Biomechanics, Patient Transfers & Immobilization Techniques Flashcards
1
Q
Define biomechanics:
A
The action of forces on bodies at rest or in motion.
2
Q
What are the fundamental concepts to good patient handling techniques?
A
- Base of support (BOS)
- Center of gravity (COG)
- Mobility and stability muscles
3
Q
Define BOS and where the area is located?
base of support
A
It is the foundation on which a body rests.
BOS is the area between the feet, including the plantar surface area, in a standing position.
4
Q
What is essential for stability?
A
A wide base of support is essential for stability.
5
Q
What things improves and enlarges the BOS?
A
Standing with the feet farther apart enlarges the BOS.
Standing with both feet flat on the floor improves the base of support.
6
Q
Where is the center of gravity located in the body?
A
At level of second sacral segment.
7
Q
What makes moving heavy objects easier and safer?
A
If the object is held close to the mover’s COG and if the body’s center of gravity is over its base of support.
8
Q
When does instability happen?
A
Instability results when the COG moves beyond the boundaries of the BOS.
9
Q
What are the mobility muscles?
A
The extremity muscles
10
Q
What are the stability (postural) muscles?
A
Torso Muscles
11
Q
What muscles should a technologist use for lifiting?
A
Mobility muscles
12
Q
What muscles should a technologist use for support?
A
Postural muscles
13
Q
What should the radiogy technologist body postition be when lifting patients?
A
Lifting should be done by bending and straightening the knees with the back straight or in a position of slightly increased lumbar lordosis. When actually lifting patients, keep the back stationary and let the legs do all the lifting.
14
Q
Where should the patients center of gravity be when being lifted?
A
The patient’s center of gravity should be held close to the mover’s center of gravity.
15
Q
When preforming transfers on a patient, what tool should you have close by?
A
Having a transfer belt handy is a good practice when planning to perform transfers.
16
Q
List 3 lifting principles for the patient:
A
- Secure loose clothing on the patient
- Always inform the patient of what you are going to do and how you intend to proceed
- Execute the transfer slowly enough for the patient to feel secure.
17
Q
What should you do once the patient is standing after helping to lift them up?
A
After the patient is standing, help him or her to pivot around to a bed or X-ray table and to sit down.
18
Q
What should you never assume about patients?
A
That they are aware of their abilites
19
Q
Who is responsible for the move of a patient and the decision on how that is done?
A
The radiographer-Can be held liable for incorrect transfer
20
Q
What are the introduction and moving steps for a patient?
General
A
- Establish the identity of the patient first and introduce yourself.
- Verify the patients’ ability to move and comply with the exam. Request patient information regarding any restrictions or precautions.
- Obtain adequate help, if necessary.
- Move the patient accordingly.
21
Q
What 5 things should you look for when assesing a patients mobility?
A
- The patient’s general condition
- Immobility or limitations in range of joint motion
- The ability to walk and weight bear
- Respiratory, cardiovascular and/or musculoskeletal problems
- Attached equipment such as IV pump, urinary catheter
22
Q
What other assesment considerations should be made?
(After explaining the transfer to the patient)
A
- Strength and endurance
- Balance
- Patient understands what is expected during transfer
- Patient accepts the transfer
- Medication history
23
Q
What is the condition that causes a drop in blood pressure when a person stands too quickly?
A
Orthostatic Hypotension
24
Q
When does orthostatic hypotension become increasinly serious?
A
When a patient has been recumbent for a long period of time.
25
Physiologically, what happens to the brain when a patient who has orthostatic hypotension rises too quickly?
Rising too quickly can deprive patients of oxygen rich blood to the brain
26
What are the symptoms of orthosatic hypotension?
Dizziness, fainting, blurred vision and slurred speech
27
What should be done for a patient with orthostatic hypotension when getting them to stand?
1. Have the patient stand slowly
2. Encourage the patient to talk by asking simple questions
3. If signs occur, slow the speed of the transfer and ask the patient to take slow, deep breaths.
4. Do not send a symptomatic patient away and risk having the patient faint on the way to his or her room.
28
When preforming a transfer with a team, should there be someone in charge?
