Patient Transport
Course Content
- Introduction to Patient Transport
- Things you Need to Think About When Transporting People
- Medical Conditions
- Falls and Fall Prevention
- Walking Aids
- Assisting to Walk
- Safety and Emergencies
- Summary to Patient Transport
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Avoiding back injuries
To hurt your back is a quite serious thing and a very easy thing to do. It totally depends on how we are feeling. The weather comes in to play, how long we have actually been seated, the position we actually take in the handling of a passenger who may be in our vehicle and then actually lifting any equipment that we may be putting into the boot of the car or on to the passenger seat, and actually helping the person into the car themselves. Your back is easily injured via your spinal column, you are injuring your vertebrae. But we also, of course, got the muscles that hold everything together and that is the tendency for most people is, muscle damage is the instant one because of heat, that we are not warmed up, we have not stretched. So that is the one which can be injured very easily, especially when we are looking at ourselves. We do not do much manual labour. So, bending and stooping, picking, lifting, we think we can use our natural strengths when we should be using our body ergonomically by using our knees and our big muscles to help us when we lift and carry. So injuring our back is a very, very serious and easy thing to do and it is something that we take for granted, our back. We think our back is nice and strong, but there are different times it could be weaker by how we are feeling. As I said, the conditions, the environment, the seating arrangements, the actual way we turn and twist. So there are lots of things that can actually lead into an injury for our back from what we are doing in our everyday life, especially as we are transporting passengers in our vehicles, we are stooping, twisting, moving. Even our necks, turning our necks to look over our shoulder when we are pulling out in traffic. That can actually cause an injury. So, we have to be conscious of what we are doing, how we are doing and sometimes just preparing ourselves to be ready to do that. And that is where the ergonomics come in. So looking at something bulky, like a wheelchair, what sort of things can people do wrong and right in lifting a wheelchair into the back of the car? Well, it is an awkward shape. If it has leg rests, if it has specifically foamed backing, or specific seating arrangements within the chair itself, that makes it more difficult to actually hold especially when we are lifting because, again, most wheelchairs are made out of metal, so that can be a cold surface when you are lifting it. Again, there are sharp objects on the edges of things. So, it is making sure that we are actually closing the chair fully properly, that it is folded into the position it should be. Any attachments that can be removed, because when you lift something and you go to put it in a small space, just even banging it against something can give you a jolt. And that again could actually throw you off balance. If the chair's fairly heavy, that again could make you twist or manoeuvre into an awkward position which can injure you. So it is physically looking at it first and thinking, "How can I make it smaller? How can I make it easier to lift?" And that is part of what we would do in a moving and handling situation is, "Can we avoid it? No, we can't," so we assess it. "Can I make it smaller? Can I make it lighter?" Yes, we can. If we have done that, we'll have reduced it and then it's made it as safe as possible for us to do. So, it is looking, assessing and then actually trying to reduce how much we are going to be lifting. But it goes back to the ergonomics protecting our back. If we lift something, we look for firm handles that are not going to move and not going to damage us by lifting it. And then we use our big muscles, bend our knees, get in the right position so we can lift, straighten up, look directly where we are going. We look at the horizon, always look with our head up, and then we actually try and keep our bodies straight. We talk about the straight spine. Our spine, as you know, is not straight. It is an S shape. So, straight as in being in a line, not twisting. Yeah? Because any time we twist, that puts pressure on our vertebrae; again, on our muscles and our ligaments that are holding everything together. So it is about our straightness as we are lifting. Use our big muscles, use our knees, stand up straight and move in a straight position. It is when we start twisting, that is the potential for back injury, especially with a wheelchair because they come in all shapes and sizes, weights and types. So, it is very important to assess it before we move it. So when helping somebody, what other ways could you hurt yourself? Well, when we are actually helping a passenger to actually get out of the vehicle, it is more of a supporting role, moving and positioning and supporting people. We do not tend to lift. We would use specialist equipment for that. But yeah, there are specific loads and stuff that we have to consider. But different ways we can injure ourself is that we are solely concentrating on the individual themselves, the person, the passenger and we are actually not looking at what we are doing, so that means we could slip off the curb or we could miss a step, which they could pull that person on top of us because we are actually supporting them. There is also specifically with passengers in vehicles is traffic. We are opening doors, we are actually parking away from the curb so we can give the person a position to come out, so that could push us further into the road. When we get out of the vehicle ourselves, when we come round with the person, we may miss a hole. But it is that supporting, when you offer that support and say, "Can I help you?" you are putting an arm out, that person is going to use you as like a crutch, so they could put a lot of weight on you. If you are not ready and not prepared, again, that could pull you down, that could twist you, that could injure you in that way as well. So, once we have arrived and we are supporting a passenger from the vehicle into their own home and the same thing coming out of the home to the vehicle, to actually transport them, there are lots of ways that we can be injured, especially if we are supporting them. A person may be leaning on us, so we miss holes, we miss steps because we are focusing on them, we forget about ourselves and then we start twisting. We put our body in a different position which is not what we should be doing ergonomically. We should be trying to keep straight. We should be able to see what the person is doing, but we need to be walking straight, keeping ourselves straight and upright because they're depending on us as their crutch. So, we are trying to prevent injury to ourselves and in supporting safely the person we are helping down to the vehicle. So if that person, their legs just collapsed away from them and they drop, should you catch them as they fall? Or how would you deal with that person if they fall to avoid hurting yourself? The best way to do that is to release the individual, but also we are looking at trying to support them as they go down, but not catching them because the likelihood is, even if it is a frail elderly person, there's still the weight of someone pulling you down could actually cause you quite serious injury yourself, then that would be, instead of being one person that might be injured, now we have got two people who might be injured. It is a bigger issue for when the emergency services arrive. So initially, we would try and support as best we can, it is more lowering the person to the floor than catching the person or stopping them from going to the floor because once someone makes a motion and moving, it is really hard to stop it. You generally have to use quite a lot of force to stop it, so it is best to try and actually support the person down to the floor and then we can deal with that situation once they are there. We are trying to prevent as much injury to us as the injury impacts to the person who may be falling themselves.
Preventing Back and Spinal Injuries When Assisting Passengers
Risks and Prevention
Understanding the risks and how to prevent back injuries:
- Common Causes: Back injuries can occur due to prolonged sitting, improper posture, and sudden movements.
- Ergonomic Approach: Use body ergonomics to reduce strain, especially when lifting and carrying heavy items like wheelchairs.
Handling Wheelchairs Safely
Key considerations when handling wheelchairs:
- Preparation: Assess how to make the wheelchair lighter and easier to handle.
- Safe Lifting Techniques: Use your knees and keep your back straight when lifting to minimise injury risk.
Assisting Passengers Safely
Best practices when assisting passengers in and out of vehicles:
- Situational Awareness: Stay aware of your surroundings to prevent slips or falls.
- Offering Support: Be prepared to support the passenger's weight securely to avoid injury.
Handling Emergency Situations
Dealing with unexpected situations during passenger assistance:
- Managing Falls: If a passenger collapses, lower them gently to the ground to minimise impact.
- Emergency Response: Ensure safety and call for emergency assistance if needed.
