Beach Transfers

Transferring a patient off the RWC sled should be done with assistance of other people where possible. Due to the nature of RWC operations, Operators may find themselves in a situation where there is no other assistance available.

When considering transfers, it is essential to assess the situation, and the risk involved. There may be cases where the patient is better left on the RWC sled. Where a transfer off the sled is required, patient movement should be minimised where possible.

Transfers with a Crewperson

Patient is face down on the sled:

1. As the RWC comes to a standstill, the Crewperson should extend one of the patient’s arms allowing the Crewperson to secure the patients chin.
2. The Crewperson will begin the patient roll by placing their outside hand under the patients outside shoulder and rolling the patient off the sled. The Crewperson must ensure they are in a squat position as they roll the patient off the sled to allow for an easy and safe lift and carry.
3. Once the patient been rolled, the Operator must grab hold of the patient’s legs above the knees and wait for the command from the Crewperson.
4. The Crewperson and Operator will then stand up together and move simultaneously making their way up the beach to an area where it is safe to assess the patient.

Patient is face up on the sled:

1. As soon as the RWC comes to a standstill the Crewperson needs to secure the patient to the sled by placing their forearm down the centre of the patient’s chest.
2. Once the patient is secure the Operator will walk around and place their foot between the patient’s feet on the bottom of the sled preventing any movement and stabilising the sled.
3. The Operator will then grab the patient’s hands and prepare to pull them up into the seated position.
4. It’s important that the Crewperson passes the patient’s right arm over their right arm (see arrow) as this will provide support to the chin when lifting the patient.
5. With the Operator holding the patient by their arms in a seated position, the Crewperson will position themselves behind the patient’s back, with their arms underneath the arms of the patient preparing for a lift.
6. Once the Crewperson is ready, the Operator will release the patient’s arms, giving the weight of the patient to the Crewperson. The Operator will then position themselves to lift the patient from the legs, above the knees.
7. When both the Operator and the Crewperson are ready to lift, the Crewperson will give the command to commence the lift.
8. The Crewperson and Operator will then stand up together and move simultaneously making their way up the beach to an area where it is safe to assess the patient.

Please refer to the safe handling section in Chapter 2.

Emergency One-Person Patient Drag

The one-person patient drag is a method of moving a patient when no other help is available. Operators should carefully evaluate the situation, and the risks involved, with all care taken to reduce the risk of injury to the Operator. A one-person transfer and drag should be used as a last resort and only when there’s significant benefit to the patient. A one-person drag should not be used when there are other people available to assist with moving a patient. Performing a one person drag significantly increases the risk of back and/or musculoskeletal injury to the Operator.

To perform the one person drag

1. With the patinet laying face dowe on the sled, slide both arms under both of the patient’s armpits from behind them to your elbow line.
2. Lift the patient by bending your knees, keeoing a straight back and maintaining a firm, balanced grip.
3. Once standing support the patient high against your chest, keeping the airway supported and open.
4. Ensure that you support the patient at your elbow line (not with your wrists), secure the patient’s left wrist with your left hand against their chest.
5. Walking backwards, drag the patient up the beach to a safe location.
6. Gently lower the patient turning them onto their left side facing the water by dropping on to your left knee (on the right-hand side of the patient).
7. Slide you left arm from under the patient’s arm pits and move to support and lower the head.
8. Assess the patient’s condition and treat as required.

Sled Quick Release Transfer

This method is used to transport the patient on the sled and will require the assistance of a minimum of three other people to assist (three + Operator). Where spinal immobilisation is required, a minimum of four people are required to assist (four + Operator). Depending on the size of the patient, more assistance may be required before performing the lift. Lifting the sled should only be done if it is safe to do so for the team rendering assistance.

To perform the transfer:

1. If spinal immobilisation is required, one member will secure the patient’s head using the trapezius grip.
2. The team performing the lift should position themselves around the sled, to ensure the sled remains secure once disconnected from the RWC.
3. Once secure, under the direction of the Operator, the sled should be disconnected from the RWC using the quick release clips, if available. (Note: The same technique could be done with traditional setups if time allows.) It is recommended that the centre release fitting is released first followed by the port and starboard quick releases.
4. The team performing the lift should then prepare to lift using safe handling practices, facing the direction of travel.
5. If the head is immobilised, the person on the head will coordinate the lift, otherwise the Operator should coordinate the lift.
6. Where possible, the patient should be moved with their feet first in the direction of travel.
7. It is essential through all stages of the lift that one member of the team clearly communicates with the patient as to what the team is doing and provides reassurance to the patient if possible.
8. Following a coordinated lift, the patient should be moved to a safe location for further treatment.