In EMT-basic class, we are told it is expected of us to be able to lift 150 pounds. At the private transport for which I worked full-time for 3.5 years, a crew of two automatically received a lift assist if the patient weighed 300 pounds or more. Considering most cots weight 60+ pounds, two EMT need to be able to safely lift at least 360#.
Are you up to the challenge? Are you able to fulfill this job requirement?
One night, my partner had traded shifts with another female EMT. She and I are similar build and height. We both are strong. Both of us, with our partners, typically refused lift assists for anything under 350#. That night, we got a page to transfer a male weighing 280#. That should have been easy for us, but when we got there, our heads went back to look up at him. We both realized, without even saying anything, he weighed probably weighed over 300#. While he finished a phone call, my partner and I went to get report from the nurse. The nurse agreed with us, the patient was probably around 320-350#. Before returning to load the patient on the cot, my partner and I agreed to lift in 2 stages to be safe. The patient was able to walk to the cot; we strapped him on using seatbelts. I took the feet. As soon as we began to lift, even just that first stage lift, with proper lifting mechanics, we realized this patient was heavier than our estimated 350#. I automatically tightened my core even more to prevent back injury…or a hernia. The ER medic came to ask if we needed help, but we had already completed the 2nd stage of our lift. We were fairly confident we could safely load the patient and cot into the squad without assistance.
Outside, my hands were in the normal lifting positions. My partner put her left hand under my right arm to grasp the middle of the bottom bar; her right hand was next to mine. We lifted, and she immediately released her hold in order to move to the side and lift the legs while I maintained the lift. Once the legs were up, she remained the side to keep the cot and patient steady as I walked forward. The patient was loaded without problem. He told us he had not been sure if two ladies would be able to lift him without help, but he was impressed.
She climbed in the back of the squad with him while I walked around to the driver’s seat. As I drove, I listened to her run through the usual questions. When she got to his weight, his answer: well, last time I weighed myself, I was about 380, but I think I’ve put on some weight since then. . .
She was the pro who didn’t appear to even bat an eye as she kept asking her questions. I in the front seat, however, was trying not to choke.
We unloaded at the hospital with no problem (unloading is always easier than loading) and returned to our squad. She drove; I called dispatch. They were informed that I understood the 2 and 3 are close together on the keyboard, so the weight report could have been an honest mistake. However, if I found out the weight was changed to avoid sending or at least offering us a lift assist due to the boards already being backed up, I would be filing a formal complaint as we and the patient could have been seriously injured if we had been a lesser-experienced crew or a crew with poor lifting technique.
EMS is a physically taxing field. I was actually injured due to a negligent partner with awful lifting form – he actually informed me that the proper way to lift is with your back, not your legs! Unbelievable. . .
Start totaling up all the weight you move on every shift. You move the patient from the scene to the cot; you lift the cot to move it to the vehicle. You lift the cot into the vehicle. If it’s a helicopter into which you’re loading the patient, now you just have to lift the cot back into your squad. If you’re transporting the patient yourself, you have to unload the patient and cot. You may have to lower the cot to move safely. Now you have to move the patient into the receiving bed and reload the cot back into your squad.
That is for a single patient. Do not forget you also have the jump bag, the monitor, any other you may need like a backboard.
We have to be physically as well as mentally strong. What goes into that?
I worked with several guys and girls who felt that our job was exercise enough. While it is true that you will gain or at least maintain a certain level of strength from moving several thousand pounds of weight with instability factored in (patients have a tendency to wiggle on the cot) every shift, it is also true that you are working the same muscles every shift. What happens if you get into a new situation?
We are all used to picking patients up off the floor. We’ve all had to carry patients up and down stairs, but when was the last time you had to carry a patient up a circular staircase? I’ve had to do that. This was back when I was one who thought that work alone was a good enough work-out. Muscles I forgot I had woke up screaming the next day.
I am a fan of free weights. Among their benefits is the fact that if you have any old injuries or other reasons that your joints may not move the way as another person, you can move the weights in a way that is best for you. This is NOT referring to poor form and technique. Someone who has knee problems may need to adjust their deadlift to a sumo stance to decrease risk of injury that would come with poor form. I use deadlifts as an example not simply because they are my favorite, but also because I feel as though they are one of the most practical exercises an EMT can do.
