SA Ambulance Service

PRIMARY CARE LEVEL ONE

Certificate II in Emergency Medical Service First Response (HLT21107)

Learners Guide

MANUAL HANDLING

Manual Handling

Published by SA Ambulance Service Organisational Capability Development Version: 2 Review: 12/07/2008 SA Ambulance Service acknowledges the valuable contribution of all who provided input and reviewed drafts. This publication has been developed for use within learning programs of SA Ambulance Service and is based on a philosophy of flexible delivery, allowing for self-paced and faceto-face competency-based education and training.

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Table of Contents
Table of Contents .......................................................................3 Overview of Icons .......................................................................4 Aim ...............................................................................................5 Objectives....................................................................................5 Introduction.................................................................................6 What is Manual Handling? .........................................................7 What is Manutension?................................................................7 Magnitude of the problem ..........................................................8 How injuries occur......................................................................9 Natural curves...........................................................................10 Maintain natural alignment of the back.....................10 Bend at the knees ....................................................10 Time and intensity ....................................................................10 Keeping the load close.............................................................11 Plan ............................................................................................13 Is any lift necessary?................................................13 Can the patient assist?.............................................13 Consider the condition/injury....................................13 Access and egress...................................................13 Using lifting aids/getting assistance .........................13 Ensure sufficient space for lift to be done ................13 Attention ....................................................................................15 Contact Details Manual Handling ..........................15 Student Learning Checklist .....................................................16

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Overview of Icons
This icon indicates the information relates to key learning objectives throughout this session, and will be included in assessments. This icon indicates the information is important to know, and will assist you in performing your role.

This icon indicates that an activity needs to be completed. It is suggested you complete activities as you come across them to help consolidate your learning.

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Aim
Demonstrate the ongoing ability to safely manage patients and equipment in accordance with organisational policies and procedures.

Objectives
By the end of this session the student will be able to: Understand the principles of manual handling Understand and demonstrate handling techniques Understand the causes of injuries Understand and demonstrate the prevention of injuries appropriate manual

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Introduction
SA Ambulance Service has had a dedicated Manual Handling program and manager in place since 2001. The team currently has 35 members from all levels of operational staff (Paramedic, Intensive Care Paramedic and Ambulance Transfer Service Officers) who are dedicated to delivering the program in the metropolitan area and across the state. The Manual Handling department delivers Manual Handling management and education across the organisation and aims to ensure a safe and professional code of practice is developed and maintained within all departments of SA Ambulance Service, in accordance with OHS standards. Training is supplied to all new recruits, volunteer and career. Career staff receive four days (8.5 hrs/day) training in their first six months and are then required to do an assessment day. On completion of their assessment they are marked as competent or non-competent in Manual Handling. Non-competent candidates are required to do their assessment again, following a two week break (minimum). During this time they will have one-on-one training with a qualified instructor. Annual updates are done for career (5 hrs) and volunteer (2 hrs + ISEP scenarios). This is usually done on-station in teams, or as regional sessions. Manual Handling is also involved in the Return to Work (RTW) program for injured staff or those returning after extended leave i.e. maternity leave. SAAS Manual Handling complies with SAAS Education Unit policy and procedures in relation to Recognition of Current Competency and appeals processes. Manual Handling has been a significant factor in the reduction of work related injuries within SAAS. The practises we teach we hope will not only be used when staff are at work but also in their everyday lives. Anthony Tossell Manager Manual Handling SA Ambulance Service

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What is Manual Handling?

any activity which requires the person to exert force in order to: LIFT LOWER PUSH PULL CARRY MOVE HOLD Or RESTRAIN

Any person, animal or thing From this definition it would be hard to find anything at work or outside of work that is not Manual Handling!

What is Manutension?
Manutension is French for Manual Handling. Manutension: Uses trained movement patterns based on biomechanical principles, which protect carer and patient Facilitates active involvement of the patient whenever possible thereby encouraging autonomy and independence Using the techniques reduces the incidence of back pain and injury

Paul Dotte: Originator of Manutension principles Background in physiotherapy, weight lifting, martial arts, spinal injury rehabilitation and biomechanics Experience as a patient

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Magnitude of the problem

SA Ambulance Service, Manual Handling injuries: Group/Region Metro Country ATS 2002 50% 36% 52% 2004 28.5% 18% 50% Change 21.5% 18% 2%

% of all injuries in 2004/5 ATS: Sprains and strains 76% Metro: Sprains and strains 59% Country: Sprains and strains 60%

Since the introduction of the Manual Handling program we have not only seen a significant decrease in the total number of Manual Handling incidences but also a decrease in the severity of injuries reported. This means people being injured are recovering and returning sooner. Multiple workplaces = Multiple hazards. Most staff have one workplace but SAAS has multiple workplaces with multiple hazards The other workplaces we visit still have an obligation to us under the OHS&W Act to provide a safe workplace

DRABC DANGER to yourself and others. Consider Manual Handling as a DANGER to your wellbeing.

