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RAD 1127 > Safe Patient Movement and Handling TechniquES > Flashcards

Safe Patient Movement and Handling TechniquES Flashcards

1
Q

What is Body Mechanics?

A

The branch of science that applies to the law of physics, specifically the action of forces on the body in motion or at rest.

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2
Q

What are the benefits of using proper bio-mechanics?

A

• Reduce injury to patient.
• Reduce injury to the healthcare worker.
• Facilitate proper transfer techniques.

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3
Q

The purpose of a patient transfer is?

A

to safely move a patient from one place to another.

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4
Q

Safety involves?

A

both the patient and the people doing the transfer.

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5
Q

What is the application of proper lifting and transfer techniques?

A

increases job safety

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6
Q

Radiologic imaging professionals who use proper transfer techniques can ?

A

reduce their injuries and minimize low back pain.

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7
Q

Rules of Body Mechanics

A

Provide a broad base of support

Work at a comfortable height

Do all the lifting with the leg muscles while keeping your back straight

When lifting bend at the knees

Do not allow twisting of your body

Keep patients close to your body – don’t reach

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8
Q

What is the Base of Support?

A

-The foundation on which the body rests or stands;

-the portion of the body in contact with the floor or another horizontal surface.

-In the standing position the base of support is defined by the persons’ stance or the distance between their feet.

-A broad base of support provided stability for the body.

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9
Q

How is the Correct Base of Support defined?

A

Standing upright with the feet parallel and spread about two feet apart or shoulder-width apart.

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10
Q

CORRECT BASE OF SUPPORT

A

A wide solid base of support is important.

Body weight should be evenly distributed on both feet.

Knees should be slightly bent.

Standing with the feet slightly wider apart enlarges the base of support.

If the feet are not separated enough, or the person has a narrow base of support, the support is unstable

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11
Q

What is the Center of Gravity?

A

The hypothetical point at which all mass appears to be concentrated.

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12
Q

Where is the center of gravity located in an erect position?

A

At the center of the pelvis at approximately Level S2 (Sacral Two).

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13
Q

How can stability be improved?

A

By keeping the body’s center of gravity over its base of support.

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14
Q

What should be done when transferring a patient?

A

Keep the patient’s center of gravity as close as possible to your center of gravity.

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15
Q

CENTER OF GRAVITY CONT.

A

Always explain and then let the patient do as much as possible.

Remain close to the patient and give the assistance that the patient needs for safety and comfort.

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16
Q

How should things be lifted

A

Dos:
Heavy objects must be held close to the body rather than away from it.

The feet must be about shoulder-width apart. A wide, solid base of support is important.

Holding the feet too close together will be unstable; too far apart will make movement difficult.

Dos:
Legs must be bent at the knees while lifting weights from the floor level and the back must be kept straight.

The stomach muscles must be pulled in. This will support the back in a good lifting position and will help prevent excessive force on the spine.

Dos:
Push up with the legs. The legs are much stronger than the back muscles.

If an object is too heavy, or awkward in shape get someone to help you lift

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17
Q

How should things NOT be lifted?

A

Don’ts:

Sudden and awkward movements while holding something heavy must be avoided.

The back should never be bent to pick something up.

Don’t twist or bend. A person should face in the direction he or she is walking.

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18
Q

What muscles are involved in patient transfers?

A

Mobility muscles (found in the limbs) (BICEPS)
LONG MUSCLE WITH WHITE TENDONS THAT CROSS JOINTS (FOR LIFTING)

Stability muscles (found in the torso).(i.e., Latisimus Dorsi)

Red muscles that provides postural support

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19
Q

For effective patient transfers and handling, technologists should use:

A

use mobility muscles for lifting and
stability postural muscles for support.

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20
Q

What is the principle of pulling during patient transfers?

A

Pull rather than push using the biceps muscles when moving patients.

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21
Q

What should be assessed before moving a patient?

A
  1. The patient’s general condition.
  2. Are the patient’s motions restricted in any way. (i.e., non-ambulatory, non-weight bearing, etc.)
  3. The patient’s strength and endurance. Always transfer across the shortest distance.
  4. The patient’s ability to understand what is expected of him/her.

5.How much cooperation can be expected.

