01The three phases of a safe transfer
Most transfer injuries — to the patient and to you — come from rushing or from a line catching. Slow is smooth, smooth is fast.
02Step by step
Before: - Position the patient's bed flush against the OR table at the same height. - Lock the brakes on both surfaces. Confirm out loud. - Lower the side rails between the surfaces.
Assign roles: - Head/airway person (often you) controls the head, ETT/airway, and IV lines, and calls the count. - Others position at the torso and legs.
The move: - Trace every line, cable, drain, and the Foley — give slack, lift bags onto the receiving side, disconnect monitors that can come off briefly. - For an awake patient: have them scoot over themselves while you guard lines. - For an anesthetized patient: use a draw-sheet or slide board, lift slightly, and slide as one unit on "one-two-three" — head and feet together.
After: - Reconnect monitors, recheck the airway and tube depth, confirm lines flow, reposition arms on boards (< 90° abduction), pad pressure points.
- The person at the head calls the move — the airway is the thing you cannot afford to lose.
- Re-check ETT depth after every move; tubes migrate during transfers and positioning.
- Sliding before the brakes are locked — beds roll apart and patients fall between them.
- An IV or arterial line under the patient or caught on the rail gets ripped out mid-slide.
- Hyperabducting the arm (> 90°) on the board → brachial plexus stretch injury.