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How injuries occur

Cumulative (gradual wear and tear) Pain is not a good indicator of damage occurring

Acute (sudden damage) Caused by unexpected movement, intense or strenuous activity

Think about everything you do. At work and at home

While some Manual Handling injuries are caused by acute injury, mostly they are the result of cumulative damage. Ive heard people say Ive never had any pain or injury as justification for poor lifting techniques. But pain is not a good indicator of cumulative damage.

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Natural curves
Maintain natural alignment of the back
Maintain the 3 natural curves of the spine the spine is under the least pressure and spinal muscles are at their strongest.

Cervical curve

Thoracic curve

Lumbar curve

Bend at the knees

Bend at the knees instead of using your back like a crane.

Time and intensity

The Manual Handling regulations state: The distance over which a load is manually handled should be as short as possible By reducing the amount of weight you lift and the time you are exposed to it, you will reduce the risk of injury. Where possible, slide instead of carry.

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Keeping the load close

Keeping the load close reduces the forces placed on the back. 10kgs carried 80cm from the body is equivalent to carrying 50kgs close to the body

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Waist level best range for loads

Between knuckle and shoulder level OK

A B

Frequently used objects should be stored in the knuckle to shoulder zone (zone A) Seldom used objects should be stored in the above shoulder or below knuckle zone (zone B).

Where do you store your KIT or OXYGEN?

The pictures demonstrate removing gear from grab and go locker in Mercedes, keeping load close to body, placing heavy equipment (LIFEPAC 12) on lower shelves. This pertains to using a 4WD as it is higher than a normal vehicle. Remember Manual Handling procedures when loading and unloading equipment from your vehicle.
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Plan
Is any lift necessary?
Planning the patient movement is the key to reducing the risk of injury Aim for minimal lift or no lift if possible

Can the patient assist?

Allow the patient to assist as much as possible as long as it is not detrimental to their condition Spontaneous movement

Consider the condition/injury

Consider the patients condition or injuries when planning the move If they have fractures, that may rule out use of the slide sheet or chair If hypotensive - not sitting upright (supine) If altered level of consciousness may need extra securing

Access and egress

Check all points of access side or rear door may be better than steps at front Move all obstructions out of the way before beginning the move Position operational vehicle downhill

Using lifting aids/getting assistance

Get assistance if the patient is heavy, in an awkward, difficult position, or access is difficult

Ensure sufficient space for lift to be done

Ensure there is sufficient space for the lift to be done in the right position and using the correct posture Slide patient to where they can be better accessed

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Do everything for the patient, but nothing they can do for themselves

Of course this does not mean making the patient walk for miles if they have an inappropriate medical condition; it just means actively encouraging the patient to do as much as their presenting problem will allow, e.g. stand transfer.

Equipment F2650 Stretcher Compact Carry Chair Lifepac 12 + 2 spare batteries Metro Trauma Kit (Red Kit) Metro Airway Kit (Blue Kit) Oxygen Kit with fibreglass cylinder D Size Oxygen Cylinder full C Size Oxygen Fibreglass full C Size Oxygen Steel full Blanket, sheet, pillow Average patient (from case card info) Yellow long board Mini pat slides Oregon splint Hare Traction Splint Slide Sheet

Weight (kgs) 57 10 11 8 7 5 14 4 6 3 90 5 1 4 2 0.5

SWL (kgs) 182 115

150

182

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Attention
Please be aware that on your Manual Handling day you will be given a questionnaire to fill out. It will consist of approximately 20 questions taken from the pre-reading material (Manual Handling) and you will have 15 minutes to complete it.

Contact Details Manual Handling

Manager: Ph: Mobile: Fax No.: Email: Anthony Tossell 8353 6199 0407 790 336 8353 8649 tossell.anthony@saambulance.com.au

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Student Learning Checklist

With the completion of this session I can now: Understand the principles of Manual Handling Understand and demonstrate appropriate Manual Handling techniques Understand the causes of injuries Understand and demonstrate the prevention of injuries

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