Four Keys to Preventing Patient Drops

Proper patient handling is something EMS professionals should think about regularly. Patient drops not only put patients at risk, they can also seriously injure EMS staff, resulting in reduced staffing, recovery times, and additional costs. With an estimated 42,000 patient drops occurring every year, it is critical for everyone working in emergency services to stay abreast of the latest and most effective patient-handling procedures. 

Industry research indicates the leading causes of patient drops include: 

• Errors in operating or selecting equipment;
• Lack of balance or insufficient muscle strength;
• Failure to evaluate on-scene hazards;
• Improper maintenance of equipment or outright equipment failure;
• Provider complacency. 

By embracing four key practices and implementing them across your organization, you can significantly decrease your risk of dropping patients, being sued, and becoming injured. 

1. Use Proper Techniques

Before you lift—The key to proper lifting starts with mastering your lift position. Get yourself as close as you can to the object you’d like to pick up. Feet should be placed about shoulder-width apart to give you the most stable base possible. Place your toes under the gurney’s edges or as close to the patient’s body as you can. 

While you lift—When preparing to lift upward, it’s essential to tighten the muscles of your core. Move with strong abdominal muscles while keeping your back as flat and relaxed as possible. In addition, utilize the leg muscles to support the lift, shifting your weight to both the balls and heels of your feet. When pushing upward during your lift, keep your shoulders aligned over your hips and tighten the muscles throughout your hips, hamstrings, and glutes. Keep these muscles, along with your abdominals, tight throughout the duration of the lift. 

2. Get Some Support

Whenever possible, don’t lift alone. Use the support of your team and divide the weight being lifted. If you have equipment designed to help, utilize it properly: Familiarize yourself with any assistance equipment to avoid user error in moments of increased stress and continually practice using the equipment during regularly scheduled trainings.

Team performance—A few practices can help ensure lifting with a team goes smoothly:

• Perform a quick assessment of the scene to look for hazards that could prevent you from moving a patient from one location to another;
• Communicate clearly as you move and verbalize all commands;
• Ensure all team members practice proper lifting techniques and are in good physical condition, capable of the demands of the procedures.

3. Strengthen Your Lift

These exercises focus on strengthening all the most important muscle groups used during lifting. Incorporating them for just a few minutes into your day-to-day routine can make a big difference in your strength and lifting ability and can help you to avoid accidental injuries. 

• Crunches (traditional, bicycle-legs, or elbow-to-knee);
• Squats (be sure your knee doesn’t go over your toes);
• Traditional planks.

Many other exercises are effective in strengthening your lifting muscle groups. These three, however, are easy to do anywhere and do not require additional equipment. The most common and debilitating injuries that occur during lifting are back injuries. Protect your back and avoid using those muscles while you lift instead with those you’ve strengthened: your core, hip flexors, glutes, and legs. 

4. Foster Increased Focus

As a provider and someone working in claims, I’ve seen firsthand how essential it is to truly focus on what’s about to occur before lifting or moving a patient. It’s also important to think about what could occur if lifters don’t pay careful attention. Bad things happen when people fail to or are unable to stay alert to their environment. Some common EMS practices that can cause a lack of attention and have bad repercussions are:

• Using cell phones or radio devices while preparing for or during patient movement;
• Being in denial that any type of incident could happen to you and your team;
• Failing to pay attention to scene-excitement dynamics and neglecting to stay focused on the task at hand.

Although patient handling is a frequent and unavoidable part of your job, much can be done to make the process more safe and effective. By using proper physical form, working as a team, exercising, and carefully planning and considering what you’re doing or about to do, you can help prevent both patient and self-inflicted injuries. 

For more, see VFIS’ back-injury prevention tips. 

Michael J. Brown, EMT-P, is a liability specialist who has been handling EMS claims at Glatfelter for 18 years. He practiced as a volunteer and career EMT and paramedic in various capacities since receiving his first EMS certification in 1974.