Ergonomics and Patient Handling Employee Training Modules. For the Fit Responder Injury Prevention Program

Size: px

Start display at page:

Download "Ergonomics and Patient Handling Employee Training Modules. For the Fit Responder Injury Prevention Program"

Allyson Oliver
5 years ago
Views:

Ergonomics and Patient Handling Employee Training Modules For the Fit Responder Injury Prevention Program Key Points review: 1) There are a certain percentage of calls where a crew can control the

1 Ergonomics and Patient Handling Employee Training Modules For the Fit Responder Injury Prevention Program Key Points review: 1) There are a certain percentage of calls where a crew can control the environment. Furniture can be moved, patient handling equipment can be utilized and ultimately the ergonomic environment can be controlled. During these routine calls the crew is also able to slow down and map out the movements. Taking control of these predictable situations allows the crew to drastically reduce the chance of sustaining a soft tissue injury. 2) When it comes to truly reducing injury the employee MUST understand that there are 3 keys to allowing the body to lift/pull/push/transfer/move & carry safely. Remember that we must give the body the MOSTABILITY (movement/stability) it needs to do its job as you are the ultimate tool and the equipment is to be used to it s full advantage instead of the equipment using us. 1. Stability: Root the floor, Hinge the Hips & Brace the Ab s. 2. Mobility: Self Myofascial Release. 3. Flexibility: Pre & on duty stretching. 3) Review the patient handling and ergonomic guidelines and make sure that you are familiar and comfortable teaching and observing employees as they learn and master these movement techniques. 4) Have the broom stick in your hands at all times, this is your best tool for teaching neutral spine, making sure that you see an employee s technique flaws and for the employee to feel faulty positioning. 5) You MUST break their habit of saying lift as this will continue poor ergonomic and rush behaviors. We must slow the crew down and allow them to get into a ready and braced position so constantly saying ready-brace-lift as a mantra during the training is imperative. Page 1

2 6) To change biomechanical behaviors takes repetitions, a lot of them. The more lifts and transfers that they are made to do the better. Rotate different partners and scenarios to ensure that each employee gets at least lifts per class. This is where the corrective exercises enter the picture, as you observe a medics inability to properly do the given task and they cannot be coached into a proper movement stop the exercise and have the employee go through the necessary M & F techniques. (refer to your TT Manual for detailed corrective actions) -Inability to squat to proper depth: Mobilize: Hips/glutes, calves, Lats/shoulder internal rotators. Stretch: Claves, glutes, Lats, Chest. -Inability to reach to the floor in a deep squat: Mobilize: Claves, glutes, hamstring, IT band, Lats, Shoulder internal rotators. Stretch: Claves, glutes, IT band, Lats, Shoulder internal rotators and pects. -Rounded upper body with patient handling: (upper cross/kyphosis) Mobilize: Pects, Lats, shoulder internal rotators, back/paraspinals. Stretch: Pects, Lats,neck, shoulder internal rotators, back/paraspinals. -Difficulty Kneeling or taking a knee to treat or extricate a patient: (too tight to open the hips into a wide/hinged stance) Mobilize: Hip flexor/quad, Glutes, Lats, Paraspinals. Stretch: Hip flexor/quad, hamstrings, inner thighs, claves, lats. 7) When teaching the techniques keep the message simple and the path clear. It s the repetitive tissue load and strain that ultimately causes the inury. No more sloppy technique. (define what that is to the medics) Your body is the ultimate tool. Give your body it what it needs to do its job. Use the equipment instead of it using you. Page 2

3 This means always keeping the key principles of patient handling in the forefront of every medics mind. Review the back pack video and the ergonomics guidelines as the keys to proper employee ergonomics. 8) Stop behaviors: To change faulty behaviors medics must be made aware of specific biomechanical behaviors that are simply unacceptable and will not be tolerated. They will have all been given the corrective strategies of the program (S-M-F) and if they are unable to perform the tasks as specified thereby endangering themselves, their partner and the patient they will be held back for additional training. *see stop behaviors in ergonomics guideline. **Ideally these modules will be set up prior to class and should take no more than minutes to run employees through the hands on modules. Training changes behavior, consistent training makes the trained behavior stick! ***Add lifts, transfers and transport situations to ALL training evolutions. Ex. ACLS = lateral transfer during the code to facilitate transport. Monthly Training Module Example Month 1: Spine board lifting techniques and transfer techniques, On duty stretching. Month 2: Bed to cot and cot to bed transfer techniques, Tennis ball key points. Month 3: Stair chair techniques, on duty stretching focus on the glutes, calves and lats. Month 4: Scoop stretcher, rescue basket and folding stretcher techniques. On duty stretching focus on upper body (neck, lats, chest) Month 5: Patient transfers, seated position to the stretcher, wheel chair to stretcher, floor to stretcher/stair chair. Self massage review for upper body. Month 6: Awkward lifting situations, when you can t get into a safe position to rescue/move a patient. Strong focus on the abdominal brace and head up position. Focus on rooting 1 foot or a wide kneeling stance to allow proper hip hinge. Self massage review for lower body. Month 7: Spine board lifting review, staggered spine board lift and staggered slide from bench seat to cot and cot to bench seat. Stretching review for lower body. Month 8: Stretcher lift review; 2 part lift, Transport vs. load height, Removing the stretcher from the truck. Stretching review for upper body. Month 9: Patient transfer review; bed to stretcher, stretcher to hospital bed, transfer sheet & slide board techniques (if locations have them). Active stretching introduction?? Page 3

