Req 10 — Patient Transport

The cardinal rule in first aid is: don’t move a patient unless you must. Moving an injured person poorly can cause pain, worsen injuries, and — in cases of spinal injury — cause paralysis. But sometimes, not moving is more dangerous than moving. This requirement covers the complete decision-making process and five transport scenarios:

• 10a — When to move and when to stay
• 10b — Choosing the best method and demonstrating carries
• 10c — Transporting from a smoke-filled room
• 10d — Transporting someone with a sprained ankle
• 10e — Improvising a stretcher

Requirement 10a: When to Move an Injured Person

When NOT to Move

• Unless there is an immediate threat to life, leave the patient where they are and wait for professional help.
• Specifically: suspected spinal injury, unconscious trauma patient, or any situation where moving could worsen injury.

When Moving IS Necessary

Move a patient when the scene itself is dangerous and cannot be made safe:

• Fire or risk of explosion
• Rising water or flood
• Structural collapse
• Unstable terrain (patient on a slope)
• Toxic atmosphere (smoke, gas)
• When the patient cannot be assessed or treated in their current position (e.g., face-down in a puddle)

The principle: A calculated move that might worsen an injury is still better than leaving someone in a burning building.

Requirement 10b: Choosing and Demonstrating a Transport Method

Factors to consider when choosing a transport method:

• Level of consciousness: Is the patient awake and cooperative, or unconscious?
• Type and location of injury: Leg injury? Spinal injury? Arm injury?
• Distance to move: A few feet to safety vs. a quarter-mile to a trailhead
• Available helpers: One person, or several?
• Terrain: Flat floor vs. rough trail vs. stairs

Common Transport Methods

One-person drags (for immediate danger, no spinal injury suspected):

• Clothes drag: Grasp the back of the collar or shirt and drag backward.
• Blanket drag: Roll patient onto a blanket and drag.

One-person carries (conscious, cooperative patient, no spinal injury):

• Pack-strap carry: Patient is on your back, arms around your neck; use for short distances.
• Firefighter’s carry: Patient draped across shoulders; challenging but frees hands.

Two-person carries:

• Two-person seat carry: Rescuers interlock wrists under the patient’s thighs and behind their back.
• Human crutch: One or two helpers support the patient under the arms while they hop on their good leg (see Req 10d).

Stretcher carries: Best for longer distances with suspected fractures (see Req 10e).

Requirement 10c: Transport from a Smoke-Filled Room

Solo Rescue from Smoke

The first principle: stay low. Smoke and hot gases rise — the cleanest, coolest air is at floor level.

Solo drag technique:

1. Stay below the smoke. Crawl to the victim.
2. Roll them face up if face down.
3. Place both hands under their armpits from behind, interlacing your fingers over their chest.
4. Back-drag them toward the exit, keeping both their head and yours as low as possible.

Alternative — clothes drag: Grip the collar or shirt tightly and drag backward.

Two-Person Rescue

1. One rescuer at the shoulders/head; one at the legs.
2. Lift on a coordinated count — keep the patient as horizontal as possible.
3. One person walks backward toward the exit; the other forward.

Safety: Do not attempt a smoke rescue if you cannot stay below the smoke level, if you are not physically capable of moving the patient, or if the room is on fire. Call 911 and provide as much information about the patient’s location as you can.

Requirement 10d: Transport with a Sprained Ankle

Human Crutch (Solo)

1. Stand beside the injured person on their injured side.
2. Place your arm around their waist; they place their arm around your shoulder.
3. Walk at their pace, letting them hop on their good leg.
4. For longer distances, this is tiring — switch sides with another helper periodically.

Two-Person Human Crutch

Two helpers flank the injured person — one on each side — each supporting one arm over their shoulder while holding the patient’s hand. All three move together.

Note for 25-yard demonstration: Your counselor will ask you to demonstrate this on a real person (or yourself). Practice coordinating the movement — “left foot, right foot” together prevents stumbling.

Requirement 10e: Improvising a Stretcher

Building an Improvised Stretcher

Option 1: Clothing and poles

1. Lay two trekking poles, straight branches, or tent poles parallel, about 18–24 inches apart.
2. Button two jackets (or thread the poles through the sleeves of two jackets).
3. The result is a stretcher — the jackets form the carrying surface, the poles are the handles.
4. Test it with a light weight before trusting it with a person.

Option 2: Tarp or sleeping bag Lay the patient on a tarp or sleeping bag. All helpers grab the edges and lift simultaneously. This works for short distances on relatively flat terrain.

Carrying the Stretcher

1. Assign one person at the head to call pace and coordinate.
2. Keep the patient’s head elevated slightly above feet (unless shock is suspected — then feet up).
3. Position carriers at each end and on the sides of a long stretcher.
4. Count “1-2-3, lift” — everyone lifts at the same time to the same height.
5. Move slowly and communicate about terrain changes, obstacles, and rest stops.
6. Rotate carriers every 25–50 yards to prevent fatigue.

For the 25-yard demonstration: You will be directing the team — give clear instructions, coordinate the lift, and maintain steady pace.

You can now assess, treat, and move patients. Next, you’ll learn about the thermal emergencies that Scouts face in the outdoors — from dehydration in the summer heat to hypothermia in a mountain storm.