  1. Give assistance that the patient needs for comfort and safety.

7.Allow the patient to do as much as possible.

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22
Q

What is the minimum number of persons necessary to assist in transferring an adult patient?

A

A minimum of three persons.

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23
Q

What is a key principle of safe transfer?

A

NEVER LEAVE A PATIENT’S SIDE DURING A TRANSFER.

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24
Q

What should be done with wheelchairs, stretchers, and gurneys during a transfer?

A

LOCK ALL WHEELCHAIRS, STRETCHERS, AND GURNEY’S.

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25
Q

PRINCIPLES OF SAFE TRANSFER

A

NEVER LEAVE A PATIENT’S SIDE DURING A TRANSFER.

LOCK ALL WHEELCHAIRS, STRETCHERS, AND GURNEY’S.

ALWAYS USE A FOOT OR STEP STOOL.

ALWAYS TRANSFER ACROSS THE SHORTEST DISTANCE.

MOVE A PATIENT TOWARDS THE PATIENTS STRONG SIDE

INFORM THE PATIENT OF THE PLAN TO MOVE

OBTAIN THE NECESSARY HELP TO FACILITATE A SAFE TRANSFER.

PREPARE THE TABLE BEFORE MOVING THE PATIENT.

MOVE THE TUBE OUT OF THE WAY.

USE SHEETS ON THE TABLE.

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26
Q

What is Orthostatic Hypotension?

A

The sudden drop in blood pressure that occurs when rising quickly from a sitting or lying position.

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27
Q

What are the signs/symptoms of Orthostatic Hypotension?

A

Dizziness, fainting, blurred vision, slurred speech.

28
Q

How can symptoms of Orthostatic Hypotension be avoided?

A

-Have the patient stand slowly

-Talk to the patient during transfer to evaluate speech.

-Slurred speech may be a sign of decreased blood flow to the brain.

29
Q

Slurred speech may be a sign of ?

A

decreased blood flow to the brain.

30
Q

What is the treatment for Orthostatic Hypotension?

A

-Slow down the transfer,
- the patient takes deep breaths,
- provide additional assistance as necessary
-Keep patients secure and monitor them until symptoms pass.

31
Q

What are the types of patient transfers?

A

Wheelchair Transfers:

  1. Standby Assist Transfer,
  2. Assisted Standing Pivot Transfer,
  3. Two person lift Transfer,
  4. Hydraulic Lift Transfer,

Stretcher (Cart, Gurney) TO TABLE Transfers:
-WITJ PATIENT ASSISTANCE
With moving Device
Without moving Device
Three-person Lift
LOG ROLL

32
Q

Standby Assist Transfers

A
  1. Position the wheelchair 45 degrees to the table.
  2. Move the wheelchair footrests out of the way and the wheelchair is locked.
  3. Instruct the patient to sit on the edge of the wheelchair seat.
33
Q

CONTINUE

A
  1. Instruct the patient to push down on the arms of the chair to assist in raising and then to stand up slowly.
  2. Direct the patient to reach out and hold onto the table with the hand closest to the table and then to turn slowly until the table is felt.
  3. Instruct the patient to hold onto the table with both hands and then to sit down.
34
Q

Assisted Standing Pivot Transfers

A
  1. Position the wheelchair at a 45-degree angle to the table with the patient’s strongest side closest to the table. If the patient has loose-fitting clothes, then place a transfer belt around the patient’s waist.
  2. Move the wheelchair footrests out of the way and be sure that the wheelchair is locked.
  3. Direct the patient to sit on the edge of the wheelchair seat, and provide assistance as needed.
  4. Instruct the patient to push down on the arms of the wheelchair to assist in rising.
  5. Bend at the knees, keeping the back stationary, and grasp the transfer belt with both hands. Block the patient’s feet and knees to provide stability, especially for patients who are paraplegic and hemiplegic.
  6. Assist the patient in rising to a standing position.
  7. Ask the patient whether he or she is feeling all right. If the patient reports any feelings of dizziness or exhibits any of the other signs of orthostatic hypotension, then let him or her stand for a moment until the feeling subsides.
  8. Pivot the patient toward the table until the patient can feel the table against the back of the thighs.
  9. Ask the patient to support himself or herself on the table with both hands and sit down, assisting, as necessary.
35
Q

Two Person Lift Transfers

A
  1. Plan for the lift by locating an assistant who will lift the patient’s feet as you lift the patient’s torso.

