Okay, new partner, here’s how I like my stretcher made up:
A clean sheet tucked under all sides, but not necessarily tied. A hospital chuck folded across the middle of the stretcher and tucked in. By the foot, I want a wool blanket, a bath blanket, a sheet, and a Johnny top (hospital gown). By the head, a pillow ( with fresh case) and a towel.
I want the bottom sheet tucked in, but not tied because if it is tied, it will be harder for you to take off, and if it is harder for you to take off, then you may be more apt to just leave it on there for the next patient, cleaning the used sheet by brushing off any dirt with your gloved hand, rather than putting down a fresh sheet.
Sure, I have been guilty of using the same bottom sheet from one patient to the next, but I want you to be a good EMT today. And if you are a good EMT, it will reflect well on me.
Once we meet the patient, depending on their condition – if I am going to be doing a 12-lead ECG, listening carefully to their lungs, or putting in an IV, then if convenient, I try to get them to take off whatever they are wearing for a top and clothe them in a fresh hospital gown. If the patient is female, I will try to have a female relative, friend or a medical person help them change. Sometimes I will hold the gown up like a curtain and let them change themselves and then slip their arms into the gown. Sometimes I do the change on scene, sometimes I wait until we are in the ambulance. The reasons for the gown are to enable me to do a better exam, make doing a 12-lead easier, and sometimes just to get them out of their damp or dirty clothes and into something fresh and clean. It also spares them from having to be undressed at the ED and snaking the IV bag through their clothes. The only cases where I remove the bottom portion of their clothes are trauma, childbirth, a definite STEMI (in a STEMI this step speeds time in the ED and enables quicker access to the groin for cath lab cannulation), or if their clothes are so damp or soiled as to be a threat to the patient.
When it is time for the patient to sit or be placed on the stretcher, I will have you take the second sheet and spread it open on top of the first (tucked in) sheet, with the sides dangling down so once the patient is on the sheet, we can each grab a side of the sheet, and adjust the patient to the most comfortable position.
I often fluff the pillow before they lay their head on it. It is a silly gesture, but one appreciated by the patient. Sometimes I apologize for no chocolates. I may finger you as the culprit – a little humor to lighten the mood.
Once on the gurney, the patient is then covered with both the sides of the sheet and a bath blanket. If it is cold enough, the wool blanket goes on top. The patient is then belted to the stretcher. I use three straps. I admit I am not fond of the shoulder straps and make a resolution to use them more often. They are excellent for holding a patient in place, but like the top strap, they are usually always undone by me to allow access to the patient during care. I need to remember to reconnect them once transport starts. Safety first.
The final item – the towel. This — particularly in winter or foul rainy weather—I use to wrap around the patient’s head to keep them warm and dry. If someone says our patient now looks like Mother Theresa, that’s a good thing.