Month: March 2022

Lifting and Carrying a Large Dog

The need to lift dogs is common in small animal clinics. What are some ways that we can make lifting easier and less challenging on our bodies?

In the previous post we talked about some basic principles of lifting and carrying. Today we’ll expand on those ideas look at lifting large dogs.

Workers restrain a standing dog. This restraint posture (one leg kneeling and the other bent) could also be used to lift this dog.

The need to lift dogs is common in any small animal clinic, especially in HQHVSN. The dogs we lift may be awake, sedated, or fully anesthetized, and each type of lift comes with its own challenge. Awake dogs may resist handling and wiggle, while anesthetized or heavily sedated dogs may be loose and floppy and difficult to grip.

What are some ways that we can make lifting easier and less challenging on our bodies?

Standing or Lying Down?

Remember that the height of the lift is a factor in the lift’s difficulty. It’s easier (ergonomically) to lift a standing dog than one who is lying down. (It may not be easier overall if the dog wiggles or resists). The standing dog’s center of mass is higher than the ground and already closer to the lifted position. This means you don’t have to lift that center of mass all the way from the floor to your waist height or to a table.

Lifting a standing dog requires less bending and less muscle effort than lifting a dog who is lying down.

Back, Hips, or Knees?

When lifting from the floor, workers may bend at the knees, hips, or back, or a combination of all three. Generally, we are told to “lift with your legs not your back.” And to some extent this is true: repeated, extreme flexion of the back puts much of the strain of the lift on the vertebral joint end plates. End plate damage may be one of the causes of chronic low back pain.

In the first picture, workers bend at the knees and hips to lift an anesthetized dog from the floor. In the second picture, workers bend at the hips with a slight knee bend and lumbar flexion.

However, the recommendation to avoid any lumbar flexion during lifting is not supported by research. It’s definitely best to avoid extreme lumbar flexion (60o or more), but it is OK to flex the back along with the hips and knees when lifting.

Lifting only with the legs has its down sides as well. People with painful knees or hips may be uncomfortable in the deep squat often portrayed in “proper lifting” diagrams. And bending and lifting at work can make certain workers more prone to knee or hip arthritis.

In the end, the best means of lifting probably involves moderate flexion of the knees, hips, and lower back. The “best” way to lift will vary depending on the specific task and the individual’s strength and pre-existing pain.

Not so good: Here the worker in magenta scrubs is bending mostly with her back rather than with her hips or knees. This lift will put unnecessary strain on her lower back. Also her hold on the dog’s stifle (knee) will not lead to a secure hold once the dog’s feet are off the ground.

Two Person Lifting

The workers are facing the same direction and will coordinate their movements through the clinic.

When lifting as a team, both team members must communicate clearly with each other. Both team members need to know where to position themselves, when to begin lifting, and where to carry the dog. For example, if a dog is to be lifted onto a table, it is important that both lifters know which way the dog should be facing on the table before they position themselves for the lift.

Use simple technology to help

Use technology for your lift! If you need to move a large sedated dog who can’t walk, consider using a stretcher or cart.

Our worker in the previous post used technology (a hand truck) to help transport a cardboard box. Likewise, we can use technology to help move our anesthetized dog. Stretchers and wheeled carts are both useful ways to turn a floppy, hard-to-grip load into a rigid load with handles.

Similarly, lowering a hydraulic table decreases the height of the lift, thereby decreasing its difficulty.

Lifting a dog from the floor to a table is hard, but lowering the table turns a 3 foot lift into an 8 inch lift and requires less effort.

Meanwhile…

I hope you all are staying safe and well. Here, spay neuter clinics go on even as we find ourselves dodging COVID and mud season simultaneously, just as we have the past two years. I feel lucky for the flexibility and adaptability of my vet techs and clinic hosts as we still manage to get those cats spayed before kitten season hits. Thanks y’all!

