A fall creates an immediate need to help a person who cannot get up on their own. Moving a person from the floor requires a deliberate and careful approach to prevent secondary injury and safeguard the helper from musculoskeletal strain. The first step involves a calm assessment to determine if a manual lift is appropriate or if professional medical assistance is necessary. Safe movement must always prioritize stability, clear communication, and working within the physical capabilities of both the fallen person and the caregiver.
When a Fall Requires Emergency Services
Before attempting any manual movement, assess the fallen person’s physical state to avoid injury. Emergency medical services (EMS) must be called immediately if the person has lost consciousness at any point, even if they appear awake now, or if they are confused and disoriented. Immediate movement is contraindicated when there is severe, unrelenting pain, particularly in the head, neck, or back, as this suggests a possible spinal injury.
Further red flags include visible signs of fracture, such as an odd joint angle, or the person’s inability to bear any weight on a limb. Heavy or uncontrollable bleeding also warrants an immediate call to 911, as do symptoms suggesting a stroke or heart attack (e.g., slurred speech or sudden shortness of breath). Attempting to manually lift or reposition a person with a suspected fracture or spinal injury can worsen their condition, potentially leading to permanent damage. Calling emergency services for a professional “lift assist” is a safe alternative if the helper is unsure how to proceed safely, even if the person appears uninjured.
Safe Manual Techniques for Assisting a Fall
If the person is conscious, coherent, and confirms they are uninjured, a manual lift can be attempted using proper mechanics and leverage. Begin by establishing clear communication, explaining each step to the person and encouraging them to assist as much as they are able. The process starts by helping the person transition from lying to a stable, low-sitting or kneeling position, often by rolling them onto their side and encouraging them to push up onto their hands and knees.
The helper must maintain proper body mechanics throughout the process to prevent back strain. This means keeping the back straight, engaging core muscles, and bending at the hips and knees, using the strong leg muscles for the lift. Position a sturdy piece of furniture, such as a dining chair, directly behind the person once they are on their hands and knees. This chair serves as a stable anchor.
The person should then bring their strongest leg forward so their foot is flat on the floor, while the helper places their hands around the person’s hips or torso for support. Using the strength of their leg muscles, the person is encouraged to push up, pivoting to sit securely on the chair placed behind them. Manual lifting should not exceed 35 pounds of unsupported weight, meaning the person must contribute significantly to the movement. If the individual cannot assist, manual lifting is unsafe for both parties and mechanical aids must be used.
Employing Specialized Mechanical Lifting Devices
When the person is completely dependent, or their weight far exceeds the safe manual lifting limit, mechanical devices are the established standard for safe patient handling. The National Institute for Occupational Safety and Health (NIOSH) recommends a maximum manual lift limit of 35 pounds of unsupported weight for a single caregiver. Exceeding this limit increases the risk of musculoskeletal injury for the helper.
Specialized equipment, often called fall recovery devices, removes the physical strain from the caregiver. One common type is the inflatable lifting cushion, such as the Elk or Camel models, which are positioned deflated beneath the person and gradually inflate using a compressor, gently bringing them to a seated position. These devices are portable and can be operated by a single person.
For transfers requiring full lift capability, mobile hoists with slings, sometimes referred to as Hoyer-type lifts, are used. These devices use electric or hydraulic mechanisms to lift the person vertically from the floor while cradled in a fabric sling. Another option is a sit-to-stand lift, which is suitable only for individuals who have some weight-bearing capacity but require assistance to rise from a seated position. Caregivers must be fully trained in the specific device’s operation to ensure a controlled and secure transfer.
After the Lift: Immediate Safety and Future Fall Reduction
Once the person is safely off the floor and seated, they should remain there for a period of rest, allowing time to check for any delayed signs of injury or dizziness. Immediately check their alertness, vital signs, and ask specific questions about any new aches, pains, or unusual sensations that may have arisen during the lift. Even if the person denies injury, monitor them closely for the next 24 to 48 hours for subtle symptoms like nausea, increased confusion, or localized swelling.
Preventative measures must be addressed to reduce the likelihood of recurrence. This involves a thorough review of the home environment to eliminate common tripping hazards, such as unsecured throw rugs or unnecessary clutter. Ensuring adequate lighting, especially at night and around stairs, is an effective environmental modification. Finally, review the person’s current mobility aids, such as canes or walkers, to confirm they are properly sized and being used consistently, as frequent falls often indicate a need for medical reevaluation or updated equipment.