Assistive devices, Lines, Tubes and Equip Flashcards
Primary indications for using an AD during ambulation include:
- decr WB on the LE
- muscle weakness of the trunk or LE
- decr balance or impaired kinesthetic awareness
- Pain
parallel bars
- provide maximum stability and security for a patient during the beginning stages of ambulation or standing
- proper fit includes bar height that allows for 20-25 degrees of elbow flexion while grasping on the bars approx. 4 to 6 in in front of the body.
- a pt must progress out of the parallel bars as quickly as possible to incr overall mobility and decr dependence using the parallel bars
walker
- can be used with all levels of WB
- the walker has a significant base of support and offers good stability
- the walker should allow for 20-25 degrees of elbow flexion to ensure proper fit
- the standard walker has many variations including rolling, hemi, reciprocal, folding, or adjustable walker with brakes, UE attachments and/or a seat platform
- the walker is used with a 3 pt gait pattern
axillary crutches
- can be used with all levels of WB, however, require higher coordination for proper use
- Proper fit includes positioning with the crutches 6 in in front and 2 in lateral to the pt
- the crutch height should be adjusted no greater than 3 finger width from axilla
- the handgrip height should be adjusted to the ulnar styloid process and allow for 20-25 degrees of elbow flexion while grasping the handgrip
- a platform attachment can be utilized with this device
- AC can be used with 2 point, 3pt, 4pt, swing to and swing through gait patterns
lofstrand crutches
- can be used with all levels of WB, however require the highest level of coordination for proper use
- proper fit includes 20-25 degrees of elbow flexion while holding the handgrip with the crutches positioned six inches in front and two inches lateral to the pt’s foot
- the arm cuff should be positioned one to one half in below the olecranon process so it does not interfere with elbow flexion
- a platform attachment can be utilized with this device if necessary.
- the lofstrand crutches can be used with 2pt, 3pt, 4pt swing to and swing through gait patterns
cane
- provides minimal stability and support for pt during ambulation activities
- the straight cane provides the least support and is used primarily for assisting with balance
- a straight cane should not be utilized for patients that are partial WB
- the small base and large base quad canes provide a larger BOS and can better assist with limiting WB on an involved LE and improving balance on unlevel surfaces, curbs and stairs.
- the cane is typically used on the opposite side of an involved LE.
- proper fit includes standing the cane at the pt’s side and adjusting the handle to the level of the wrist crease at the ulnar styloid
- the pt should have a 20-25 degrees of elbow flexion while grasping the handgrip
- thr straight cane can be used with 2pt, 4pt, modified 2pt and modified 4pt gait patterns
nasogastric tube NG tube
- a nasogastric tube is a plastic tube inserted through a nostril that extends into the stomach
- the device is commonly used for short-term liquid feeding, medication administration or to remove gas from the stomach
- the position of the tube in the nostril and back of the throat can inhibit a cough and be irritating for the patient
gastric tube
G tube
- tube inserted trhough a small incision in the abdomen into the stomach
- the tube can be used for long-term feeding in the presence of difficulty with swallowing due to an anatomic or neurologic disorder or to avoid the risk of aspiration
jejunostomy tube
-J tube
- tube inserted through endoscopy into the jejunum via the abdominal wall
- the tube can be used for long-term feeding for patients that are unable to receive food by mouth
intravenous system
- consists of a sterile fluid source, a pump, a clamp, and a catheter to insert into a vein
- an intravenous system can be used to infuse fluids, electrolytes, nutrients, and medication
- intravenous lines are most commonly inserted into superficial veins such as the basilic, cephalic or antecubital
- intravenous infusion lines permit nutrients to be introduced when the gastrointestinal tract is not able to digest and absorb food
arterial line
- monitoring device consisting of a catheter that is inserted into an artery and attached to an electric monitoring system
- an arterial line is used to measure blood pressure or to obtain blood samples
- the device is considered to be more accurate than traditional measures of BP and does not require repeated needle punctures
- if an arterial line is displaced, a PT should apply direct pressure to limit blood loss and call for assistance
central venous pressure catheter
- used for measuring pressures in the right atrium or the superior vena cava by means of an indwelling venous catheter and a pressure manometer
- it is used to evaluate the right ventricular function, right atrial filling pressure, and circulating blood volume
- the use of the catheter significantly reduces the need for repeated venipuncture
indwelling right atrial ctaheter
- is inserted through the cephalic or internal jugular vein and threaded into the superior vena cava and right atrium
- the catheter is used for long-term administration of substances into the venous system such as chemotherapeutics agents, total parenteral nutrition, and antibiotics