While I strive to avoid machines, mainly for the reason that they increase risk of injury due to forcing your movements along a specific track, I realize that for someone, machines can help build confidence. They can, if used correctly, increase strength as well.
Bodyweight exercises. This category has the potential to be some of the most challenging exercises you can do! Think of burpees. Planks. Squat jumps. I use these exercises and others to work on core strength which leads to a decreased fall risk for all ages.
Flexibility and Mobility
Regardless of what kind of training you choose, flexibility and mobility training is a must!
Think of the body-builders you see or even the non-competing guys at the gym who just want to have as many muscles as possible. Do you think they can touch their toes keeping their knees straight? What about being able to crouch on the ground to soothe a patient who fell an hour ago and was just found? Can they reach up to get a ladder off a truck? Having muscles is good and takes a lot of hard work, but being able to use those muscles is even better. It’s still going to take some work, but focus and commitment will pay off in the long run.
The nice thing about this category of training is the ability to do the basics, which are always needed, without any equipment. For example, neck circles. Unless you have been told by a joint specialist (orthopedic surgeons, chiropractors) that you are not to move you neck in full range of motion (you have had bones fused together), slowly rolling your neck around is a great way to loosen tight muscles. I usually start with my chin down towards my chest then rolls as if trying to touch my ear to my shoulder (without shrugging! Keep your shoulders relaxed.). Let it continue to roll back so your head is dropped back with your chin in the air; roll to the other shoulder and back to the starting position. Start doing 10 of these one direction then switch directions. After a week or two, up the number to 15 each way. After about 5-6 weeks, you should be able to do 30 times around each direction and still feel a good stretch! Note how much your range of motion has increased throughout this time period too. You may have also noticed a decrease in headaches and an increase in shoulder movement.
Do you remember studying chain reactions back in school? Think about it this way: if your muscles around the neck are tight, they’re pulling the muscles around your shoulders and thoracic vertebrae tight as well. If the muscles in the thoracic region are tight, they’re going to be affecting movement in the lumbar and pelvic region. Have you noticed this before? Maybe you notice that when your lower back is tight, your hips and knees feel off.
When you’re getting ready to work-out, you want to get in a good, moving warm-up to help prevent injury. High knees, bum kicks, scapular retractions, and even burpees are great ways to warm up your muscles and get your joints ready to move. (They will also help better your lifts, but that’s a whole other article.) The end of the work-out is the time for the stretches most people think about when they hear the word flexibility. This is the time for the static (not moving) toe touches, butterflies, hand over your head, and the list continues. This allows your muscles to basically cool down and can eliminate soreness later – especially if you do these stretches again before you go to bed for the night where immobility typically leads to soreness in the morning.
Let’s go back to that second question I asked: are you able to fulfill this job requirement?
My partner once arranged for another girl to cover his shift with me. He thought I would appreciate not being the only girl on the road for a change. The conversation was fine. However. I told dispatch at the end of that shift that I would not be working with her again for the foreseeable future. Why? Her skills were solid; she was very knowledgeable about our field.
She called for a lift assist every time the patient weighed over 200 pounds. Running squad in an urban area – in any area – meant that we were essentially useless that night. Dispatch couldn’t keep sending two trucks to every call. They had us stage between a couple of our more frequent nursing homes…just in case. I was quite annoyed. I invited her to work out with me, but she said oh no, she felt like she was getting stronger at this job. I let it drop, not wanting to come off as a know-it-all or hurt her feelings as she was quite petite.
Shortly after I left the private company, my partner did as well. He went to a new private transport company and was assigned another female partner. At one point, someone – possibly even me – posted something on his Facebook page about lifting heavy patients. Can you imagine how unhappy and, quite frankly, disgusted I was when I read her comment about “no, that’s why I like having a male partner. They can do the heavy lifting or call a lift assist.”
I fired off a message to my partner to please tell me she was joking. He just responded with “I miss you.”
When you are at work, in our field, your risk factors become everyone else’s risk factors.
If you are at risk of injury because you don’t know how to lift properly, your partner is at risk of injury. If you slip when moving a patient downstairs because of poor balance, your partner might end up being your next patient.