A manual Hoyer lift, also known as a hydraulic patient lift, is a device designed to safely transfer individuals who cannot bear their own weight. It uses a hydraulic cylinder and a manually operated pump handle to raise and lower a patient suspended in a sling, preventing strain and potential injury to both the patient and the caregiver. Its function is to move a non-ambulatory person between surfaces, such as a bed, wheelchair, or commode. Safe operation requires meticulous attention to detail. For optimal safety, especially for new users or during complex transfers, having two trained individuals present is highly recommended to manage the lift and stabilize the patient.
Preparation: Sling Placement and Environment Setup
Before initiating any transfer, the environment must be assessed and secured to ensure a clear pathway for movement. Obstacles in the transfer route, such as rugs, clutter, or uneven flooring, must be removed to prevent the lift from tipping or becoming snagged. The destination surface, whether a wheelchair or a commode, must be positioned and its wheels locked securely to prevent movement upon arrival.
The manual lift requires specific preparation before the sling is attached. The adjustable base legs must be spread to their widest position and locked to maximize stability and reduce the risk of tipping. The casters should not be locked, as the lift needs to move slightly to center itself beneath the load as the patient is raised. The swivel bar or cradle should be lowered to a height that allows easy attachment of the sling straps.
Correct sling placement is the most important preliminary step. If the patient is lying down, roll them onto their side (the log-rolling technique), facing away from the caregiver. Fold the sling lengthwise and place it against the patient’s back, aligning the bottom edge near the base of the spine for a full-body sling. Gently roll the patient back onto the sling, then repeat the process to pull the sling through, ensuring it is centered and smooth beneath the body.
Executing the Lift and Movement
With the sling positioned, attach the straps to the lift’s cradle or spreader bar. The straps, often color-coded, must be connected using the same length on both sides to ensure the patient is lifted evenly and remains centered. The leg straps are brought up between the patient’s legs and then either crossed or attached directly to the cradle hooks, depending on the sling type, to prevent the patient from sliding out.
Once all loops are securely attached, the hydraulic pump is engaged by ensuring the control valve is fully closed, usually by turning it clockwise. The caregiver then pumps the handle repeatedly with steady, smooth strokes to slowly elevate the boom and lift the patient. The patient should be raised only high enough for their buttocks to fully clear the surface they are being lifted from, which is often an elevation of just a few inches.
As the patient’s weight is fully supported, they will naturally be brought into a sitting position. Keep the patient centered over the base of the lift and encourage them to cross their arms across their chest for stability. Always push or pull the lift using the steering handles on the mast, never by pushing on the boom, as this can destabilize the unit.
When maneuvering the lift, all movements must be slow and deliberate, avoiding sudden jerks or turns. The caregiver should turn the patient to face them during movement, providing reassurance and allowing continuous monitoring of their comfort and balance. The lift’s wheels should remain unlocked during transfer to allow the lift to navigate and self-adjust to the shifts in the patient’s weight.
Safe Lowering and Patient Positioning
Upon reaching the destination surface, position the lift so the patient is squarely over the center of the chair or bed, and confirm the destination surface’s brakes are locked. Control the lowering process by slowly opening the hydraulic pressure release valve, typically a knob or lever near the pump handle. Turn the valve counter-clockwise, often no more than one full turn, to initiate a gradual descent.
As the patient lowers toward the seat, gently push back on their knees to help their hips slide fully to the back of the seat, ensuring a proper sitting posture. Once the patient is fully resting on the surface, close the hydraulic valve. Slightly push down on the boom to create slack in the sling straps, enabling the safe removal of the sling loops from the cradle hooks.
Critical Safety Protocols and Troubleshooting
Routine inspection of the lift and its components is a necessary safety protocol before every use. Visually check the sling for signs of wear, such as tears, fraying, or damaged stitching; a compromised sling is a safety hazard and must be discarded immediately. Verify that all pins, bolts, and connections on the lift frame are secure and properly seated.
The patient’s weight must never exceed the maximum capacity for both the lift model and the specific sling. If the hydraulic pump begins to fail (e.g., leaking fluid or inability to hold weight), the lift must be taken out of service immediately until professionally repaired. If the patient shows any sign of distress, pain, or imbalance during the lift, immediately stop the upward motion and slowly lower the patient back to the starting surface to reassess the situation.