4 Month 10: On duty nutrition class, eating to survive and thrive in your EMS career.???? Video??? Month 11: Active stretching, Awkward lifting situations and technique review. Month 12: Group roundtable discussion on how to best launch and run an employee fitness and wellness program. Expanded Education Modules: Month 1: Spine board lifting techniques and transfer techniques. 1.0 Root the floor, Head up, shoulders back, ab s braced. 1.1 Power stance (lifting with the palms up). 1.2 No See-Saw at the top of the lift so make sure they are close to the board when they lift. 1.3 Stretcher placed at thigh height when placing the board/scoop on to the stretcher. 1.4 LSB Lift on a mega-mover: 2 responder lift & 4 Responder lift. 1.5 Stretching review: Hip Flexor and Hamstring Month 2: Bed to cot and cot to bed transfer techniques, Tennis ball key points steps to proper lifting 2.2 Beds adjusted to a height allowing a hip hinge 2.3 pre-slide the pt. to the side of the bed (use a friction reducing tarp on ALL lateral transfers-per the policy) 2.4 Both responders on the SAME SIDE of the bed, one at the hips and one at the shoulders Tennis ball hips/glutes and IT Band. Month 3: Stair chair techniques, on duty stretching focus on the glutes, calves, lats. Page 4

5 3.1 Review proper posture for lifting a non-tracked stair chair (5 lifting keys) Facing the patient or facing away 3.2 review proper ways to place the pt. in the stair chair Two person mechanical advantage lift using a mega-mover person mechanical advantage lift using a mega-mover Avoid single responder stand and pivot at all costs, always use both responders & always use a tool to gain mechanical advantage. Month 4: Scoop stretcher, rescue basket and folding stretcher techniques. On duty stretching focus on upper body (neck, lats, chest) 4.1 Review the 5 keys to proper lifting 4.2 Line Backer stance when lifting and carrying any object 4.3 Keep the object close to your body at all times; avoid leaning and twisting. 4.4 Always try to use a transfer aid to reduce load (tracked stair chair, multiple responders) Month 5: Patient transfers, seated position to the stretcher, wheel chair to stretcher, floor to stretcher/stair chair. Self massage review for upper body. 5.1 Always use a 2 responder lift mechanical advantage lift using a mega-mover type device. 5.2 avoid a 1 rescuer stand and pivot (pt s hands on the neck of the EMT as they are lifted from the chair) 5.3 What can the patient do for themselves? 5.4 Ambulatory assist; both medic supporting from the sides at each arm as they assist to the cot. 5.5 floor to cot; mechanical advantage lift using a mega-mover type device. Month 6: Awkward lifting situations (See ergonomics policy), Self massage review for lower body. 6.1 Strong focus on the abdominal brace and head up position. Page 5

6 6.2 Focus on rooting 1 foot or a wide kneeling stance to allow proper hip hinge. 6.3 broom stick as a training tool 6.4 set up awkward lifting and moving situations to test their critical decision making. 6.5 It s OK to move a patient in a few small steps instead of one big forceful movement. Month 7: Spine board lifting review, staggered spine board lift and staggered slide from bench seat to cot and cot to bench seat. Stretching review for lower body. 7.1 Two responder staggered slide from cot to bench seat / bench seat to cot. 7.2 Staggered 2 step LSB lift Head first followed by the foot stretcher against the bench seat and raised up to the level of the seat Head is lifted half way and held in a half squat, then the LSB is raised. Month 8: Stretcher lift review; 2 part lift, Transport height vs. load height, Removing the stretcher from the truck. Stretching review for upper body. 8.1 A two part lift is ok and preferable with a heavy patient 8.2 when lifting from the floor use the top handles 8.3 Root-hinge-brace-head & shoulder up! 8.4 No back extension during the lift, use the stick to be sure 8.5 wide stance and a small squat when removing the cot from the truck; do not let them use their back to put the cot down when removing from the truck. 8.6 Transport height vs. load height. Review a two stage lift per the ergonomics policy. Month 9: Patient transfer review; bed to stretcher, stretcher to hospital bed, transfer sheet & slide board techniques. Active stretching review. 9.1 Focus on pre-positioning the body, Ready-Brace-Lift. Page 6

7 9.2 remind them to utilize locking wheels, walls, cabinets etc. to secure the stretchers allowing both responders to pull from the same side. 9.3 bring the pt. as close as possible (pre-position) before transferring; avoid excessive lean. 9.4 active stretching review. Month 10: On duty nutrition class, eating to survive and thrive in your EMS career. (video or lecture) Month 11: Active stretching, awkward lifting situations and technique review. Month 12: Group roundtable discussion on how to best launch and run an employee fitness and wellness program The following section is a sample of how to run the hands on training on a quarterly training cycle. 1 st Quarter 1. Active pre-shift stretching review 2. LSB lifting & movement techniques a. 2 person lift from the floor b. 4 person lift form the floor c. 2 person tarp lift d. 4 person tarp lift e. warrior stance cot transfer f. LSB 2 step slide to the bench seat 2 nd Quarter 1. Passive Stretching review 2. Bed to bed lateral transfers with friction reducing device. 3. Mega-mover type device 2 & 4 responder chair lift. 4. Mega-mover type device 2 responder floor/bathroom/confined space mechanical advantage lift. 3 rd Quarter 1. Tennis ball self-massage review. 2. Cot load a. single and double responder technique 3. Cot unload a. single and double responder technique 4 th Quarter 1. Foam roller review (or introduction) 2. Assistive device review a. hover jack/hover mat b. Bariatric device use (cot, lifts, winch etc.) Page 7

8 3. How to eat on the street video Page 8

Correcting Forward Pelvis (Bubble Butt)

Correcting Forward Pelvis (Bubble Butt) Forward Pelvis - Ab Strengthening: Knee Ups Start: Lay flat on the floor with knees bent and arms at side. Finish: Pull knees up to stomach as far as you can. Duration: