Lifting, Moving, and Extrication Techniques - NREMT: EMT Level

Rotate patient as a unit to place a device while limiting spinal motion. Log rolls maintain axial alignment for device placement or assessment with minimal spinal disruption.

Keep the weight close to the body at waist level. Positioning the load near the body's center of gravity reduces torque on the spine and distributes force evenly.

Turn by pivoting the feet; do not twist the torso. Pivoting with the feet preserves spinal neutrality and prevents torsional stress on vertebral structures.

One leader gives clear countdown commands (for example, “On 3”). A single leader's countdown ensures synchronized movements, reducing the risk of uneven lifting and potential harm.

Assess the scene for hazards and plan the move. Initial assessment identifies risks and enables strategic planning for safe, effective patient handling.

Move to protect from immediate danger without delaying for immobilization. Emergency moves prioritize immediate safety from threats, forgoing full precautions to expedite relocation.

Planned move when no immediate hazard exists; use proper equipment. Nonemergency moves allow time for equipment and techniques that maintain patient stability and rescuer safety.

Direct carry with a draw sheet (sheet transfer). Draw sheets provide a low-friction surface for lateral transfers, minimizing patient discomfort and rescuer effort.

Moving a stable patient up or down stairs in a confined space. Stair chairs enable safe navigation of stairs for seated patients where space limits other devices.

Prevent rescuer injury while safely moving the patient. Proper body mechanics prioritize rescuer safety by minimizing musculoskeletal strain and ensure patient stability during transport.

Portable stretcher (carrying device). Portable stretchers are lightweight for manual carrying, suitable for brief transports of supine individuals.

Wheeled ambulance stretcher (gurney) or wheeled litter as available. Wheeled devices facilitate efficient movement over distances, reducing physical strain on rescuers.

Extrication and short-term movement, not routine transport. Long spine boards support spinal immobilization during removal from hazardous or confined environments.

Scoop stretcher. Scoop stretchers assemble beneath the patient without rolling, preserving spinal integrity during lifts.

Moving a patient in tight spaces where a rigid stretcher will not fit. Flexible stretchers adapt to narrow or irregular paths, allowing transport where rigid options are impractical.

Two rescuers carry patient by wrists and ankles; short distance only. Extremity lifts offer a simple, equipment-free method for brief carries in non-spinal injury cases.

Drag patient by clothing/blanket to quickly remove from danger. Ground drags enable single-rescuer extraction in urgent scenarios, prioritizing speed over comfort.

Stop the move and reassess stabilization and technique. Pausing allows evaluation of pain causes, preventing exacerbation of injuries through adjusted methods.

Use a power lift: back straight, lift with legs, arms locked. Power lifts utilize leg strength and locked posture to lift safely, avoiding back strain.

Use a power grip and squat; lower with legs, not the back. Squatting with a firm grip controls descent using legs, protecting the spine from excessive load.

At the foot end (lower end) to support most of the weight. The lower position bears greater upward force against gravity, requiring more strength for stability.

Bent at hips and knees (squat), with back straight. Bending at the hips and knees engages stronger leg muscles, maintaining spinal alignment to reduce injury risk.

At the head end (upper end) to control descent. The upper position enables better leverage to regulate speed and maintain level during descent.

Quickly remove patient with manual C-spine when immediate threat exists. Rapid techniques emphasize manual stabilization for swift vehicle removal in unstable conditions.