Safe handling and transportation of patients
Objective of this session
This is to introduce participants to some common prescribed methods of safe handling and
transportation of casualties. The session has a specific focus on safe handling of critical
casualties with spine injury.
Session Plan
Time Topic Methodology
15 Minutes Some common and safe Classroom training, Role Play, and
methods to carry a victim Q&A
15 Minutes Stretcher and its safe use for Classroom training, Role Play, and
critical victims Q&A
15 Minutes Transporting a casualty with Classroom training, Role Play, and
spinal injury Q&A
Tools and Resources required
Flipcharts; Cut pieces of cards; Markers; Tape and chart stands
Key Messages
1. To maintain an open airway.
2. To resuscitate the casualty if necessary.
3. To prevent further injury (Keeping head and spinal damage in mind).
4. To arrange urgent and safe removal to hospital.
Content:
After appropriate First Aid has been given the following principals of transport must be kept in mind.
The position assumed by the casualty or in which he has been placed, must not be
disturbed unnecessarily.
Throughout the transport a careful watch must be kept on
The general condition of the casualty.
o Any dressing that may have been applied.
o Any recurrence of bleeding.
The transport must be safe, steady and speedy.
Some common Methods to carry:-
Though it is challenging for a single First-Aider to transport a casualty, certain methods will facilitate
the task and can be very effective. These are the Cradle, the Human Crutch, the Pick-a-Back, and the
Fireman’s Lift-and-Carry.
If one or two volunteers available
41 | P a g e
Cradle Human crutch
Pick-a-Back. The Fireman’s Lift-and-Carry
42 | P a g e
Removal and transportation methods two or more first aiders can use
Four-Handed Seat
This method is
used when the
casualty can assist
the First Aiders by
using one or both
arms. It requires
two people.
Fig. 153 The four handed
Fig. 154 The two handed seat-Without
using casualty's hands
Two-Handed Seat
Fore-and-Aft Method:
This method is mostly used to carry a
casualty who is unable to assist the
bearers by using his arms.
Kitchen Chair Carry
This method is best used for a lightweight casualty over a
short distance.
43 | P a g e
Stretchers
Ordinary stretcher Telescopic stretcher
Carrying a loaded Stretcher
Depending on the availability of manpower one can decide whether the stretcher is to be carried by
four or two persons.
Lowering a loaded stretcher:
(a) “Lower Stretcher’’ the four bearers will stoop, gently lower the stretcher to the ground and
rise together.
(b) Hand Carriage by Two Bearers: “Hand Carriage by Two Bearers - “Lift Stretcher’’ will pick the
stretcher steadily together keeping the stretcher at a straight level.
To Load an Ambulance
Rotate the stretcher, so that the head is
loaded first in the ambulance. Head is carried in first
The stretcher is lowered with its head one pace from the door of the ambulance. The casualty will be
loaded head first while loading, take side pace to the ambulance raising the stretcher evenly to the
level of the berth to be loaded. The front bearers place the runners in the grooves and then assist
the rear bearers to slide the stretcher into its place and secure it. If slings have been used they
should be kept with their stretcher.
44 | P a g e
Transport a Case of Spinal Injury
Injuries to the spine can involve one or more parts of the back and/or neck: the bones (vertebrae),
the discs of tissue that separate the vertebrae, the surrounding muscles and ligaments, or the spinal
cord and the nerves that branch off from it.
The most serious risk associated with spinal injury is damage to the spinal cord. Such damage can
cause loss of power and/or sensation below the injured area. The spinal cord or nerve roots can
suffer temporary damage if they are pinched by displaced or dislocated discs or by fragments of
broken bone. If the cord is partly or completely severed, the damage may be permanent.
The spinal cord is protected by the vertebrae (back bones). Injury to a vertebra or to an inter-
vertebral disc may damage nerve roots that emerge from the spinal cord or damage the cord itself.
The Casualty could be either conscious or may be unconscious.
To assess gently tap the shoulder and observe by gently asking the question to see the response, if
casualty response indicates consciousness.
If you suspect neck injury place rolled-up blankets, towels, or items of clothing on either side of the
casualty's head and neck, while you keep her head in the neutral position. Continue to support the
casualty's head and neck throughout until emergency medical services take over.
For an Unconscious Casualty
Steps
Kneel behind the casualty's head. Grasp the sides of her head firmly with your hands over
the ears. Steady and support her head in the neutral head position, in which the head, neck,
and spine are aligned.
If necessary, open the casualty's airway using the jaw thrust method - Place your hands on
each side of her face with your fingertips at the angles of her jaw. Gently lift the jaw to open
the airway. Take care not to tilt the casualty's neck.
Transport the casualty with spinal injury with special care to neck, head and spine from hard
plank or stretcher as stated above to the ambulance.
Emergency Method for loading fractures of the spine when there is no blanket under the
casualty and none is available -
o Open out the casualty jacket and roll it firmly so that the rolls are close to each side.
o Place the casualty on the stretcher adopting the same procedure as described for
the standard Method except that the bearers grasp the rolled up jacket and/or the
clothing and /or bandage round the casualty’s thigs instead of the rolled edges of
the blanket. When the clothing is insecure, a broad bandage must be placed round
the body just below the shoulder for the bearers to grasp.
o In the case of cervical injuries, place firm supports such as rolled-up blankets or
sandbags on each side of the head to steady it.
o Place a folded blanket in the hollow above the heels so as to relieve pressure on
them.
o Wrap the casualty.
If he is to be carried over rough ground, reduce his body movements to a minimum by
binding him firmly but not too tightly to the stretcher, with broad bandages. These should
45 | P a g e
be applied round the pelvis, thighs and calves, and round the body and arms, just above the
elbows.
On reaching shelter, do nothing further until the arrival of medical aid. The above method of
transportation of spinal injury case is to be used only if hard board is not available.
Materials available for this session:
8. Safe Handling and Transportaion.pptx
46 | P a g e
