transportation of the injured

transportation of the injured

The process of moving an injured person to a hospital or other treatment center. In serious injuries such as cranial and spinal trauma, airway compromise, and hemorrhage, the patient should be moved by properly trained support personnel with equipment to stabilize vital structures and prevent further injury. In particular, the airway should be secured, ventilation provided, circulation supported, and the spine protected from injury with specially designed appliances. It is crucial that critically injured persons receive definitive care within the first hour of their injury to optimize their chances of survival. Patients with lesser injuries whose vital signs are relatively stable may be transported by ambulance litter, private vehicle, or wheelchair, or by means listed here.

Carrying in arms: The patient is picked up in both arms, as the carrying of a child.

One-arm assist: The patient's arm is placed about the neck of the bearer, and the bearer's arm is placed about the patient's waist, thus assisting the patient to walk.

Chair carry, chair stretcher: Any ordinary firm chair may be used. The patient is seated on the tilted-back chair. One bearer grasps the back of the chair and the other the legs of the chair (either the front or rear, depending on the construction of the chair). Both bearers face in the same direction.

Fireman's drag: The patient's wrists are crossed and tied with a belt or rope. The bearer kneels alongside the patient, with his or her head under the patient's wrists, and walks on all fours, dragging the patient underneath.

Fireman's lift: The bearer grasps the patient's left wrist with the right hand. The bearer's head is placed under the patient's left armpit, drawing the patient's body over the bearer's left shoulder. The bearer's left arm should encircle both thighs, then lift the patient. The patient's wrist is transferred to the bearer's left hand, thus leaving one hand free to remove obstacles or to open doors.

Four-handed basket seat: Each of two bearers grasps own wrist and then grasps the partner's free wrist. The patient sits on this support.

Pack-strap carry: The patient is supported along the bearer's back. The patient's right arm is brought over the bearer's right shoulder and held by the bearer's left hand. The patient's left arm is brought over the left shoulder and held by the bearer's right hand. The patient is thus carried on the back, with the arms resembling pack straps.

Piggyback carry: The patient is supported along the bearer's back with the knees raised to the sides of the bearer's torso. This leaves the patient practically in a sitting position astride the bearer's back, with arms around the bearer's neck or trunk.

Six- or eight-person carry: This is done as the three-person carry, except three or four bearers are on each side of the patient, thus dividing the patient's weight more uniformly.

Three-handed basket seat: The bearer grasps his or her own wrist; the partner grasps the bearer's wrist and leaves one arm free for supporting the patient.

Three- or four-person carry: This is the litter-type carry used by emergency squads. Three persons kneel on one side of the patient, place their hands under the patient, and lift up. The head bearer supports the patient's head and shoulders, the center bearer lifts the waist and hips, and the third bearer lifts both the lower extremities. A fourth person, if available, should help steady the patient while he or she is being lifted.

Two-handed seat: The bearers kneel on either side of the patient. Each passes one arm around the patient's back (under the armpits) and the other arm under the knees and lifts the patient carefully in a sitting position.

Wheelchair, improvised: To make this, the legs of a chair, preferably one with arms, are fastened to parallel boards and skates or casters are attached to the bottom of the boards. A footrest can be made by attaching a broom handle or stick across the parallel boards in front of the chair.

Vehicles: If an ambulance is not available, stretchers can be improvised with ropes and chairs, ladders, or poles. The patient should always be tied to the stretcher during transportation. Several bearers will be necessary to assist entering and leaving the vehicle.