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Foundations II > Transfer Basics: Exam 1 > Flashcards

Transfer Basics: Exam 1 Flashcards

1
Q

Transfers

A

Patterns of mvmt by which pt moves from one surface to another

  • Goals:
    • ​pt moves w/ max lvl of indep and safety
    • pt progression
      • DEC lvl of assist
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2
Q

3 main types of transfers

A
  1. Dependent—cannot help us @ all
  2. Assisted
  3. Independent
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3
Q

high risk pt handling tasks

A

high risk of msk injury for staff

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4
Q

high risk areas

A

high proportion of dependent pts req’ing full assist

based on dependency lvl of pts and freq. they are encouraged to get OOB

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5
Q

NO lift policy

A

mech. lifting equip req’d

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6
Q

pt handling aids

A
  • used to assist in lift
    • gait belts—DO NOT FORGET THE GAIT BELT!!!
    • stand assist aids
    • sliding boards—have it ready if you need it!!!
    • surf. friction reducing aids

​

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7
Q

Transfer Safety Checklist

MEMORIZE!!!

A
    1. Organize environment, equip and yourself
      * gather equip BEFORE moving pt
      • ​gait belts
      • slide board, slings, lifts
    1. Do a visual assessment of the space that the transfer is taking place
      * allow enough room for EVERYTHING!!!
    1. Make sure surface is STABLE
      * LOCK WHEELCHAIR AND BED BRAKES!!!
    1. Standard precautions—assume everyone is sick
    1. Informed Consent!!!
    1. Give insructions and demonstrate first
    1. Prepare the patient
      * draping, protect body parts, PRECAUTIONS
    1. Body mechanics
    1. Explain EACH PART of transfer
    1. Watch pts arms/hands and toes
      * prevent pinching
    1. NEVER allow a person to grab a hold of your neck
    1. Momentum is your friend!!!
    1. ALWAYS ENSURE NON-SKID FOOTWEAR IS DONNED!!!
      * ​DO THIS FIRST THING!!!
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8
Q

Safety 1st!!!

A

NEVER compromise safety

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9
Q

Transfer Type

Dependent

A
  • pt MINIMALLY able to assist w/ mvmt
  • can be 1 or multi-person assist
  • often utilize devices/equip. to assist
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10
Q

Transfer type:

Assisted

A
  • pt is ABLE to assist w/ PART of transfer
  • often only need one person
  • may or may not utilize assist. equip.
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11
Q

NO lift transfers

A

mechanical lift equip.

*hospitals have no-lift policies

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12
Q

Dependent Transfer:

Draw Sheet Lift

A
  • cart to treatment table w/ draw sheet
  • type of patient:
    • comatose
    • complete paralysis
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13
Q

Dependent Transfers:

2-Person Lift

A
  • 2 person lift FROM WC TO/FROM surface
    • ​pt has some head control and no precautions
  • VERTICAL lift
    • pt lifted UP first
  • Type of pt:
    • ​paraplegic
    • multiple fx’s of BOTH LEs
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14
Q

Special Equipment

Ceiling mounted mechanical lift

A

lifts pts who are totally dependent, partial or NWB, obese, phys limits

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15
Q

special equipment:

Floor mechanical lift

“Hoyer” lifts and slings

A

used when pt unable to assist OR too heavy to assist manually

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16
Q

other special equip:

bed–> mat/horizontal surface

A

bed to stretcher or gurner from supine

shearing forces applied b/w device and transfer surface NOT pts skin

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17
Q

Draw sheet technique

A

boosting

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18
Q

THA and Spinal precaution transfer

A

CAN ONLY DO STAND-PIVOT TRANSFER

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19
Q

Assisted & Indep. Transfer types (3)

A
  1. slide board/beasy board
  2. squat pivot or “Pop-over”
  3. Stand & pivot
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20
Q

Transfer Biomechanics

Head Hips Relationship

USE THIS!!!

A
  • Head and hips move in OPPOSITION
  • REMEMBER DURING ALL TRANSFERS!!!
    • dependent
    • indept.
  • assists w/ UN-weighting buttocks and DEC shearing forces
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21
Q

ALL successful transfers req. the pts hips be __________ to the edge of the surface

A

MOVED FORWARD

get them close to where you want them to go!!!

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22
Q

Transfer belt/Walking belt

A

Gait belt

23
Q

Gait belts and injury

A

reduce risk of injury

24
Q

When putting on the gait belt…

A

don/doff in supported sitting position

BEFORE you put it on…..MAKE SURE YOU ARE HOLDING ON TO THEM!! DO NOT LET GO OF PATIENT!!!

25
Q

GAIT belt pos.

