Problem Solving

The driver for the urgent tier motor meets us at the front door.

"She's in some state. Been there for 5 days hasn't moved. She's quite a big lady but she isn't in the position to help herself. The wound from her breast is infected and extends down her side from under her armpit. Its actively bleeding so we can't get under the arms to lift her. The daughter says she apparently isn't aware that she has breast cancer and she won't communicate with us at all. We just can't move her on our own"

We enter the property, which is cramped, extracting her from the house maybe difficult which ever way we do it.

The patient is sat on a sofa which looks to have collapsed under her. The smell of dirt, urine and faeces fills the air. She makes for a sad sight. She's given up.

We have to think of the best way to get her off the sofa and out of the house.

Attempt No 1:

We use a slide sheet as a sling and pass it around her back and under her arms. It'll be soft enough on her wound and give us some leverage. We position the carry chair. Two of us will use the sheet from the front to pull the patient up, one will push the patient from the back and the 4th person will block her feet to stop her sliding in the hope that she will support her own weight long enough to switch her on to the chair.

It is on this last point that the plan fails. It becomes apparent that the patient has totally given up and is not able to support herself in anyway what so ever. The attempt results in us lowering the patient to the floor.

Attempt No 2:

I suggest trying to use the Manger Elk. This is a lifting cushion which assists to raise patient's off the floor without needing to lift them.

We position the equipment and get the patient onto the cushion as best we can. We use the slide sheet to pull her into the Elk.

We position ourselves to try and support her as best we can while the cushion inflates. She slouches and begins to slide off the front of the cushion and no amount of repositioning and support will make this manoeuvre work.

Attempt N0 3:

We lay the patient down on the floor and wrap her in a blanket to try and keep her warm and comfortable.

The orthopaedic stretcher is brought in, measured up and prepared next to the patient. We get the trolley and place it by the front door and then do a walk though the hallway to plan the best way to lift her out. We have to move some clutter to help ease our transition. Its not ideal, we are going to have to bodily lift her over part of the banister at the bottom of the stairs to get around the corner and out the front door. At times like this the 'no lifting' policy goes out the window and you just have to get on with it.

We get the patient on to the ortho stretcher and strap her up tightly. I surprise myself by getting it right first time even though I hadn't had to use this particular technique since the training school.

The lift goes well and we finally get the patient out the front door and in a comfortable position on the trolley. A swift move into the urgent tier vehicle and she is nicely packaged for the doctors and Holy Hospital to begin to deal with her problems.



I remember the application packs for this job saying 'Good at problem solving'. Its jobs like this that make you realise why.