lateral manual transfers Flashcards
dependent
patient is unable to participate in the activity
maximum assistance
patient requires more than 75% assist to complete activity
moderate assistance
patient is able to assist in at least 50% of the activity
minimal assistance
patient is able to complete as least 75% of activity
contact guard (CD)
hands are on the patient, but not giving any assistance
close supervision (CS)
patient requires someone an arm’s reach away as precaution
independent
patient is able to consistently perform the activity safely w/o intervention
general procedures for lateral transfers
lift, shift, and lower
gait belt!!!
plan ahead
explain procedures
secure surfaces
transfer is complete only when patient is comfortable and secure
CHECK BRAKES!!!
seated transfers
dependent lateral lift
lateral seated transfer with & without sliding board
anterior-posterior transfer with & without sliding board
pivot transfers
squat pivot
stand pivot
must be able to weight bear through at least one leg
transfers with gait belt
never put directly over ski (always over clothes to prevent skin damage)
around waist
not interfering with incisions or ostomy bags
use a supinated grip (palms up)
remove carefully
put on while seated and readjust standing to make sure it’s secure
dependent lateral lift transfers
remove leg rests and near armrest
position chair close to surface
secure surfaces
lift, shift, lower
watch body mechanics
3 people: 1 leader, 1 holding thighs, 1 holding knees/legs
head calls moves and holds patients crossed arms
leader’s legs can straddle the wheel and may have one leg up on the surface for stability
seated dependent repositioning
goal: patient hips fully back and centered
grasp patient’s crossed arms
lift patient’s hips up and back
one person dependent lateral lift transfer
often used with patients with SCI
one continuous pivot motion
watch body mechanics
independent transfer board transfer
angle wheelchair close to the bed
lean trunk to one side and place board under patient
press down on board with flat hands and lift, shift, and lower as needed
remove board
don’t allow patient to grasp end of board or put finger through handles
independent lateral seated transfer without board
similar to squat pivot transfer
grab edge of surface and armrest to lift bottom and pivot to the side
clinician assisted transfer board transfer
typically guard from front
assist with hip movement (control centrally, direct distally (CCDD))
may need to make several small movements to complete the transfer
seated anterior-posterior transfer
typically between bed and wheelchair
also called “straight-on” or “front-to-back”
chair faces bed and both knees are extended
often used by patient with bilateral LE transfemoral amputations or SCI
requires good upper body strength to perform independently
ready position for assisted pivot transfer
scoot hips forward in the chair
- lift, forward shift, and lower
- alternate weight shifts
- forward hip slide
feet back with inner foot slightly forward
nose over toes
hands on arm rests
setting up the environment
ensure proper footwear
remove obstacles
equalize surface heights
secure both surfaces
use a gait belt for dependent transfers
clinician position for assisted pivot transfers
in front of patient
hips and knees flexed with wide stance
inner foot slightly back
grip on gait belt
blocking the knees
creates extension moment to counteract the flexion moment at the patient’s hips and knees
contact on patient’s proximal tibia
1:1, 2:1, or 2:2
rising for assisted pivot transfer
count of 3
can rock for momentum
clinician leans posteriorly to help patient rise
before having patient sit back
reach hands to arm rests
flex trunk
feel seat with back of legs
controlled descent-no plonking!
squat vs standing pivot transfer
different in amount of uprightness
can different in hand placements
patient may pause when upright in standing pivot
seated repositioning
be sure patient’s hips are fully back in the seat
patient uses UEs and LEs to lift hips up and back (requires forward trunk lean)
clinician assisted from the front with knee block or from back with underarm lift
completing the transfer
no transfer is complete until the patient is comfortable, safe, and has a way to call for assistance
unilateral limited weight-bearing
slide the affect LE forward before rising
hold NWB limb slightly off ground during pivot
pivot on the uninvolved LE through series of small hops
extend knee of involved LE b4 sitting
extend NWB limb all the way out so they can pivot hop on the strong side
hemiplegia
easier to transfer on the stronger side
may need to rely on stronger side for unilateral pivot
may need to support the involved UE
do not pull on patient’s involved arm!
THA posterior approach
scoot forward in chair without trunk flexion beyond 90 degrees
extend knee of involved LE b4 standing and during sitting
avoid forward trunk flexion beyond 90 degrees
avoid IR during pivot
avoid adduction
SCI
level C7 and lower typically has potential to perform transfers independently
sitting pivot transfer: feet contact floor for stability, but force to power the transfer comes UEs and trunk momentum
car transfers: wheelchair to car
slide seat back and recline seat
remove armrest and leg rest on side close to door
position in door opening and lock brakes
sit to sit, then bring legs into car afterward
scoot to front edge of chair and position feet
grasp secure item of the car (don’t hold onto anything that can move)
flex trunk and neck
pull with arms and pivot hips into car
bring LEs into car
adjust position as needed