A

just below abdomen

fingers width tightness

26
Q

Gait belt NOT used for…

A

pregnancy

abdominal sx/hernia

27
Q

Sliding/transfer board transfers

who used for?

A
  • Indiv’s w/ very weak LEs who CAN participate w/ transfers but NOT able to complete a full squat pivot/stand transfer
  • USE TRANSFER BOARD
28
Q

Sliding board tips

A
  • Head hips relationship!!!
  • aim board for far ischial tuberosity
  • “Mini pops”
    • do it in segments
  • NOT SHEARING
    • we want to UNWEIGHT the buttocks
      • LIFT THEM

**Instruct pt to push down with their arms to gen. force to lift buttocks

29
Q

What mm must be strong for slide board transfers?

A

Serratus anterior

30
Q

Sliding board transfers..

or any really

A

MAKE SURE YOU REMOVE THE ARM RESTS OF WC!!!!!

LOCK BRAKES!!!

ELEVATE THE BUTT—NO SHEARING

31
Q

Squat pivot/pop-over transfers

A

pt takes active wt into the LEs but does NOT achieve full upright

stepping stone to achieve full stand pivot

32
Q

Setting up squat pivot/pop-over

A
  • wc LOCKED/SECURE and angled ~45deg
  • LEG RESTS OFF OR OUT OF WAY!!!
  • BRAKES LOCKED!!!
  • pt moves to EOB w/ or w/out assist
  • feet back and flat on floor
    • under pts COM
    • shoulder w/ apart
    • inside foot forward/angled in
  • trunk flexes OVER BOS…head over knees…nose over toes
33
Q

Therapist pos. in squat pivot/pop-over

A

FRONT of pt

flex knees/hips

wide BOS, stabilize back

34
Q

Blocking knees:

blocking WEAKER side

A

PROTECTION

35
Q

Blocking knees:

blocking STRONGER side

A

protection IF weaker side buckles

36
Q

Rationale for blocking knees

A
  • counterforce prevents pts tibias from moving forward over feet w/ weak quads
  • leverage pt for facilitating transfer
37
Q

Decision Tree for Blocking Knees

A

see pic

38
Q

Ant-post squat pivot/pop-over

A

MUST have good UE strength and motor control

good hamstring length

risky bc legs catch, wc moves

39
Q

Stand pivot transfers

A
  • performed w/ pt taking full active wt thru LEs
    • ​2 components
      • ​sit to stand
      • pivot and sit
  • ****@ least 3-3+/5 @ knees!!!
  • NOTE THEIR STRENGTH!!!
  • REMEMBER WE WANT THEM TO USE THEIR LEGS IF POSSIBLE
40
Q

Sit to Stand transition tips

A
  • Nose over Toes to unload trunk so hips can move
    • hips to head rule!!!
  • pts feet flat on floor
    • hips/knees @ 90deg
    • feet back closer to chair legs
    • arms/hands supporting pt in sitting or lap
41
Q

Stand pivot

“the Pivot”

A
  • pivot WITH the pt
    • watch hip precautions!!!
      • in this case…transfer TOWARDS non-involved side
  • ensure clearance of your feet and pts feet
    • no tripping
  • move WITH pt until they are able to feel the surface against back of legs
  • instruct pt to reach back for chair PRIOR to sitting
42
Q

chair to bed: stand pivot

pos. feet

A

see pics

43
Q

Stand pivot

A

see pics

44
Q

Reach back for wheelchair BEFORE you sit down!!!

A

say this!!!!

45
Q

WC–> Toilet

technique same but spatial concerns

add. assist devices?

A

raised toilet seat

toilet bars

46
Q

WC to tub

A

NON-SKID tub mat

dry feet as much as possible!!!

check water temp

do NOT use towel bars as grab bars

use flattest part of tub for devices

47
Q

tub/shower ADs for THA

A

see pic

48
Q

WC to car

A

easier to backseat***

  • park lvl ground
  • move CLOSE to car
  • seat back as far as poss
  • wc facing b/w open door and car seat
  • BACK INTO CAR W/ HIPS FIRST
49
Q

Special considerations transfers:

orthopedic

A

TJA precautions

wt. bearing status

use of walker for NWB

50
Q

Special considerations transfers:

Neurologic

A
  • SCI
  • Strokes
    • neglect
    • balance
    • vision
    • mm tone, strength
    • motor planning
51
Q

HOW to choose transfer type

pts MUST:

A
  • Have ability to learn, process, plan motor skills
  • have suff. strength, ROM, endurance
  • have accurate perception of the surface that they are transferring to
    • moving or stable?
52
Q

Transfer Completion Checklist

A
  • Is pt secure and safe?
  • call bell w/in reach?
  • all important items near pt?
  • remove all equip/put room back in order
53
Q
A

Foundations II (13 decks)

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