Posted By Ken Taylor Whilst appreciating that we are now in the days of bed-lifts and evacuation lifts, I still remember attending a training session on the evacuation of bed-confined persons wrapped up in tied mattresses by dragging them along corridors and eventually down stairs! Needless to say, willing and able-bodied volunteers were used for the training! Considering the implications of the Manual Handling Regs, etc but also the possibility of lifts not being available the impracticality of wheel-chairs or Evac+Chairs for some patients/clients and the space required for numerous beds at refuges, I would be interested to hear whether there are any remaining vestiges of this practice and if anything has been published for the health community in this respect.

Posted By John Webster Ken It is a sad fact of life that in an impoverished NHS, old and inadequate hospital buildings are still in use. Whilst most patients can be safely evacuated by other means, there will always be those for whom transfer from bed to a wheelchair or evacuation chair is just not an option. Where the layout of an area requires there to be 2 escape routes, it is a fair bet that only one of the routes will be capable of taking a hospital bed. In those situations, we require the potentially affected beds to be fitted with ski-sheets. (For the uninitiated, these go below the matress and have two or three seat-belt type buckles which are pulled out and over the top, effectively wrapping the patient in the matress. There is a loop handle at each end with which the mattress can be dragged.) They are a last resort, hopefully never to be used, but with two people are actually very easy to pull off the bed and along a smooth floor surface and even down stairs (easier than controlling the descent of an evac chair). In practice, these would be the last patients to be evacuated, and it is anticipated that, with assistance arriving from unaffected areas, three or four staff could be available. Unfortunately they are hopeless on carpeted floors, and difficult to use with air matresses - increasingly in use(control of pressure sores) by just the type of patient who cannot be moved by other means. For these situations, we are looking at a padded vinyl variety which has to be placed under the patient but otherwise is used in a similar way. I believe that, both from a patient safety and from a staff moving and handling perspective, the "reasonably practicable" test is satisfied. Of course, I would prefer a nice new hospital with a sprinkler system and wide doors and corridors and fire-safe lifts big enough for beds. Anyone got a spare £20million or so?

Posted By john o'meara Ken and others. A new program started on Australian TV last night called "The New Inventors". Incredibly, the very first invention showcased was a thing called the "Albac Mat". It seems to do the exact job you want. Please look at the programme: http://www.abc.net.au/newinventors/ There's a video demo of the mat in use. Interestingly the other two inventions showcased also had improved H&S outcomes - the "No Dump" blocking plate (you've gotta read this one to believe it) and the "Coconet". J.

Posted By John Webster Ken Any evacuation of patients using ski-sheets would almost certainly be undertaken by nurses - and lead by the nurses caring for the patients in question. These are the people most highly trained in moving and handling, and should be capable of on the spot assessment of risk, calling for assistance according to the situation. We don't practice with people acting as "patients", but more because of the risk of injury to the "patient". Training is done by demonstration. Any practice is with empty beds with a couple of pillows as the patient. Stairs do not really present a problem to the rescuer. The patient, safely wrapped in a matress with pillows and bedding, is dragged (no lifting) feet first down the stairs - often easier than on the level. Its probably the only time that a live patient is ever tranported feet first (unless appearing in Casualty or Holby City!). The person at the head end does not lift either, just applies a slight tension to reduce the bouncing of the head and control any tendency for the bundle to slew. It is not necessary to carry out a full simulation of a situation in order to provide training or for that training to be adequate. This is particularly true of emergency training where all anyone can hope to do is learn and practice the relevant techniques and procedures and hope they all come together if the proverbial ever hits the fan.