Definitions

Lift Assist

A call where a patient or family member requests help repositioning a person who cannot self-mobilize, without an acute medical complaint.

Public Assist

A call where the primary need is non-medical (e.g., locked vehicle, locked house, well-being check that turns out to be uneventful).

Purpose

To ensure every lift assist and public assist receives a complete medical screen, that members lift safely, and that the agency has a documented record consistent with the standard for any patient contact.

Scope

Applies to all dispatched lift assist and public assist calls, and any call that becomes a lift assist on arrival.

Why This Matters

• Older adults who experience a fall have a 30%+ readmission and morbidity rate. A fall is rarely 'just a fall.'
• Repeated lift assists at the same address frequently indicate untreated medical decline, caregiver stress, or unsafe home environment.
• Lifting injuries are the most common cause of EMS provider injury.

On Scene — Medical Screening

1. Treat every lift assist as a patient encounter. Obtain a chief complaint and vitals.
2. Specific assessment for: head impact, hip injury, dehydration, weakness, syncope, medication changes, infection (UTI, pneumonia).
3. Glucose check if any altered mentation, recent diabetic medication change, or anyone with insulin.
4. Inspect the head, neck, hips, knees, wrists. Many fall-related injuries are subtle.
5. Orthostatic vitals when appropriate.
6. Ask: 'Why did you fall? What were you doing?'

Safe Lifting Technique

• Two-person minimum for any meaningful lift. Three-person preferred.
• Communicate the count: 'On three.'
• Bend at the knees, neutral spine.
• Use mechanical assistance when available (HoverMatt, MegaMover, slider sheet).
• Clear the path before moving.
• If the patient cannot assist and the lift requires more force than crew can deliver safely, request additional resources.
• Never substitute force for technique.

Transport Decision

• Any injury, ongoing symptom, change in mental status, or new condition since prior baseline — recommend transport.
• Documented capacity refusal per the Patient Refusal SOP.
• Repeat callers within 30 days are flagged for additional assessment and community referral.
• Where capacity is intact and no acute medical issue is identified, refusal may be appropriate after thorough documentation.

Repeat Lift-Assist Patterns

Repeat lift assists are an early warning. Two or more lift assists at the same address in a 30-day window trigger a community paramedicine or social work referral. Document the pattern in the PCR and flag the address per the agency's community paramedicine workflow.

Home Safety & Social Factors

• Note environmental factors: throw rugs, lack of grab bars, hoarding, unsafe staircase, no working lights.
• Ask about caregiver presence and capacity.
• Identify medication concerns: many bottles, no medication organizer, expired medication, no current list.
• Refer to local Area Agency on Aging, fall-prevention programs, social work as appropriate.

Mandatory Reporting Triggers

See Mandatory Reporting SOP. Repeated lift assists in conjunction with caregiver hostility, untreated pressure wounds, dehydration, or financial exploitation patterns require an Adult Protective Services report.

Documentation

• Patient name, identifiers.
• Reason for call, mechanism (if a fall).
• Full vital signs.
• Examination findings — pertinent positives and negatives.
• Glucose and orthostatic vitals as indicated.
• Capacity assessment if refusing transport.
• Repeat-caller status and any referral made.
• Disposition and follow-up.

Responsibilities

Training

• Initial training in geriatric falls and lifting biomechanics.
• Annual refresher with case-based scenarios.
• Joint training with community paramedicine and social work referral pathways.

References

• CDC STEADI — Stopping Elderly Accidentscdc.gov/steadi
• NAEMT Geriatric Education for EMSnaemt.org
• Community Paramedicine Program (if applicable)[INSERT REGIONAL PROGRAM]

Adapt this template

Before this template becomes your department's policy, review the following items and adjust accordingly. Anything else that does not match your operation should be updated as well.

• Define your repeat-caller threshold and referral pathway.
• Identify your area's social-work / Aging contacts.
• Cross-reference Patient Refusal, ePCR Documentation, and Mandatory Reporting SOPs.