Yes someone should take charge, but work as a team
| Make sure to review transfer proceedures with the team
29
For a wheelchair transfer of a patient, what key principles should you always do to keep the patient safe/unharmed?
1. Assess patient condition.
2. Determine patient’s strong and weak sides
3. Always position the patient so that he or she transfers toward the strong side.
4. Lock wheelchair locks and move footrests out of the way
30
If a patient in a wheelchair needs assistance, what steps should be taken to help them?
1. Remove or swing away leg rests
2. Position wheelchair at a 45 degree angle to the table and make sure the locks are engaged
3. Estabilish a wide BOS for your stability and hold patients COG near yours
31
# For a patient in a wheelchair:
What should be done to reduce stress to a patient's shoulder girdle when lifting them with a transfer belt?
Hold paitient with the **transfer belt around their wasit**
32
What are the four types of wheelchair transfers?
* Standby assist
* Assisted standing pivot
* Two-person lift
* Hydraulic lift
33
When is the standby assist transfer used?
Used for patients who can transfer from a wheelchair to a table on their own.
34
What are the steps when preforming a standby assist for a patient in a wheelchair?
1. Position the wheelchair at a 45-degree angle to the table.
2. Talk to the patient prior to their movement to determine how much, if any, assistance is required.
3. Provide movement instructions to the patient continually during transfer.
35
When is the Assisted Standing Pivot Transfer used for a patient in a wheelchair?
For patients who cannot transfer independently but can bear weight on their legs.
36
What are the steps when preforming an assisted Standing Pivot Transfer?
1. Position the wheelchair at a 45-degree angle to the table with the patient’s stronger side closest to the table
2. Consider using a transfer belt to enable a secure grip on the patient (especially if they are wearing loose clothing).
37
When is the 2 person lift used?
Use on patients who are lightweight and cannot bear weight on their lower extremities.
38
What should the stronger person lift during a two person lift and what should the other person lift?
The stronger person should lift the patient’s torso while the second person lifts the patient’s legs.
39
Who directs the movement during a two person transfer?
The person lifting the torso
40
What is the procedure for a two person lift?
1. Lock the wheelchair in place.
2. Remove the armrests (if possible) and swing away or remove the leg rests.
3. Ask the patient to cross their arms over their chest.
4. The stronger person stands behind the patient, reaches under the patient’s axillae, and grasps the patient’s forearms.
5. The second person squats in front of the patient and cradles the patient’s thighs in one arm and the calves in the other.
6. On command, the patient is lifted to clear the wheelchair and is moved as a unit to the desired location.
41
When are hydrollic lifts used?
Used when patients are too heavy to lift manually.
42
What is the proceedure for the Stretcher/Gurney/Cart Transfer
1. Position the stretcher alongside the table on the patient’s strong or less affected side.
2. Make sure wheels are locked and immovable.
3. Allow patient to assist with the move based on the patient’s ability and condition.
4. If the patient cannot assist, use transfer aids.
5. If the patient cannot transfer on their own, cart transfers usually require three people.
6. For the actual lateral transfer, both transfer surfaces must be side to side, as close as possible, and at the same height.
43
What are the types of Stretcher to Table Transfers?
1. Sheet transfer
2. Lateral transfer board
3. Log roll
44
How is the best lateral transfer best accomplished?
By using a sliding/slider board which is a glossy plastic board that is radiolucent
45
What proceedure should be used for a trauma patient?
Log roll
46
What is the obective for a log rol proceedure?
The objective of the log roll procedure is to maintain correct anatomic alignment of the spine in order to prevent the possibility of neurologic injury.
47
What are the benefits of transfer roll boards?
Minimal effort is required to perform the transfer
48
Describe the Supine/Dorsal Recumbent body position:
1. Patient is flat on their back.
2. The feet and neck will need to be protected when the patient is in this position.
3. Pillow for neck.
4. The feet should be supported to prevent plantar flexion (footdrop) if the patient is to remain in this position for several hours.
