Patient Packaging and Litter Transport

1
Patient Packaging and Litter Transport

• MPSAR - January 20, 2007
• Todd Shechter and Chris Davis

2
Points to cover

• Dont intend this to be a medical
  training/disclaimer
• Review of equipment
• Patient Packaging
• Decision to use a litter
• Preparing patient
• Moving patient
• Litter transport
• HEATPAC Personal Heater

3
Review of Equipment

• Break-apart/solid litter
• Sleeping bag
• Bivy sack
• Blankets
• Pad
• (subjects clothes/pack/sack/pad)
• (our clothes/pack/sack/pad)

4
Decision to use a litter/carry

• Is a litter REALLY needed? (are there other ways
  to get a person out?)
• Consider resources needed for litter transport
  (4-8 people)
• Factors to consider
• Strength of the group
• Equipment available
• Extent of patients injuries
• Terrain
• Time
• If a litter is needed, consider sending a
  scouting team to route-find

5
Preparing patient for litter

• Splinting where necessary, remember BUFF
• Big, Ugly, Fat, Fluffy
• Sleeping pad as improvised splint for ankle
• Sleeping pad cut-out as improvised c-collar
• Use of SAM splints

6
Moving Subject

• The airway must be open and serious bleeding
  stopped
• Only after initial pain and fear have subsided
• Plan moves so patient is only moved once if
  possible
• Prepare materials before patient is moved
• The process should be rehearsed
• The body should be kept in a straight line

7
Moving subject - BEAM

• BEAM Body Elevation And Movement
• Stand along both sides of subject
• Arms interweaved
• Person on head in charge, must keep head stable
  and level
• Ask is anyone not ready?
• If possible, only lift (not move) subject then
  slide litter under subject

8
Patient Packaging

• Litter is main tool - developed in 1895 by
  Charles Stokes (Stokes/metal litter)
• BCSO (CMRU/MPSAR) litters are Ferno-Washington
  Litters
• Remain secure in the litter, any of five
  positions
• horizontal
• on their side
• feet down
• head down
• face down
• Normal position horizontal or feet down
• Start with splinting/wound management
• Padding beneath patient, litter pads are not
  enough

9
Patient Packaging - 2

• Tarp, blanket, or bivy in litter -- our litter is
  not their last transport mechanism
• Ask if need to pee/poop before loading
• Padding, padding, padding
• Under knees, between legs, along sides, around
  head
• Not under neck
• Never leave subject unattended, always have plan
  if need to tip subject
• Strap subject in tight, dont depend on seat belts

10
Patient Packaging - 3

• On-going care pedal pulse/vitals
• Ask subject if they feel numbness/tingling/hot
  spots (indicates straps too tight or loose)

11
Litter transport

• Rescuer on head is in charge
• Before lift, ask is anyone not ready?
• Feet first, rescuer on head can see forward
• People to clear trail/rotate out
• Straps to adjust height
• Snow travel webbing/ropes to help pull
• Communicate with your subject

12
Use of Tagline

• Webbing or rope on head of litter
• Used to ensure no extension if litter drops

13
HEATPAC Personal Heater

• Used for warming hypothermic subjects
• Works by warming air and circulating through
  tubes
• Charcoal fuel element, D-cell battery, match to
  start
• Start with vent open, close after 10 min
• 20 minutes to reach operating temp
• Lasts 8-12 hours
• Exhaust to open air if possible
• Do not use in confined spaces (in vehicle)

14
Final thoughts

• Litter is our last resort to transport a subject
• Prepping litter and subject will help for a
  successful transport
• Communication among team and to SAR Base
  essential
• Were not their last form of transportation
• During transport rescuer on head is lead rescuer