(A) Purpose. To establish standard operations procedures for the proper handling of stretchers.
(B) Policy.
(1) All County EMS shift personnel are expected to strive to achieve and maintain the procedures set forth in the document entitled “Harnett County Emergency Medical Services Stretcher Handling”.
(2) The shift supervisor shall utilize these procedures in work planning performance review process to evaluate the performance of each member of his or her shift.
(C) Procedures for stretcher handling.
(1) At no time will a stretcher be raised or lowered from the side positions when there is a patient on the stretcher. If the stretcher must be raised or lowered while the patient is on the stretcher, one attendant will go to the head position and the other attendant will go to the foot position. Once both attendants are in place, the stretcher may then be raised or lowered.
(2) When loading the stretcher into the EMS unit, both attendants will go to the side of the stretcher and grasp the bottom rail of the stretcher, lifting at the same time. It may be necessary to elevate the front portion of the stretcher as to clear the unit’s floor before entering.
(3) The unloading procedure is basically the same as loading. The one difference being the driver will press the stretcher release button and both people will grasp the stretcher from the end and roll it back to them. As the stretcher rolls back, both attendants will move along beside the stretcher and grasp the bottom rail to remove it from the unit to the hospital loading dock or whatever area they are to unload at.
(4) When bringing a stretcher down or up a set of stairs or down or up an incline of any type, always try to keep it level. In many cases, it is better to put the shorter person on the end that does not have to be lifted. This way, the taller person can get his or her arms under the end that has to be raised and, in many cases, lift it above his or her head to keep it level.
(5) When moving a stretcher with a patient aboard, the stretcher will always be moved feet first. There are two exceptions and this will be explained later. The attendant at the foot of the stretcher will walk in front of the stretcher and not to either side. The attendant at the head of the stretcher will walk in the same position (in the center line of the stretcher) and not out to either side. This allows him or her to keep an eye on the patient at all times and does not take up as much space when coming down the hallway.
(6) There are two times you will go in head first.
(a) When you have reached the entrance to the emergency room, you may go in head first. Remember, all the heads of the ER beds face away from the entrance doors. So, if you go in head first you won’t have to turn your stretcher and your patient around.
(b) When you start to enter an elevator, let one attendant stand straddling the opening of the door. This will ensure that the doors don’t close on your patient and stretcher. When you are ready to take the patient from the elevator, it will be done the same way.
(7) At no time will any patient be left on an EMS stretcher unattended, there will be one attendant with the stretcher and patient at all times. Always remember, as long as you have a patient on your stretcher, you and County EMS are liable for the health and well-being of that patient. Once the patient is removed from your stretcher then, and only then, your liability is over, but if the other emergency service needs help, you may do whatever you can to help.
(8) When you enter the ER with your patient and transfer the patient to the ER bed, remove your stretcher from the ER so it will not cause congestion in the ER area. If you are going to be tied up assisting the ER personnel, at least one attendant should make the stretcher so it will be ready if your unit receives another call.
(D) Movement and care of patient.
(1) When you enter the emergency room with your patient, place the head of your stretcher at the foot of the ER bed if you are going to have to move the patient yourself. If the patient is able to move without any further medical danger, then pull your stretcher alongside of the ER bed.
(2) If the patient is going to be lifted to the ER bed, place the head of the EMS stretcher at the foot of the ER stretcher. Both attendants move to the side of the EMS stretcher and let the side rail down. Place one foot on the bottom rail of the EMS stretcher to stabilize it while you are preparing for a two-person lift. Once both attendants are ready, lift the patient to the ER stretcher and remove your hands and raise both side rails.
(3) If your patient is able to move, pull your stretcher to the side of the ER stretcher. Let your side rail down and place your hand on the side of the lowered side rail. Both attendants take position at the head and foot of the stretcher, placing their outside foot on the bottom rail of the EMS stretcher. Next grasp the ER and EMS stretchers together with your hand. With these two steps, neither stretcher will move when the patient slides from one to the other. Now ask your patient to move to the next stretcher for you. After this is done, put up both side rails.
(Res. passed 1-3-1989)