steady is fast.

 

[EMS49393]

First off, most of the time the highest position on the stretcher is a loading position, which tilts the head up several degrees and makes the stretcher more unstable. Lower it a click to the traveling position, that will improve your safety.

DO NOT ROLL THE STRETCHER SIDE-WAYS. It seems stupid, but that is how they most often tip. If you roll it sideways, and one wheel catches a bump, it will toss the entire thing. I learned this first hand while teaching safety to a pile of EMT's that proved this theory in practice.

Most, if not all ambulances have a stair chair, scoop stretcher, reeves stretcher, or any variation of those. They are not decorations. They are to be used. Do not carry your stretcher up and down stairs, that is just freaking ridiculous, not to mention heavy and dangerous. The average stretcher now weighs over 100lbs and some are closer to 125lbs. Throw a 200 pound patient on that and you're trying to carry over 300 pounds down a flight. Your back will punish you severely for your error in judgment.

Use YOUR equipment. It is not quicker to pack up Granny on one of her kitchen chairs and take her down the front flight of steps. Those chairs are not designed for that, and if they break, someone is going to be talking to your legal department about it, believe me.

Take your time. I don't care how critical your patient is, it is not a race, and your patient will be a great deal more critical if you drop them.

 

[mycrofft]

All good tips.

Add some:
1. Why raise the ambulance litter full up during rolling movement if you do not have to?
2. Good one about the dialysis scales. Gently rolling over low but sharply raised lines like sidewalk seams and those scales is best done just off "straight on"; that way one wheel at a time is being impacted and three others are maintaining balance.
3. Strongest carriers at the pt's upper torso, and and try to keep patient as level as possible. If the pt must be carried at a distinct angle, THEN strongest to the bottom. Communicate, change positions if it is needed.
4. Use even numbers of carriers, not counting the head, for balance.
5. The head carrier calls the orders, the foot carrier warns the head carrier.
6. NEVER leave a pt on a rolling ambulance litter (aka "cot") without at least one of you having one hand gripping the frame, and best if it is then sided against a wall. I've seen "momentarily" un-handed litters lead to tipping many times, even after telling the receiving person not to leave the pt; they will do it every dang time.
7. Be cognizant of what to do if things require you to suddenly set it down, then do it when need be.

 

[JPINFV]

As others have said, when moving always move forward and back, never side to side.

True, the lower the setting, the lower the center of gravity. However, in my experience this normally doesn't matter if the terrain is level (such as in nursing homes and hospitals).

If taking the gurney over steps, drop it down a few levels so that the undercarrage is out of the way when you lift up.

As with everything, if anything seems off, stop and reevaluate.

 

[katgrl2003]

If you don't think you can move a patient safely, don't do it! Never be afraid to ask for help.

 

[46Young]

Another thing - I like to flake out a draw sheet on the cot before placing the pt there. In addition to making it easier to do a bed transfer, it's also easier to reposition the pt if they're listing to one side, or if they slide down towards the feet. If the pt is leaning to one side, it inreases the risk of tipping the cot. I also like to flake out a blanket over the sheet when it's cold outside. You can quickly move the pt from the chair to the cot, burrito wrap them, place another blanket over the top of them, and have full coverage in under 30 secs.

 

[46Young]

If you don't think you can move a patient safely, don't do it! Never be afraid to ask for help.

Seriously. Even if they're crashing, it's not worth blowing out your back, your shoulder, your biceps or whatever. It's not worth going on disability or ending your career. Work them where you are until you get enough help. It's not your fault if the 350 lb CHF'er w/ DM lives on the second floor of a tight apartment.

 

[abckidsmom]

What everyone else said. Watch carefully when you're parked on a curb, loading or unloading the patient. City streets that have been repaved a million times can have a nice grade to them, and the stretcher will roll down that hill, hit the curb and tip.

The stretcher needs to have 3 points of contact with the ground: The wheels, and your two feet. If you are walking, you only have 1 foot on the ground, so your partner needs to have a hand on the stretcher and be in control of it too.

 

[medicdan]

When you have a patient loaded always keep three hands on the stretcher. Always. When approaching the ambulance, whoever is at the head should keep one hand on the stretcher, the other unlocking and opening the truck door, while the other remains at the feet, with two hands on the stretcher.
Check your stretcher at the beginning of the day-- make sure the releases work, straps are clean (and secure), remove crap from behind the head, etc.

 

[JPINFV]

Seriously. Even if they're crashing, it's not worth blowing out your back, your shoulder, your biceps or whatever. It's not worth going on disability or ending your career. Work them where you are until you get enough help. It's not your fault if the 350 lb CHF'er w/ DM lives on the second floor of a tight apartment.

In addition, if you have a breakaway transfer flat and don't think the patient will tolerate a draw sheet, place the transfer flat onto the gurney in the same style.


Also, if walking a patient to the gurney, have one person stand on the opposite side of the gurney as the patient. That person can put their feet on the inside of both wheels so that the gurney is chocked going both ways.

 

[PotashRLS]

Never be in a hurry with a cot!! If a crew member is wheeling, handling, or loading incorrectly or inappropriately, tell them after the call. If their behavior is detrimental to the patient, tell them immediately but discretely.

 

[feldy]

always watchout when loading and lifting the carriage up...make sure the release is infact being releases as we all know that they might not click.

I almost tipped the cot the other day while lifting the carrage with a pt b/c the release wasnt being held all the way.