Lifting and Carrying

Let’s start with some ergonomics fundamentals: lifting and carrying. This post shares some basic concepts that we’ll be able to apply later to specific veterinary activities like lifting and carrying dogs.

This will be the first in a series of posts about ergonomics in the veterinary clinic–and everywhere else. It’s been a long pandemic, but in the past half-year I’ve had a couple of opportunities to talk about veterinary tasks aside from surgery. Today’s slushy snowstorm seems like a good time to share some of the illustrations and ideas from these presentations.

March “snowstorm” with Spaymobile in background

Lifting and Carrying: the fundamentals

Let’s start with some ergonomics fundamentals: lifting and carrying. This post shares some basic concepts that we’ll be able to apply later to specific veterinary activities like lifting and carrying dogs.

First, what are the characteristics of a lifting task that can make it more or less hazardous?

  • Weight of load
  • Distance of your hands from your lower back
  • Height of lift (From floor or from above knee height? How high do you need to lift?)
  • Twisting and side bending
  • Working in a restricted space
  • Good grip, or irregular, bulky, floppy, unpredictable load
  • Flooring condition (dry, clean, good condition, or wet or uneven)
  • Communication and coordination when lifting as a team
Carrying an object close to the body and near waist height

For our lifting and carrying example, we’ll use the ubiquitous brown cardboard box. In the first illustration, the lifter is carrying a box near her body and near waist height. This puts the object close to her center of mass and puts the least amount of strain on her body. It makes intuitive sense to us that she would carry the box this way instead of carrying it with her arms extended, far away from her body and her center of mass.

In this next set of illustrations, it looks a bit strange to carry the box with extended arms. But when the worker is carrying a larger box of the same weight, she is essentially doing just that– carrying the weight further from her center of mass and putting more strain on her back. A bulky object’s center of mass is further from the worker’s center of mass, meaning that even if this object is the same weight as the first box, it puts more strain on the worker’s back. The increased strain is due to the leverage created by the weight’s greater distance from the worker’s core.

While carrying a box far from the body looks strange, it’s the same strain as carrying a big box of the same weight.

(Want to learn more about how lifting strain increases depending on the size, shape, and weight of the object and the height of the lift? Check out the NIOSH Lifting Equation.)

Another circumstance where the worker might be holding an object far from her center of mass is when obstructions in the environment require her to do so. Removing objects that obstruct work areas (such as boxes obstructing a countertop) may seem obvious but it can also be the “low hanging fruit” when making ergonomic improvements.

In the first illustration, the worker has to extend her arms to place the object on the counter. In the second, the obstructions are removed and she can place the object without extending her arms as far.

Yet another reason for carrying a weight far from one’s body because it the load is smelly, damp, messy, or covered in some bodily fluid– but the same principles apply. If it’s a soiled but lightweight cat carrier, it makes sense to hold it at arm’s length on the way to the wash area. But if it’s a whole load of smelly laundry or a patient covered in pee, using a protective barrier (plastic bag or clean towel) and holding the weight close to the body is a better choice because it allows for a more secure hold and less strain on the lower back.

Lifting below the knees or above the shoulders adds additional strain.

Lifting or placing objects below the knees or above the shoulders also adds additional strain on the worker’s body. Low placement may put strain on knees and lower back, while high placement can strain shoulders and arms (and introduce the risk of the object falling). Heavy items that need to be lifted and carried (cases of wet food; trays of instrument packs) should be near waist level to reduce the strain of lifting them. Lightweight objects can be placed on high shelves, with the bottom shelves reserved for heavier objects that will be transported with mechanical help like a wheeled cart or items that are used less often.

A worker uses a hand truck/ a dolly/ a trolley/ a two-wheeled cart to transport a large box. (Nomenclature for this device varies a lot as you can hear in this link )

Mechanical help can be an excellent way to reduce strain when transporting objects. Gurneys, hand trucks, carts, and other devices bear the weight of the load, freeing the worker from the heavy lift.

Next time we’ll talk about the ergonomics of lifting and carrying dogs– stay tuned!