49
Describe the lateral recumbant position body position:
1. Patient is on side with knees flexed.
2. Relieves pressure on most bony prominences.
3. Patient may be supported with pillows/sandbags or sponges to maintain position
50
Describe the (high) folwer body position and what it is used for:
* Semi-sitting position with head raised at an angle of 45 to 90 degrees.
* This position is used for patients in respiratory distress.
51
Describe the semifowler body position
* Patient’s head is raised at an angle of 15 – 30 degrees.
* Feet must be supported to prevent foot drop.
52
When is the sims body position used?
The position is frequently used for diagnostic imaging of the lower bowel as an aid in inserting the enema tip.
53
Describe the sims position
* Patient lies on either side with the body inclined slightly forward with the top knee bent sharply and the bottom knee slightly bent.
* The forward arm flexed, and the posterior arm extended behind the body.
54
When is the Trendelenburg/Reverse Trendelenburg body position used?
Patients are occasionally placed in this position during imaging procedures and for the promotion of venous return.
55
Decribe the body position for the Trendelenburg/Reverse Trendelenburg:
The table or stretcher is inclined with the patient’s head lower than the rest of the body.
56
What can a skin breakdown result in?
A pressure sore known as a decubitus ulcer that may take weeks or months to heal.
57
Who is most vulnerable to skn damage?
Elderly patients are particularly vulnerable to skin damage.
58
What are the mechanical forces that may predispose skin to breakdown?
immobility, pressure and shearing force
59
What skin damage can result from immobilizing a patient for extended periods of time?
Can result in ischemia and tissue necrosis, resulting in ulceration.
60
# True or false?
Although a patient is not likely to be kept on a radiographic table for long periods of time, the patient should be allowed to change positions occasionally.
True
61
How often should immobilized patient be turned in general, and on an x ray table?
In general: Every 2 hours
On a hard surface (x ray table): Every half hour
62
What are two ways to prevent skin damage?
1. Place a pillow or soft blanket under pressure points
2. Not moving patients too quickly so that a shearing force is not created
3. Keep the area dry and clean if the patient is sweating profusely
4. Care should be taken to prevent bruising the feet while the move is made
63
What are the pressure points on the body?
Scapulae, sacrum, trochanters, back of knee and the heels of the feet.
64
What is the most significant contributing factors to unacceptable image quality?
Motion
65
What are the two types of patient restraints?
simple or complex
66
What is the most effective means of immobilization?
Communication
| Empathy with the patient’s condition can also be effective in facilitati
67
What is the reason for use of positioning spounges?
Positioning sponges allow for increased accuracy by supporting the patient or anatomic area of interest
68
What are sandbags used for? Give an example:
Sandbags are extremely helpful in reducing voluntary motion. Commonly used in lateral c-spine and acromioclavicular imaging to depress shoulders.
69
Are sandbags radiolucent?
No, radiopaque
70
What sitiuation would be the best to use tape?
. It is best used on patients who are cooperative and need assistance in holding perfectly still during exposure
71
Where is the stability bar located?
On the upright bucky
72
What are the benefits of a stability bar?
1. Moves the patient’s arms above their head but also serves to provide stability and steadiness
2. Adjustable: can be used with the patient standing or sitting.
3. Reduces repeats
73
When should velcro straps be used?
1. Can serve as safety precaution when performing a procedure on a patient who is nor completely cognizant – sedated, diminished mental capacity
2. used facilitate the protection of the patient from injury
3. used to support the patient firmly during positioning of table
74
# True or false?
Velcro can used to apply compression to the pelvis in certain procedures.
False, Velcro can be used to apply compression to the **abdomen ** for certian procedures
75
What is the most common spinal trauma traction device?
cervical collar
76
Can images be taken with a cervical collar and spinal board?
Yes, since they are radiolucent to some degree and should NEVER be removed without the approval of a physician
77
When should the mummy wrap be used?
For children who are still too young to understand cooperation.
78
What is the upright restraint used for infants called and what type of imaging is done using it?
Pigg-O-stat used for upright chest and abdomen imaging
79
What is the oldest that the pigg-o-stat can accomidate?
3-4 depending on size
80
What are the benefits of the octostop and what are its limitations
Benefits:
Radiolucent material
Durable
Limitations: Only can be used for up to 1 years old
