Restraint for radiology

Question 1

What is low stress handling

Answer 1

The handling of patients in a manner that decreases their stress/anxiety
Using touch and handling to help calm and reassure the patient
Involves:
Moving slowly but confidently
Handling in a gentle manner
Avoiding loud, sudden movements or noise
Allowing the patient to become comfortable and adjusted to their surroundings and the procedure

Question 2

Important rules in restraint

Answer 2

At least one person should have their hands on the patient AT ALL TIMES when they are on the table
Holding a leash does not count as hands on
The patient should be held/restrained in a way that they feel secure on the table and that the restrainer can easily react and prevent issue if the patient tries to move
The person restraining the patient is responsible for restraint
Keep your focus on the restraint and allow your group mates to worry about positioning, labels, collimation, etc.
AT ALL TIMES the restrainer should have complete control of the head
NEVER restrain on a joint
Teamwork and Trust
Communication

Question 3

Moving the patient on and off the table

Answer 3

For larger patients: move them beside the table before you pick them up
Position them in the correct direction for the exposure before you pick them up
Use the appropriate number of people to pick up patient
Do not allow pride to cloud your judgment – lifting a large patient on your own does not make you better at your job
Ensure the patient is held firmly against your body(bodies) with the head under full control before lifting from floor
Attempt to lay the patient onto the table directly into the position they are to be in for the exposure
i.e.: for a lateral view, it is best to lay them directly onto the table into lateral
Move with patience and purpose
Do not rush your patient into position
Do not release your patient before they have calmed/relaxed
When ready to remove patient from table:
Have control of the head
Hold firmly against your body (bodies)
Move table to an appropriate height if this is a possibility

Question 4

Lateral restraint

Answer 4

Move patient beside the table
Restrain around the neck, keeping head well controlled and close to body
If two people are needed, ensure both people are holding patient firmly against their bodies
Lift patient so ventral aspect of thorax/abdomen is at about tabletop height
Gently roll the patient onto the table (on their side)
Pull legs towards you for one side or rotate away from you for the other side
Have their body in contact with the table at all times (do not rotate them in the air)
Keep control of head
Use your body to apply pressure to their body as you roll
As you stand:
Keep ahold of legs
Keep some amount of pressure on patient with hands
Keep control of head
Deep chested animals should never be rolled over on their back! ALWAYS legs under to switch sides

Question 5

Sternal restraint

Answer 5

Move patient beside table
Restrain around the neck, keeping head well controlled and close to body
If two people are needed, ensure both people are holding patient firmly against their bodies
Lift patient high enough for legs to go onto the table
Very tall or long legged patients – can lower table if able or may be easier to have them step onto the table
Slowly lower them into a laying position
Easiest if you never allow them to “get their feet under them”
Pressure over shoulder blades will help reduce their urge to sit up or stand
A towel/mat/blanket on table may make them feel more safe/steady
AT ALL TIMES – keep control of the head

Question 6

Ventral dorsal restraint

Answer 6

EXACT same procedure as lateral to get onto the table
Once patient is on the table in lateral:
Restrainers should move themselves into position for proper restraint
Head person at head end, Hind end person at hind end
Head Restrainer
Hold patient just above elbows (not on joint)
“Squeeze” the patient’s head between forearms/elbows
Hind End Restrainer
Hold patient between stifle and tarsus
If they are quite noncompliant can hold closer to hips if able
AT THE SAME TIME – both people should roll the patient onto their back
Use appropriate “comfort items” as needed for specific breeds/builds
Ex: padding, mats, etc…

Question 7

What to do when animals start to panic

Answer 7

Small patients
Apply appropriate pressure to keep them in recumbence if possible
Pick them up into arms
Keep control of head
Medium to large patients
Control the head
Apply pressure appropriately to keep them in recumbency
Over shoulder blades and hips for sternal
Over neck/shoulder area and hips for lateral**
Squeeze between arms for VD OR roll them into lateral to calm
Pull firmly into body or use your body over top of them for pressure
If there is concern for injury to patient or personnel remove the patient from the table appropriately
1-2 people
Hold firmly against body
Control head and legs