When using the power lift technique the weight you are lifting should be

Wheeled Stretcher:  Two basic types of stretchers are used: the two-person and the one-person. The two-person requires two EMTs to lift and load in the ambulance, whereas, the one-person stretcher has special loading wheels at the head that allows one EMT to load it into the ambulance. Stretchers are usually adjustable to different heights and different angles. Some can be adjusted to elevate the legs (Trendelenberg position). Additional equipment may be attached to the stretchers including oxygen, IV lines, and cardiac monitors or defibrillators.

Guidelines for Moving Stretchers

• Stretchers should be handled by two EMTs with both hands on the stretcher. Other personnel or bystanders may be asked to help carry additional equipment if necessary.
• Never leave the patient alone on the stretcher.
• Load the stretcher with the foot end first or going upstairs.
• Position one EMT at the foot and one EMT at the head of the stretcher when rolling it. The EMT at the foot should pull while the EMT at the head should push.
• Always maintain a firm grip on the stretcher when rolling to prevent a tipover.
• Lower the stretcher and carry end to end if the ground is to rough to roll the stretcher safely.
• Use four EMTs, one at each corner, when moving a stretcher across extremely rough terrain.
• Turn corners slowly and squarely, avoiding sideways movements that might make the patient dizzy.
• Lift the stretcher over rugs, grates, door jams, and other such obstacles on the ground or floor.
• Keep the patient secured with belts at all times while on stretcher even if the stretcher is not being moved.

Loading the Ambulance

• Place the head end of the two-person stretcher close to the bumper of the ambulance, and make certain it is locked at its lowest level.
• The EMTs stand on opposite sides of the stretcher, bend at the knees while keeping their backs straight, and grasp the lowest bar of the stretcher.
• Hands are positioned at each end of the lowest bar with both palms facing up.
• On signal, both EMTs stand and move toward the rear of the ambulance until the front wheels rest on the floor at the back of the ambulance.
• Roll the stretcher forward and guide it into the front of the stretcher catch. Then the foot end of the stretcher is locked into place.
• NOTE: Load hanging and portable stretchers before the wheeled stretcher. Obstetrics patients may be loaded feet first so that it is easier to manage an impending delivery. Make sure that all patients and stretchers are secure before moving the ambulance.

Unloading the Ambulance

• Unlock the latch at the foot end of the stretcher catch and pull the stretcher until the rear wheels are at the lowest end of the floor.
• Grasp the lowest bar on each side of the stretcher with palms facing upwards as it is rolled out.
• Once the head end of the stretcher is clear of the ambulance, keep the stretcher level and lower it to the ground by bending at the knees while keeping the back straight. The stretcher may then be raised by triggering the appropriate release handle.
• Alternative. Once the head end of the stretcher is level and clear of the ambulance, the driver's side EMT may trigger the handle release and allow the base of the stretcher to slide down the legs of the EMTs. This method avoids the extra lift from the ground but requires the use of the main stretcher bar for lifting and simultaneous release of the handle.
• Portable stretchers, or "folding stretchers" weigh 8-15 pounds and can carry a patient up to 350 pounds. They are more easy to use when carrying patients down stairs, down hill, or over rough terrain. It can be suspended from the ceiling with special brackets, placed on the floor, or secured to the squad bench.

Stair Chair

These are designed for patients that can sit up while being carried. They are useful for taking patients up or down stairs, or through narrow passageways. The patient must be transferred to the stretcher once back at the ambulance. 

The extremity lift is used to place the patient in the stair chair. All belts and straps must be secured before moving patient. The patients wrists may be loosely tied to prevent grabbing onto fixtures and causing loss of balancewhen moving them. The chair is tilted slightly backwards to allow movement with the wheels on the chair.

Long Backboard

There are several styles of backboards:

• Ohio is coffin-shaped to fit easily into a basket stretcher or helicopter.
• Farrington is rectangular with rounded corners.
• Aluminum are usually foldable but they can be uncomfortable in cold weather and prevent x-rays from being taken.
• Miller is made of molded plastic and is strong and buoyant.
• Vacuum molds to the patient once they are positioned in it.

The importance of a backboard is in spinal immobilization and moving the patient, especially during rapid extrication, and providing secondary support when using a short spineboard.

Short Backboard

This is used when a spinal injury is suspected and the patient is in a seated position. They made be made from wood, aluminum, or plastic. A vest type is also used when a patient is found inside a small car or place. It wraps around the patient and has all the straps attached or enclosed.

Scoop (Orthopedic) Stretcher

This is designed to easily lift supine patients. The stretcher is made of a rectangular aluminum tube with V-shaped lifts to "scoop" patients from the floor or ground without changing their position. Its greatest advantage is that it can be used in confined spaces where other stretchers cannot fit.

 The scoop may be used to initially lift the patient with a suspected spine injury. The patient should then be placed immediately on a long backboard for immobilization. If no spine injury is suspected, the scoop can then be placed with patient onto the stretcher for transport.

    The following steps are used with the scoop stretcher:

• Adjust the length of the scoop stretcher on the ground beside the patient to accommodate the patient.
• Separate the stretcher halves and place one half on each side of the patient. Do not lift equipment over patient.
• Slightly lift the clothing on one side of the patient while another EMT slides one half of the scoop under the patient's side. Repeat on the other side. If a spine injury is suspected, another EMT must maintain cervical spine support at all times.
• Lock the head end of the scoop in place, then bring the foot end together until the assembly is locked. If any resistance is met, have an EMT gently lift one side of the patient. This move prevents the patient's clothing from being caught or their skin from being pinched.
• Attach the padded head strap. Use at least three straps to secure the patient to the scoop stretcher before lifting.

Flexible Stretcher

Do not use the flexible, or "pole" stretcher if spine injury is suspected. It is designed for the following uses:

• limited access space
• on stairs or around cramped corners
• when other equipment is not available

Patient Positioning

EMTs should consider not only the best equipment to use but the position of the patient. The following general rules apply:

• Unresponsive patients without suspected spine injury should be placed in the recovery position on their left side.
• Patients with chest pain or difficulty breathing should NOT be walked to the ambulance.
• Patients with suspected spine injury should be fully immobilized on a long backboard.
• Patients with signs and symptoms of shock should have their legs elevated 8-12 inches.
• Place the pregnant patient with hypotension on her left side.
• Load the pregnant patient whose delivery is imminent feet first into the ambulance to allow for more room to work.
• An infant's own car seat should be used if possible. It can be secured to the stretcher with the straps. It can also serve as an immobilization device with padding and taping.
• Patients with head injury and no suspected spine injury should be transported in a semi-sitting position at about a 45 degree angle. This reduces pressure inside the skull and risk for increased bleeding.
• Trauma patients with multiple injuries should always be transported on the long backboard to provide full body immobilization.
• Use discretion when moving and positioning a disabled patient. Increased communication is necessary with visually or hearing impaired patients. Take extra care when securing patients with physical deformities. Use pillows, rolled towels, or other supports and padding to create a more comfortable position.
• Elderly patients should be placed in a position that will be as comfortable as possible for their condition. Extra time and care with patients with conditions such as arthritis, osteoporosis, or other conditions is important to reduce risk of further injuries.