intracranial pressure monitor
- an intracranial pressure monitor measures the pressure exerted against the skull using pressure sensing devices placed inside the skull
- excessive pressure can be produced by a closed head injury, cerebral hemorrhage, overproduction of cerebrospinal fluid or brain tumor
- types of intracranial pressure monitors include epidural sensor, subarachnoid bolt, and intraventricular catheter
oximeter
- is a photoelectric device used to determine the oxygen saturation of blood
- the device is most commonly applied to the finger or the ear
- oximetry is often used by therapists to assess activity tolerance
- PT should monitor changes in oxygen sat during exercise and position changes
Pulmonary artery catheter
- Swan-ganz
- is soft, flexible catheter that is inserted through a vein into the pulmonary artery
- the device is used to provide continuous measurements of pulmonary artery pressure
- the patient should avoid excessive movement of the head, neck, and extremities to avoid disrupting the line at the insertion site
nasal cannula
- consists of tubing extending approx. one cm into each of the pt’s nostrils
- the tubing is connected to a common tube that is attached to an oxygen source
- this method of oxygen therapy is capable of delivering up to 6 liters of oxygen per minute
oronasal mask
- consists of a facepiece designed to cover the nose and mouth with small vent holes to expel exhaled air along with a breathing tube and connector
- the device is used most often for oxygen therapy, however, can be used to administer medications, mucolytic detergents, or humanity, by the use of an accessory nebulizer
tent
- an oxygen tent refers to a canopy placed over the head and hsoulders or the entire body for the purpose of delivering oxygen at a higher level than normal
tracheostomy mask
- placed over a stoma or tracheostomy for the purpose of administering supplemental oxygen
- the mask is held in place by an elastic strap placed around the patient’s neck
balanced suspension
- balanced suspension traction requires pins, screws and wires to be surgically inserted into bone for the purpose of applying a traction force using an externally applied weight
- this type of traction is most often utilized with comminuted femur fractures
- balanced suspension traction requires prolonged immobilization and therefore incr the incidence of secondary complications such as contractures or skin breakdown
external fixation
- refers to a surgical procedure where holes are drilled into uninjured areas of bone surrounding the fracture
- the fracture is then set in the desired anatomical configuration using specialized wires, pins, bolts, and screws
- an external frame is used to maintain the bony fragments in the desired alignment
- External fixation enhances stability and allows for earlier mobility while maintaining the desired alignment
internal fixation
- refers to a surgical procedure that attempts to promote the healing process of bone w/o appliances being applied external to the skin
- common type of internal fixation include metal plates, rods, wires, screws, and nails
- is often employed with comminuted or displaced fractures
- the procedure provides needed stability to healing joints which allows earlier mobility and less postoperative complications
external catheter
- is applied over the shaft of the penis and is held in place by a padded strap or adhesive tape
Foley catheter
- is an indwelling urinary tract catheter that has a balloon attachment at the indwelling end
- the balloon which is filled with air or sterile water must be deflated before the catheter can be removed
suprapubic catheter
- is an indwelling urinary catheter that is surgically inserted directly into the patient’s bladder
- insertion of a suprapubic catheter is performed under general anesthsia
chest tube
- flexible plastic tube that is inserted through an incision into the side of the chest
- the tube uses a suction system to remove air, fluid or pus from the intrathoracic space
- a chest tube can cause significant discomfort and result in inhibition of a cough, deep breathing, and mobility
seat height/leg length
- instructions: measure from the user’s heel to the popliteal fold and add 2 in to allow clearance of the footrest.
- avg adult size: 19.5 to 20.5 in
seat depth
- instructions: measure from the user’s posterior buttock, along the lateral thigh to the popliteal fold; then subtract approx. 2 in to avoid pressure from the front edge of the seat against the popliteal space
- avg adult size: 16 inches
seat width
instructions: measure the widest aspect of the user’s buttocks, hips or thighs and add approx. 2 in. this will provide space for bulky clothing, orthoses or clearance of the trochanters from the armrest side panel
- avg adult size: 18 inches
back height
instructions: measure from the seat of the chair to the floor of the axilla with the user’s shoulder flexed to 90 deg and then subtract approx. 4 in. this will allow the final back height to be below the inferior angles of the scapulae
- avg adult size: 16 to 16.5 in
armrest height
instructions: measure from the seat of the chair to the olecranon process with the user’s elbow flexed to 90 deg and then add approx. 1 in
- avg adult size: 9 in above the chair seat