It is commonly accepted that ambulance staff undertake a large amount of lifting and
handling in their daily work. Their primary role is to provide pre-hospital care and to
transport sick and injured people to hospital. The emergency nature of the job means
that ambulance workers have to assist people who are incapable of moving themselves
in awkward and potentially hazardous environments. While safer lifting policies have
been introduced ambulance workers still lift weights which other healthcare workers
However since the introduction of manual handling regulations and more recently CEN
standards, ambulance services and manufacturers have been trying to find new ways
of moving and transferring patients. Ambulance services have purchased new
equipment to reduce musculoskeletal risks but there is little scientific evidence to
support their purchasing choices. This thesis presents two case studies describing
ergonomic equipment evaluations of stretcher loading systems and mobility equipment
to provide a scientific basis to support purchasing decisions.
Case study one is a comparative analysis of stretcher loading equipment used in UK
ambulance services. The study was carried out in two phases. Phase 1 was a field
study which used observation and interview methods to identify issues affecting
equipment use in a range of environments. Phase 2 was a simulation study which
used task simulation to assess the postures adopted during loading and unloading
activities with each system. Both phases identified the tail lift as the preferred system
to reduce manual handling and improve patient and operator safety.
Case study two is a comparative evaluation of mobility equipment. User trials were
carried out to evaluate 12 transport chairs and 4 stretchers for Accident and
Emergency and Patient Transport Service staff to identify preferred equipment for each
team. 16 staff assessed the equipment by conducting task simulations and completing
questionnaires for each product. Postures adopted during the tasks were assessed
using Rapid Entire Body Assessment. The mechanised stair climber chair was the
preferred chair for both teams. The stretcher analysis was inconclusive. This thesis has used two case studies to establish a protocol for field and lab based
evaluations of movement and transfer equipment in the future for the ambulance
vehicle. A more comprehensive procurement process is recommended to include
detailed ergonomic evaluation, ensuring that the end user is fully represented. The
thesis concludes that automation is way forward to reduce manual handling risks posed
to ambulance workers. The output from case study 1 (tail lift) has been included in the national specification for future Emergency Ambulances in the UK.
A Doctoral Thesis. Submitted in partial fulfillment of the requirements for the award of Doctor of Philosophy of Loughborough University.