Pilot study for examination of back stresses in emergency service personnel during the transport of patients on staircases

Status:

completed 07/2016

Aims:

Emergency service personnel must frequently transport patients up and down staircases. In the process, they must handle high loads and adopt unfavourable body postures owing to the limited width of the staircases. In addition, they are required more and more often to transport heavy patients.

Depending upon the number of emergency responders available and the transport equipment employed, high stresses may arise upon the musculoskeletal system and in particular upon the back. An additional problem is that the proportion of female emergency responders is increasing and that lower load limits apply to women than to men.

Alternative equipment supplementing the conventional transport equipment is now available for relieving the stress upon the emergency responders. For a number of reasons however, its use is not yet widespread.

In this pilot study, the back stress arising during the transport of patients on staircases was determined with use of two conventional and two alternative items of transport equipment, in order to demonstrate the potential stress reduction achieved by use of the alternative equipment.

The study was to examine the extent to which the results of the pilot study could serve as a basis for a follow-on project, for example for the formulation of prevention recommendations for the field in cooperation with the affected accident insurance institutions.

Activities/Methods:

The existing German and foreign literature concerning the transport of patients on staircases was first surveyed and evaluated. Laboratory experiments were planned based upon the results of this research and a market analysis. Two conventional items of equipment (an escape chair and an emergency carrying sheet) and two alternative items of equipment (a tracked stair chair and an evacuation slide sheet) were used by two test subjects to transport a dummy on a staircase. Suitable measurement methods (e. g. CUELA, force-measurement handles) were combined and used for qualitative and quantitative measurement/calculation of body postures and movements, action forces and compression forces on the lumbar spine. The exertion perceived subjectively by the test subjects was recorded in parallel by means of a questionnaire employing the Borg scale. Six male emergency responders, aged under 40 and free of health complaints, completed the tests. The results were interpreted, including by statistical review of the measurement parameters for the alternative equipment compared to the conventional equipment.

Results:

Based upon the results of the literature survey, a suitable test schedule and an extensive measurement setup (five measurement systems operating in parallel: three times CUELA inertial and twice force-measurement handles, together with questionnaires concerning the subjectively perceived stress) were combined and trialled. This procedure enabled the stress situation of the two-man rescue teams to be recorded simultaneously.

The data obtained show that the development, adaptation and design work performed on the software and hardware enabled the desired parameters to be recorded. Scope for optimization of the measurement technology was identified, and is to be exploited for follow-on measurements in a main study.

The results deliver preliminary information on the stresses that may arise when the different forms of equipment are used for the transport of patients on staircases. Besides the direction of transport (up or down stairs) and the equipment used, the carrying technique also had an influence upon the level of physical stress experienced by the test subjects. Based upon the measurement results and consultation of the test subjects, a trend can be discerned for a reduction in the stress when the alternative transport equipment tested is used.

The findings of this pilot study are to be used to prepare a main study, which in turn is to form the scientific basis for suitable prevention recommendations.

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