Lavender S A, Conrad K M, Reichelt P A, Meyer F T, Johnson P W
Department of Orthopedic Surgery, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612, USA.
Appl Ergon. 2000 Feb;31(1):45-57. doi: 10.1016/s0003-6870(99)00027-7.
Paramedics who perform emergency rescue functions are highly susceptible to musculoskeletal injuries. Through an interview and survey process firefighters, many of whom are cross-trained paramedics in a consortium of 14 suburban fire departments, identified and rated tasks that were perceived to be both strenuous and frequently performed. The objective of the current study was to describe the working postures and the forces applied as firefighter/paramedics (FF/Ps) simulated specific roles within the following tasks identified by the survey: (1) transferring a patient from a bed to a stretcher using bedsheets, (2) transferring a patient from the ambulance stretcher to a hospital gurney, (3) carrying a victim down a set of stairs and around a landing using a stairchair, (4) carrying a victim down a set of stairs and around a landing using a backboard, and (5) carrying a victim down a set of stairs using a stretcher. Ten two-person teams of FF/Ps participated and were videotaped to obtain postural data for the upper and lower extremities as they performed each role in the simulated two-person tasks. Trunk postures were obtained using lumbar motion monitors. Static hand forces were estimated using a hand-held dynamometer at the most physically demanding points for each role within each task. The postural and force data were averaged across subjects performing identical roles to quantify the postures assumed by the FF/Ps at the most strenuous moments during task performance. Based on these analyses we concluded that: (1) when transferring victims from a bed to a stretcher the FF/P on the bed was able to maintain an upright and more stable posture by standing as opposed to kneeling, (2) an interface board should be used to reduce the frictional forces when transferring victims from a bed to a stretcher or from a stretcher to a gurney, thereby reducing the need to lift the victim with flexed torsos and/or shoulders, and (3) equipment and training that encourages the FF/P in the leader role to walk facing forward during victim transport, especially when descending stairs, potentially results in safer transit.
执行紧急救援任务的护理人员极易受到肌肉骨骼损伤。通过访谈和调查过程，消防员（其中许多人是14个郊区消防部门组成的联盟中经过交叉培训的护理人员）识别并对那些被认为既费力又经常执行的任务进行了评级。本研究的目的是描述消防员/护理人员（FF/Ps）在调查确定的以下任务中模拟特定角色时的工作姿势和施加的力：（1）使用床单将患者从床上转移到担架上，（2）将患者从救护车担架转移到医院轮床上，（3）使用楼梯椅将受害者抬下一组楼梯并绕过楼梯平台，（4）使用背板将受害者抬下一组楼梯并绕过楼梯平台，以及（5）使用担架将受害者抬下一组楼梯。十组由两名FF/Ps组成的团队参与其中，并在他们执行模拟双人任务中的每个角色时进行录像，以获取上肢和下肢的姿势数据。使用腰部运动监测器获取躯干姿势。在每个任务中每个角色最费力的点使用手持测力计估计静态手部力量。对执行相同角色的受试者的姿势和力量数据进行平均，以量化FF/Ps在任务执行最费力时刻所采取的姿势。基于这些分析，我们得出以下结论：（1）将受害者从床上转移到担架上时，床上的FF/P站立而非跪着能够保持直立且更稳定的姿势，（2）在将受害者从床转移到担架或从担架转移到轮床时应使用接口板以减少摩擦力，从而减少用弯曲的躯干和/或肩膀抬起受害者的需求，以及（3）鼓励担任领导角色的FF/P在运送受害者时，尤其是下楼梯时向前走的设备和培训可能会使转运更安全。
