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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

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
GAIT belt pos.
just below abdomen fingers width tightness
26
Gait belt NOT used for...
pregnancy abdominal sx/hernia
27
Sliding/transfer board transfers who used for?
* 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
Sliding board tips
* 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
What mm must be strong for slide board transfers?
Serratus anterior
30
Sliding board transfers.. or any really
MAKE SURE YOU REMOVE THE ARM RESTS OF WC!!!!! LOCK BRAKES!!! ELEVATE THE BUTT---NO SHEARING
31
Squat pivot/pop-over transfers
pt takes **active wt into the LEs but does NOT achieve full upright** **stepping stone to achieve full stand pivot**
32
Setting up squat pivot/pop-over
* 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
Therapist pos. in squat pivot/pop-over
FRONT of pt flex knees/hips wide BOS, stabilize back
34
Blocking knees: ## Footnote **blocking WEAKER side**
PROTECTION
35
Blocking knees: blocking **STRONGER side**
protection IF weaker side buckles
36
Rationale for blocking knees
* counterforce prevents pts tibias from moving forward over feet **w/ weak quads** * leverage pt for facilitating transfer
37
Decision Tree for Blocking Knees
see pic
38
Ant-post squat pivot/pop-over
MUST have good UE strength and motor control good hamstring length risky bc legs catch, wc moves
39
Stand pivot transfers
* 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
Sit to Stand transition tips
* 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
Stand pivot "**the Pivot"**
* 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
chair to bed: stand pivot ## Footnote **pos. feet**
see pics
43
Stand pivot
see pics
44
Reach back for wheelchair BEFORE you sit down!!!
say this!!!!
45
WC--\> Toilet technique same but spatial concerns add. assist devices?
raised toilet seat toilet bars
46
WC to tub
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
tub/shower ADs for THA
see pic
48
WC to car
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
Special considerations transfers: ## Footnote **orthopedic**
TJA precautions wt. bearing status use of walker for NWB
50
Special considerations transfers: **Neurologic**
* SCI * Strokes * neglect * balance * vision * mm tone, strength * motor planning
51
HOW to choose transfer type pts MUST:
* 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
Transfer Completion Checklist
* Is pt secure and safe? * call bell w/in reach? * all important items near pt? * remove all equip/put room back in order
53

Foundations II (13 decks)

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