Health Science Core Chapter 7 and 11

1. McFatter Technical Center Emergency Medical Technician - Basic Health Science CoreChapter 7 and 11 Revised: August 2007

2. Chapter 7 The Safe Workplaceand Lifting/Moving Patients Revised: August 2007

3. Proper Body Mechanics • Body Mechanics - Efficient and safe use of the body during activity • Prevent injury • Correct problems related to posture and lifting • Most common injury for loss of time from the job is back injury Revised: August 2007

4. Anatomy of the Back • Important to maintain proper alignment so the weight is evenly distributed throughout the vertebrae and discs • 33 total vertebrae • Discs are cartilage that absorb shock to the spine • Several muscles support the spine and need to be kept strong and flexible Revised: August 2007

5. Back tips • Maintain broad base support with your feet • Always bend your knees, keep back straight, and use leg muscles to lift • Keep the load close to your body Revised: August 2007

6. Back tips • Use body weight to push and pull an object • Do not twist and turn. Try to turn your entire body • Test the weight before attempting to lift it. Revised: August 2007

7. Needle Sticks Reduce needle sticks: • Sharp objects must always be disposed in a puncture resistant container after use • Utilize needles that lock the needle in the hub Revised: August 2007

8. Patient Moving • Should get assistance with moving • Tell the patient what will happen • Prepare equipment that you are moving the patient to: • Gurney • Stretcher • Wheelchair • Backboard • Stair chair Revised: August 2007

9. Patient moving • Utilize slide board when available • Lock equipment in place • Ex. Gurney wheels • Ex. Wheelchair wheels • Provide a count for everyone to begin assisting with the move • Patient should be instructed on how to position limbs. • Ex. Arms crossed Revised: August 2007

10. Patient Moving • If side rails are on the equipment, make sure they are always placed up • Moving stretchers into the up position, make sure the legs lock • Moving stretchers out of rescue unit, make sure the carriage legs drop and lock before moving the upper wheels off of the rescue floor • Moving stretchers on uneven terrain, support at the head and foot of the stretcher or use 4 rescuers on each corner. Revised: August 2007

11. Patient MovingPower lift • Get as close to the object as you can. • Spread your legs shoulder width apart. • Bend your knees and squat down. • Lock your back into an upright position and tighten abdominal muscles. • When lifting with other students, one person should be coordinating the lift. • Lift up by using your legs. • Keeping your back locked upright position while completing the lifting motion. Revised: August 2007

12. Lifting Guidelines • Must communicate the plan with everyone on the team before lifting the patient • Estimate weight of patient before lifting and make sure you can safely lift this weight • Patients over 250lbs should be lifted with 4 or more rescuers • Know the weight limitations of your equipment Revised: August 2007

13. Lifting Patients Down Stairs • Secure patient to stair chair, backboard, or other suitable equipment • Rescuers take their places around the patient • Additional rescuer provides spotting on the stairs, opens doors, and assists as needed Revised: August 2007

14. Emergency Moves Moving a patient before initial assessment and care are provided when there is some potential danger. Example: • Fire • Explosion • Hazardous material incident Revised: August 2007

15. Non-urgent Moves Scene and patient is stable. The rescue crew can plan how to move the patient. Revised: August 2007

16. Moving Geriatrics Rescuers should apply additional care to geriatric patients • Brittle bones • Rigidity and spinal curvatures • Fear of hospitals Revised: August 2007

17. Patients who Smoke • Never allow to smoke near oxygen equipment • Make cause explosion • Never allow to smoke in bed because they could fall asleep • Keep lighters and matches away from children or confused patients Revised: August 2007

18. Hazardous Work Environments • Personal safety is number one • Utilize proper forms of protection • Alert supervisors and other workers of possible hazards in work area • Remove from use any equipment that is hazardous and send to appropriate person for repair Revised: August 2007

19. Electrical Shock Prevention • Do not use any equipment until you have been properly instructed • Inspect electrical cord (do not use if damaged or frayed) • Do not use equipment cords that have the one of the three prongs removed • Do not use damaged or malfunctioning equipment • Avoid using electrical equipment on wet surfaces Revised: August 2007

