3.18.03 Patient and Staff Protection

3.18.03 Patient and Staff Protection (Revised 5/2025)

OVERVIEW

Amerimed desires to transport every patient in a safe, professional, and efficient manner. Occasionally we are presented with request for service that may not be appropriate for EMS transport. It is our desire to triage these patients such that they receive the care they need in the safest, most efficient and effective manner possible.

This procedure outlines three (3) phases of service that we should consider on every request for transport: the pre-transport, during-transport phases, stretcher operations and knowledge.

SECTION A

PRE-TRANSPORT
Prior to the transport, crews should conduct the following assessment:
• During the morning truck check, ensure the unit is equipped with buckle guards and soft restraints as required by the daily unit truck check.
• In conversation with the patient care team at the pickup location, the risk of potential combativeness and/or elopement should be determined.
o Specific questions to ask should include-
1. What is the current mental state of the patient?
2. Has the patient verbalized the desire to leave the facility against medical advice?
3. Has the patient been cooperating with the care plan?
4. What is the diagnosis of the patient? (E.G. Suicidal ideations and/or homicidal ideations versus accidental overdose)
• After discussion, if it is determined that the patient presents a risk of combativeness and/or flight/elopement:
• Request physician orders for soft restraints. Once ordered, restraints should be applied while in the pickup facility immediately after patient is transferred to the Amerimed stretcher.
• If the facility will not support the use of soft restraints, the crew should call their Officer in Charge (OIC) for further direction.
• The OIC could recommend transport:
• With the use of soft restraints
• Utilize local law enforcement to transport the patient

SECTION B

DURING TRANSPORT

During transport, if the attendant feels the risk of combativeness and/or flight/elopement is high:
• Remove patient’s footware
• During all transports the following should be in place:
• Buckle guards to prevent the patient from releasing the safety seat belts in order to leave the stretcher.
• All exterior doors of the transport unit shall be locked utilizing the extra door locks provided. These door locks require specific knowledge to open a door. The patient should not have the knowledge required to open these doors.
• Use of a trigger word. The use of a trigger word between the Driver/Operator of the vehicle and the attendant should be utilized during transport to allow the attendant and driver to communicate a single word that notifies the Driver/Operator to immediately slow the vehicle and pull into a safe zone in the case of patient combativeness and/or flight/elopement.
o The trigger word to be used is “Oklahoma”, and when verbalized from the Attendant to the Driver/Operator of the vehicle would cause the vehicle to safely and immediately slow down and drive into a safe area.
• Call for support of Law Enforcement utilizing the two-way radio to MedComm immediately.
• De-escalation techniques should be utilized first. (Talk the patient down).
• If time allows, physician orders can be requested via radio or cell phone for soft restraints from the receiving facility.
• In the event that none of the above measures are effective, ensure crew safety by removing yourself to a safe location.
• While our care for the patient’s safety is one of our primary concerns, physical altercations with the patient should be avoided at all costs in order to protect crews as well as patients.
• Notify Medcomm immediately via 2-way radio. Keep MedComm updated on all events

 SECTION C

Stretcher operations and knowledge
Safe Stretcher Operations and use of Stryker Power-PRO 2 Stretcher
Equipment Overview
The Stryker Power-PRO 2 stretcher is a powered stretcher that helps EMS teams lift, move, and transport patients. It uses a battery to raise and lower the stretcher with a button, which helps reduce injuries to EMS workers. It also includes straps to keep patients safe, side rails, wheel locks, and other safety features.
Daily Safety Checks
• Make sure the stretcher is clean and free of damage.
• Check that the battery is fully charged. Use the LED lights to see the battery level.
• Confirm all straps are working and attached to the correct points.
• Make sure the stretcher is locked into the ambulance’s stretcher mount before driving.
• Check that the wheels, side rails, and control buttons all work properly.
Transferring the Patient and Using Restraints
• Always lower the stretcher to match the height of the bed or chair.
• Lower the side rails and place the patient on the stretcher safely.
• Use all patient restraint straps: shoulder, waist, thigh, and ankle if needed.
• Tighten straps so the patient is secure but comfortable. Not to restrict breathing.
• Raise the side rails and adjust the backrest or footrest if needed.
Raising and Lowering the Stretcher
• Use the power buttons at the foot end of the stretcher:
• Press the up (+) button to raise.
• Press the down (–) button to lower.
• Always use two people when raising or lowering a stretcher with a patient.
• If the battery is dead, use the red manual release handle to lower the stretcher.
• Keep hands and feet clear of moving parts.
Transporting the Patient
Transport the stretcher in the lowest safe position. Stretcher of all makes should be transported (moved/rolled) in the lowest position possible to create a low center of gravity and help prevent the tipping or turning over of the stretcher.
• Always move the stretcher head-first or foot-first — never sideways.
• Lock the wheels when the stretcher is parked or in use.
• Avoid curbs, rough terrain, and steep slopes when possible.
• Use the correct handles for pushing and pulling the stretcher.
Loading and Unloading the Stretcher
• Make sure the stretcher is lined up with the ambulance’s loading system.
• Press the release or extend buttons only when the safety bar connects with the vehicle hook.
• Always confirm the stretcher locks into the stretcher fastener before transport.
• When unloading, use two people and guide the stretcher safely out.
• Make sure wheels touch the ground before removing the stretcher from the hook.
Battery and Charging
• Charge the stretcher by locking it into the power-load system in the ambulance. (if applicable)
• Do not use if the battery is cracked or damaged.
• Keep batteries dry and clean. Do not touch battery terminals with metal objects.
• Charge the battery daily or as needed based on usage.
Important Safety Reminders
• Always use all safety straps.
• Do not modify or repair the stretcher without permission.
• Never let an untrained person use the stretcher.
• Avoid rushing. Always check the cot is locked, stable, and safe.
• Keep the stretcher clean and report damage right away.

If you are unsure how to safely use any piece of equipment, it is your responsibility to notify your OIC prior to use.