Подъём пострадавшего на носилки: методы и техника

Procedures to lift someone onto a stretcher

Casualty lifting is the first step of casualty movement, an early aspect of emergency medical care. It is the procedure used to put the casualty (the patient) on a stretcher. Developed emergency services use lifting devices, such as scoop stretchers, that allow secured lifting with minimal personnel. Other methods (explained below) can be used when such devices are not available. Since only stabilised casualties are moved (except in unusual circumstances), the lifting is usually never performed in emergency; emergency movements are sometimes performed to respect the Golden Hour. This depends on the organisation of the medical services and on the specific circumstances. Maximum care must be taken to avoid to worsen an unstable trauma. The head neck chest axis must be kept straight to protect the spine, and the first responders must keep the patient's body stable (no movement of the feet) during the lift. The first responders have to carry a heavy load (probably more than 20 kg for an adult casualty) in an uncomfortable position. There is thus a risk of injury to the carrier, especially of the lumbar back. To avoid an injury, they must push with their legs (quadriceps), trying to keep their back straight.

The use of a scoop stretcher allows a secure lifting with only two team members even in case of a spinal trauma. The use of this device is thus recommended for most operations. However, in many situations, there is a lack not of people but of devices. Additionally, the scoop stretcher does not allow to maintain the legs up or a half seated position for the casualty. For these reasons, the other methods are still taught.

With only four first responders, it is necessary to use a "simple" lift (pont simple in French): the chief plays the role of the first team member, stepping over the casualty and placing one hand under the neck, the other hand under the back, between the shoulder blades. The stretcher can come from the feet or from the head. This method is not adapted in case of suspicion of a spine trauma.

When the casualty has no specific trauma, it is possible to slide a long spine board little by little. A team member lifts a part of the body (head, then shoulders, then hips), and the other one slide the board.

The translation lift, or "Dutch" lift, is used when it is not possible to push the stretcher: there no room for the stretcher at the feet or head of the casualty, or the stretcher cannot slide/roll on the ground, or there are not enough first responders available. In such a case, the stretcher is placed besides the casualty. With four first responders (including the chief), the first and second team members step over the casualty and the stretcher, the foot is on the farthest pole of the stretcher. The chief holds the closest pole with their knee on the ground, and the third team member with their ankle. The positions of the hands are the same as for the vertical lift with five first responders. The first in place is the chief. The stretcher is slid besides the casualty, the pole against the thigh of the chief. Then, the third team member takes place. Once the both extremities of the pole are blocked, the other team members can step over the casualty (one by one, holding the others' shoulder to avoid falling) without any risk of rocking for the stretcher. On the order of the chief, the casualty is lifted and translated on the stretcher. This method can be performed with only three first responders. In this case, the chief plays the role of the first team member; blocking the pole with their ankle, and putting one hand under the neck, the other one under the back, between the shoulder blades. Only the team member at the hips steps over the stretcher.