20. Acid and alkaline chemicals can cause direct skin contact burns or inhalation injury from fumes Never combine acid chemicals with alkaline chemicals Chemical Injury Prevention Acid black lesion Alkaline white lesion Revised: August 2007

21. Chemical Injury Prevention • Always wear gloves when handling chemicals. • Read labels of containers that you are using • Do not use solutions that are missing labels or unreadable • Use chemicals in a well-ventilated area • Exposed to chemicals, immediately flush with water Revised: August 2007

22. Material Safety Data Sheet Document that identifies chemicals used in a specific department with details regarding the chemical 1. Component data 2. Fire and Explosion data 3. Health hazard data Revised: August 2007

23. Material Safety Data Sheet • Other information: • Employee protection • Reactivity data • Storage precautions • Physical data • Environmental protection Revised: August 2007

24. Hazard Communication Label Locate outside the building Revised: August 2007

25. Fire Safety RACE • Rescue patient • Activate the alarm • Contain the fire • Extinguish the fire Revised: August 2007

26. Fire Safety • Remain calm and do not panic • Turn off oxygen • Close doors and windows to contain and slow spread • Use fire fighting equipment Revised: August 2007

27. Fire Safety Extinguishers look at label and make sure the extinguisher classification is appropriate for the fire Revised: August 2007

28. Fire Safety PASS • Pull pin • Aim handle • Squeeze handle • Sweep back and forth at the base of the fire Revised: August 2007

29. Chapter 11Fundamental Patient Care Equipment Revised: August 2007

30. Beds and Gurneys • Gurney is a stretcher which is used for transporting patients • Beds: • Stryker frame or circular double frame bed – rotating along patient axis allowing you to turn the patient over without his/her assistance. • Roto-Rest bed – mattress alternated pressure to prevent skin breakdown Revised: August 2007

31. Ambulation Equipment • Wheelchair – wheel for transporting patients • Crutches – for orthopedic injuries that all the patient independent movement • Canes – assist patient with balance and reduce falling • Walkers – allow patient to move with more support than a cane Revised: August 2007

32. Respiratory Devices Oxygen deliver devices • Nasal cannula – delivers low percentage of oxygen • Oxygen mask – delivers higher percentage of oxygen • Nebulizer – delivers fine mist of medication • Respirator or ventilator – machine that mechanically breathes for the patient Revised: August 2007

33. Intravenous Therapy • Fluids of sterile water mixed with dextrose or electrolytes • Hospitals use infusion pumps to deliver intravenous fluids at accurate amounts • Do not adjust settings or turn off the pump Revised: August 2007

34. Excretory Equipment • Bedside commode – portable toilet usually kept by the patient’s bedside • Indwelling catheter or folley catheter – catheter inserted into the urinary bladder • Suctioning device – used to prevent inhaling solids or liquids or keeping them from choking on secretions Revised: August 2007

35. Crash Cart Contain defibrillator, oxygen tank, suction machine, medications, intravenous solutions, advance airway equipment, and other equipment for cardiopulmonary arrest Revised: August 2007

36. Patient Care Unit • Bed • Over-bed light • Table • Personal storage • Call light and intercom system that allows the patient to contact for assistance • Television Revised: August 2007

37. Rescue Apparatus • Method to transport patient to the hospital and carry necessary equipment • Configurations are personal preference. Each agency designs the vehicle based on needs. Some carry a lot of equipment and therefore need a bigger vehicle Revised: August 2007

38. Other Transporting Vehicles • Helicopters – used for long transports or transports that would be delayed by traffic • Pumpers – designed to fit a stretcher and carry full ambulance equipment • Fix wing aircraft – used for long distance transportation Revised: August 2007

39. Stretcher Revised: August 2007

40. References • Pollak, Andrew N. Emergency Care and Transportation of the Sick and Injured. 9th ed. Sudbury, Massachusetts: Jones and Bartlett, 2005. • Stevens, Kay, and Garber, Debra. Introduction to Clinical Allied Healthcare. 2nd ed. Clifton Park, New York: Thomson Delmar Learning, 1996. Revised: August 2007