2.Lock the wheelchair, remove the armrests, swing away or remove the leg rests, and direct the patient to cross his or her arms over the chest.

3.Stand behind the patient, reach under the patient’s axillae, and grasp the patient’s crossed forearms. Direct the assistant to squat in front of the patient and cradle the patient’s thighs in one hand and the calves in the other hand.

4.On command, lift the patient to clear the wheelchair, and move the patient as a unit to the desired place

36
Q

Hydraulic Lift Transfers

A

Use these for heavy patients.

Familiarize yourself thoroughly with lift operations before using this type of lift.

Patients need to be seated on a lift sling before using this type of lift.

Sending a patient back to the ward to return sitting on a sling is better than risking injury to the patient, the mover, or both by attempting transfer without using a sling.

Communication is critical to a success lift.

37
Q

Stretcher (Cart, Gurney) Transfers

A

a)With Patient Assistance
b)Stretcher to Table Transfer:
With Moving Device
Without Moving Device

a) Three Person Lift
b)Log Roll

38
Q

Stretcher Transfers w/Moving Device

A
  1. Move the cart alongside the table, preferably on the patient’s strong or less affected side. Place it as close to the table as possible, and then secure it by depressing the wheel locks.
  2. Place the patient at an oblique angle away from the table while the moving device is placed at the midpoint of the back.
  3. Return the patient to a supine position so that he or she is halfway onto the moving device.
  4. Grab the draw sheet and use it to move the patient slowly onto the table.
  5. Remove the moving device, turning the patient obliquely if necessary.
39
Q

Stretcher Transfers w/o Moving Device

A

Move the cart alongside the table, preferably on the patient’s strong or less affected side. Place it as close to the table as possible, and then secure it by depressing the wheel locks.

  1. Begin by rolling up the draw sheet on both sides of the patient. Be sure that the draw sheet is completely under the patient and straightened before the transfer.
  2. Support the patient’s head and upper body from the far side of the radiographic table. Direct a second assistant to support the patient’s pelvic girdle from the cart side and a third assistant to support the patient’s legs from the table side.
  3. Cross the patient’s arms over the chest to avoid injury or interfering with a smooth transfer.
  4. Direct the second assistant supporting the pelvic girdle to stand on the opposite side of the cart, and make sure that the cart does not move away from the table during the transfer.
  5. On command, grasp the rolled-up draw sheet and slowly pull the patient to the edge of the cart. On a second command, slowly lift and pull the patient onto the table.
40
Q

Who is in charge during a patient transfer with multiple persons? (logroll)

A

The person positioned at the patient’s head.

41
Q

What is a ‘Logroll’ transfer?

A

A special type of transfer used for patients with suspected spinal injuries.

42
Q

In logroll, where are the persons positioned?

A

One person is positioned at the head and two people are positioned at either side of the patient.

43
Q

logroll

A

The patient is rolled onto their side so that i.e., a transfer board may be positioned under them.

The patient’s head must always remain aligned with the spine.

44
Q

What should a RAD TECH NEVER REMOVE?

A

Cervical collars should never be removed by the Radiologic Technologist.

45
Q

What should be done to prevent falls during a transfer?

A

Make sure stretcher side rails are always raised and locked.

46
Q

If the patient will be standing or walking, THEY SHOULD?

A

If the patient will be standing or walking, make sure that they have on hospital slippers or non-slip footwear.

47
Q

Patient Transfers Tips

A

When more than one person is transferring the patient, the person in charge of the transfer is the person positioned at the patient’s head.

The person in charge will give the commands and direct the transfer.

Never stand or kneel on the X-ray table when transferring a patient.

48
Q

MORE TIPS

A

Always pull a patient towards you – never push them onto the table or away from you.

The easiest way to transfer a patient from a cart to the x-ray table is to use a sheet under the patient to slide the patient over.

Also available are many commercial devices for transfers

Note: Some commercial devices are radiolucent others may not be and if radiopaque must be removed before any radiographs are taken).

