Moving and Handling of People using Ambulance Equipment — Education Qualifications and Awards Vocationally-Related Qualification Public Services Revision
This element focuses on the safe and effective use of key ambulance-based patient handling equipment—stretchers, carry chairs, orthopaedic stretchers, and
Topic Synopsis
This element focuses on the safe and effective use of key ambulance-based patient handling equipment—stretchers, carry chairs, orthopaedic stretchers, and longboards—within a manual handling framework. Learners must demonstrate competence in operating these devices, assessing risks, communicating with colleagues, and adapting techniques to patient needs and environmental challenges. Mastery ensures patient dignity, minimises injury to both patient and practitioner, and aligns with legal and organisational policies governing moving and handling in pre-hospital care.
Key Concepts & Core Principles
- Patient Assessment: The systematic approach to evaluating a patient's condition, including the primary survey (ABCDE) and secondary survey (history, vital signs, and focused examination).
- Trauma Management: Techniques for managing injuries such as fractures, dislocations, burns, and bleeding, including the use of splints, bandages, and tourniquets.
- Medical Emergencies: Recognition and initial management of conditions like cardiac arrest, stroke, diabetic emergencies, and anaphylaxis, including the use of automated external defibrillators (AEDs) and adrenaline auto-injectors.
- Scene Safety and Communication: Ensuring the safety of the rescuer, patient, and bystanders, along with effective communication with emergency services and other healthcare professionals.
- Legal and Ethical Considerations: Understanding consent, confidentiality, and the duty of care, as well as the legal framework governing emergency medical practice in the UK.
Exam Tips & Revision Strategies
- In practical assessments, verbalise each step of your dynamic risk assessment and manual handling decisions to demonstrate underpinning knowledge.
- When using the stretcher, always confirm that the head and foot ends are locked into the receiving fixture before patient transfer.
- On the carry chair stair descent, the operator at the foot end descends first, facing forward; practice this sequence to ensure safe momentum control.
- For orthopaedic stretcher scenarios, show awareness of scoop attachments and how to separate the frame without jarring the patient.
- During longboard immobilisation, remember the mantra 'head, chest, pelvis, legs' for strap tightness and order, and routinely re-check strap tension after moving.
- Reference the HSE’s Manual Handling Operations Regulations 1992 when justifying your technique, especially for high-risk moves.
- Always demonstrate a post-incident check—equipment cleaning, inventory, and reporting of any issues—as this is an assessable aspect of safe systems of work.
- If a simulated patient presents with obesity or bariatric needs, explicitly state your adaptation to equipment (e.g., bariatric stretcher extensions) and increased crew numbers.
Common Misconceptions & Mistakes to Avoid
- Forgetting to engage stretcher brakes before transferring a patient, leading to uncontrolled movement.
- Using a carry chair on stairs without properly tilting the chair back, which places excessive strain on the shoulders and risks patient slipping.
- Applying orthopaedic stretcher straps too loosely, compromising spinal alignment and patient safety during transport.
- Attempting a log-roll for longboard application with insufficient crew, causing twisting of the spine or uncontrolled patient movement.
- Lifting with bent back and straight legs instead of squatting, violating basic manual handling principles.
- Failing to communicate the lift plan, resulting in asynchronous team movements and increased injury risk.
Examiner Marking Points
- Award credit for demonstrating correct pre-use inspection of each equipment type, identifying defects and reporting them before deployment.
- Expect clear verbal communication with the patient and team members throughout the handling procedure, including commands for coordinated lifts and reassurances.
- Look for application of TILE risk assessment (Task, Individual, Load, Environment) prior to any move, with adjustments made for patient condition and physical surroundings.
- Assess ability to adopt a stable posture and appropriate grip techniques (e.g., power grip, palm grip) while operating the equipment, avoiding twisting and over-reaching.
- Require evidence of smooth, step-by-step transfer using the ambulance stretcher with correct bed-to-stretcher or ground loading, including securing of brakes and safety straps.
- Check proper use of the carry chair on stairs, with one operator supporting the head end and the other controlling the foot end, employing a chair tilt and safe footing.
- Verify orthopaedic stretcher application includes securing the patient with full-length spinal straps, maintaining alignment, and using a scoop or split-litter technique if applicable.
- Confirm longboard use involves log-rolling with sufficient team members, correct strap order (chest, pelvis, legs), and immobilisation of the head with blocks and tape.