Moving an incapacitated person in an emergency requires careful consideration to prevent additional injury to both the person being moved and the rescuer. Improper movement can worsen existing injuries, especially those involving the spine or head. The goal of emergency transport is to move the person to a safer location or into medical care with the least amount of movement and strain. Effective preparation and adherence to established protocols are necessary before attempting any physical movement.
Initial Safety Assessment
The first action in any emergency is to confirm the scene is safe for both the injured person and the rescuer. Once the environment is secure, rapidly assess the person’s injuries and condition before attempting movement. Avoid moving the person if a spinal or neck injury is suspected, as this could lead to permanent paralysis. Signs of a potential spinal injury include severe neck or back pain, numbness or weakness in the limbs, or an oddly positioned head or body.
Movement should only be attempted if the person’s life is in immediate danger from environmental hazards, such as fire, toxic fumes, or an unstable structure. Before moving, quickly check for severe, life-threatening bleeding and control it with direct pressure if possible. Also confirm the person has a clear airway and is breathing, as these take precedence over other injuries. If movement is unavoidable, maintain the head, neck, and torso in a straight line, moving the person as a single unit to minimize spinal movement.
Essential Body Mechanics for the Carrier
Protecting yourself from injury is necessary, as lifting or carrying dead weight significantly increases the strain on your body. Proper biomechanics utilize the strongest muscle groups to manage the load. When preparing to lift, maintain a wide stance with your feet shoulder-width apart for a stable base of support.
The primary force for the lift must come from your legs, not your back. Achieve this by squatting down near the person while keeping your back straight. Keep the person’s weight as close to your torso as possible; this reduces the leverage force acting on your spine. When moving, avoid twisting your body; instead, pivot with your feet to change direction and prevent rotational stress on the lower back.
Single-Rescuer Transport Methods
When only one person is available, the choice of carry method depends on the person’s condition and the distance they need to be moved.
Clothes Drag
The Clothes Drag is the fastest method for moving someone a short distance, especially when a spinal injury is suspected, because it keeps the body relatively flat. To perform this, kneel behind the person’s head and grasp their clothing firmly beneath the shoulders, supporting the head with your forearms. Use your legs to pull the person in a straight line, minimizing twisting motion.
Pack-Strap Carry
The Pack-Strap Carry is efficient for covering longer distances when the person does not have suspected spinal injuries. Start by helping the person into a sitting position and turning your back to them. Have the person place their arms over your shoulders, or if they are unconscious, cross their arms and grasp their wrists over your chest. By squatting slightly and leaning forward, use your legs to stand, settling the person’s weight onto your back and hips for balance during the walk.
Fireman’s Carry
The Fireman’s Carry is another single-person option for covering long distances, but it is difficult to get the person into position without assistance. This method involves hoisting the person over one shoulder, distributing their weight across your neck and shoulder. While it allows the rescuer to use one hand for support, this carry method is fatiguing and is generally not recommended for untrained rescuers.
Assisted and Team Transport Techniques
Two or more rescuers can move a person more safely and efficiently because the weight is distributed and greater stabilization is achieved.
Extremity Carry
The Extremity Carry is a two-person technique used for a person who is conscious or unconscious. The first rescuer stands at the person’s head, reaching under their armpits and locking hands across the chest. The second rescuer squats between the person’s legs and grasps them under the knees. Both rescuers then lift simultaneously on command, ensuring a level and stable movement.
Two-Person Seat Carry
The Two-Person Seat Carry is ideal for a conscious person who can assist slightly but cannot walk, or for transporting an unconscious person over moderate distances. The two rescuers kneel on either side of the person and slide one arm behind the back and the other under the knees, grasping each other’s wrists to form a secure seat. Lifting together from the squatting position, the rescuers walk in synchronization while keeping the person well-supported.
Blanket Carry
For team movements over rough terrain or long distances, creating an improvised litter or using a blanket drag offers the best stability and weight distribution. A simple Blanket Carry involves using a blanket or sturdy fabric beneath the person and having multiple rescuers hold the edges. This technique distributes the person’s weight evenly across the group and minimizes pressure on any single body part during transport.