49
Q

What is the easiest way to transfer a patient from a cart to the x-ray table?

A

Use a sheet under the patient to slide the patient over.

50
Q

What are the most common patient positions?

A
  1. Supine
  2. Prone
  3. Lateral
  4. Sims’
  5. Fowler’s
  6. Trendelenburg
51
Q

MOST COMMON PATIENT POSITIONS

A

Supine – Patient is lying flat on their back, face up.

Prone – Patient is lying flat on their stomach, face down.

Lateral – Patient is lying on their side.

Sims’- Patient is lying face down in a 45-degree oblique position.
The front knee is flexed and raised towards the head.
This is an easy position for inserting enema tips for BE studies

Fowler’s – Patient is lying face up with the head and chest elevated.- This is a good position for patients who are having difficulty breathing.

Trendelenburg – The patient is lying supine (face up) with the head lower than the pelvis, usually 45 degrees. This position is usually used in treating shock, but if there is an associated head injury, the head should not be kept lower than the trunk

52
Q

How can patient comfort be increased during positioning?

A

Use pillows for the head and radiolucent table pads if possible.

53
Q

Make your patient as comfortable as possible:

A

Patients who are comfortable will be better able to cooperate.

Use pillows for the head and radiolucent table pads if possible.

Place a pillow, bolster, or sponge under the knees to reduce the straightening of the spine when the patient must lay supine.

For patients lying on their side a cushion or pillow may be placed between the knees to relieve pressure on the spine.

Make sure anything that you place under the patient is translucent or out of the X-ray field.

Raise your patient’s head.

Patients who have difficulty breathing when placed in a supine position should have their
heads raised immediately.

Patients who are nauseated should also have their heads raised.

54
Q

What should be done with a patient’s valuables?

A

Metal objects must be removed for certain x-ray procedures; never leave valuables in a changing or dressing room.

55
Q

How should clothing be removed from a patient?

A

Always remove clothing from the uninjured side first.

56
Q

Care of a Patient’s Valuables

A

Metal objects such as chains, watches, etc. must be removed for certain X-ray procedures.

Only remove objects that will interfere with radiographic procedures.

If jewelry cannot be removed, make a notation for the radiologist.

Never leave valuables in a changing or dressing room.

Items belonging to the patient should always remain with the patient.

57
Q

Guidelines for Positioning a Patient

A

Prepare the patient by explaining what will happen before and during the procedure.

Place and lock the stretcher or wheelchair as close as possible to the table.

Move the radiographic tube out of the way.

Transfer the patient as a single unit

Let the patient assist as much as possible.

Place the patient’s arms over their chest when transferring.

Roll the patient towards you.

When turning a patient on their side place support under the head and between the knees.

Provide positioning support items to increase comfort. (i.e., pillows, sponges)

58
Q

MAIN RULE IN TRANSFERRING

A

ALWAYS GET HELP TRANSFERRING
A PATIENT IF YOU NEED IT.

59
Q

Assisting Patients to Dress or Undress

A

Always remove clothing from the uninjured side first.

When redressing the patient put the clothing on the injured side first.

Changing a Hospital Gown of Patients with IVs. Slip the gown off the unaffected side first.

Place the IV bag and tubing through the armhole of the gown.

Only lower the bag if necessary to change the gown. Do not discontinue IV flow

60
Q

What is Paralysis?

A

Loss of voluntary movement (motor function).

Paralysis that affects only one muscle or limb is partial paralysis, also known as palsy; paralysis off all muscles is total paralysis.

61
Q

What is Hemiplegia?

A

Paralysis that affects one side of the body.

62
Q

What is Paraplegia?

A

Paralysis that affects the lower half of the body.

63
Q

What is Quadriplegia?

A

Paralysis that affects the body from the neck down.

64
Q

how many person is required when transferring an adult patient

A

3

65
Q

CONCLUSION

A

Communication with patients and team members is critical to safe and efficient transfers.

Work as a transfer team with a clear leader during the transfer.

Let the patient assist with transfers if possible
.
Use a broad base of support and maintain your center of gravity over the base during the lift.

Use transfer and positioning aids when possible.

Work as a transfer team!

RAD 1127 (17 decks)

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