Patient Casualty Handling

Patient/Casualty Handling

Marlon Bernardo, RN Centro Escolar University

Learning Objectives At the end of this lecture demonstration, you should be able to:  Define emergency rescue, including its indications and methods.  Identify the factors to be considered in the selection or choosing the transfer method.  Discuss pointers to be observed during transfer.  Demonstrate methods of transfer: one-man, two-man, threeman, and four-man assist/carries/drags.

Emergency Rescue is a rapid movement of patient from unsafe place to a place of safety.

Indications for Emergency Rescue 1. Danger of fire or explosion. 2. Danger of toxic gases or asphyxia due to lack of oxygen. 3. Serious traffic hazards. 4. Risk of drowning. 5. Danger of electrocution. 6. Danger of collapsing walls.

Methods of Rescue 1. For immediate rescue without any assistance, drag or pull the victim. 2. Most of the one-man drags/carries and other transfer methods can be used as methods of rescue. Transfer is moving a patient from one place to another after giving first aid.

Factors to be considered in the selection or choosing the transfer method: 1. 2. 3. 4. 5. 6. 7.

Nature and severity of injury. Size of the victim. Physical capabilities of the first aider. Number of personnel and equipment available. Nature of evacuation route. Distance to be covered. Sex of the victims. (last consideration)

Pointers to be observed during transfer: 1. Victim’s airway must be maintained open.

2. Hemorrhage is controlled. 3. Victim is safely maintained in the correct position.

4. Regular check of the victim’s condition is made. 5. Supporting bandages and dressing remain effectively applied.

6. The method of transfer is safe, comfortable and as speedy as circumstances permit.

7. The patient’s body is moved as one unit. 8. The taller first aiders stay at the head of the victim.

9. First aiders/bearers must observed ergonomics in lifting and moving of patient.

Methods of Transfer 1. One-man assist/carries/drags

- Assist to Walk

- Fireman’s Drag

- Carry in Arms (cradle)

- Blanket Drag

- Pack Strap Carry

- Armpit/Shoulder Drag

- Piggy Back Carry

- Cloth Drag

- Fireman’s Carry

- Feet Drag

- Inclined Drag (head first- passing a stairway)

Assist to Walk  Ma’am/Sir, I will assist you to sit in the count of three. Please cooperate… One, two, three…  Ma’am/Sir, I will assist you to stand in the count of three. Please cooperate… One, two, three…

Carry in Arms (One-Person Lift) This only works with a child or a very light person.

Fireman’s Carry This technique is for carrying a victim longer distances. It is very difficult to get the person up to this position from the ground. Getting the victim into position requires a very strong rescuer or an assistant.

Pack-Strap Carry

When injuries make the firefighter carry unsafe, this method is better for longer distances than the one-person lift.

Piggyback Carry

Fireman’s Drag

Feet Drag The feet drag (ankle pull) is the fastest method for moving a victim a short distance over a smooth surface. This is not a preferred method of patient movement.

Cloth Drag

Armpit/Shoulder Drag The armpit/shoulder drag (shoulder pull) is preferred to the ankle pull. It supports the head of the victim. The negative is that it requires the rescuer to bend over at the waist while pulling.

Inclined Drag

Blanket Drag This is the preferred method for dragging a victim.

2. Two-man assist/carries - Assist to Walk - Four-hand Seat - Fireman’s Carry with Assistance

- Hands as a Litter - Carry by Extremities

Assist to Walk/ Human Crutch/ Two-Person Drag For the conscious victim, this carry allows the victim to swing their leg using the rescuers as a pair of crutches. For the unconscious victim, it is a quick and easy way to move a victim out of immediate danger.

Four-Hand Seat This technique is for carrying conscious and alert victims moderate distances. The victim must be able to stand unsupported and hold themselves upright during transport.

Hands as a Litter (Two-handed Seat) This technique is for carrying a victim longer distances. This technique can support an unconscious victim.

Chair Carry This is a good method for carrying victims up and down stairs or through narrow or uneven areas.

Carry by Extremities

Fireman’s Carry with Assistance

3. Three-man carries - Bearer’s Alongside (for narrow alleys) - Hammock Carry

COMMAND USED IN 2 OR MORE RESCUERS Preparatory

Executory

• Ready to kneel …….…………………… Kneel • Hands over the patient………………….. Move • Ready to insert………………………….. Insert • Patient on your knees, ready to lift ……... Lift • Patient’s body press to the chest……… .. Press

Preparatory

Executory

• Ready to stand…………………………. Stand • Face the Leg/Head …………………….. Move • Ready to walk, inner foot first………… Walk • Ready to stop…………………………… Stop • Face center……………………………… Move • On your knees and rest…………………. Kneel • Ready to unload………………………… Unload

Reminders All team members must answer “ready” after the leader gives preparatory command. Likewise, leader shall only give the executory command for all members who answered “ready.”

Bearer’s Alongside (for narrow alleys)

Hammock Carry (for wide spaces) Three or more rescuers get on both sides of the victim. The strongest member is on the side with the fewest rescuers.

4. Four-man Carries and with the use of Equipment - Four-Man Hammock Carry - Blanket Carry - Commercial Stretcher

Four-Man Hammock Carry

Blanket Lift This technique is for lifting a patient into a bed or stretcher, or for transporting them short distances.

Stretcher Lift

References  The Philippine National Red Cross (2007). Participant’s Workbook: Standard First Aid. Philippine Copyright, 1999  CERT Los Angeles Lifts and Carries (2001). [Accessed online] http://www.certla.com/liftcarry/Liftcarry.htm