Transfers And WC Flashcards
Bed chair transfer: safety
•Minimize distance between chair and bed
•Patient should wear non‐slip socks or shoes
•Use a gait belt
•Patient should initiate stand with wide base of support, feet underneath their center of mass
•Transfer towards the patient’s stronger side
•Patient should make contact with surface before sitting
Sir to stand transfer
- Ask the patient to put their hands on the armrests of the chair
- Ask the patient to lean forward in the chair and move towards the front of the seat
- Ask the patient to put their feet flat on the floor. The feet should be hip width apart and under their knees
- Ask the patient to lean forward while still sitting, so their upper body is above and over the tops of their knees
- Carer to stand in the lunge position, facing forward at the side of and behind the client
- Outside hand is flat on the front of the patient’s shoulder, inside arm across lower back around the hips, not the waist
- With weight on the carer’s back foot, rock forward with patient, same verbal cues (‘ready, steady and stand’), stand up with client and bring inside leg through to step in tight to client’s side. The carer’s hip should be touching the patient’s side
From standing to sitting
- Ask the patient to feel for the chair (or bed) with the backs of their legs, reach for the arms of the chair and gently lower themselves.
- Encourage the patient to bend forward at the hips to facilitate a better position for sitting. Either say ‘lean forward and bend at your hips’ or place the carer’s hand in front of the client’s hip.
Sit to stand with lift
Used to quickly and easily transport or transfer residents from one sitting position to another.
•Patient is full weight bearing and needs assistance rising from a seated position.
•Is cooperative.
•Fear and anxiety are a barrier.
•Patient displays mild cognitive impairment.
•Bears substantial portion of weight consistently.
•Can hold onto the handle with at least one hand.
•Displays no more than a mild deficit in standing balance
•Displays limited ability to pivot transfer in standing position.
Standing pivot ( one person assist
Step 1
•Have patient move to edge of seat
•Angle the patients heels in the direction
•Squat, and grip your thighs on the outside of their legs, gripping tightly
•Ensure their arms are in a safe place
Step 2: Stand
•Reach to the belt avoid gripping clothing
•Rock the patient forward (counting to 3)
•Maintain good body mechanics, keeping your back straight keep your hands on the belt as you prepare to pivot
Step 3: Pivot
•Keep three points of contact at the knees, hips, and shoulders
•Taking small steps, use your legs to guide the patient back toward the surface they will sit on
•Continue to step until the back of the patients legs are touch the surface they will sit on
Step 4: Sit
•If the patient is able to, have them reach back for armrest or seat
•Slowly lower, guiding their hips far back into the chair
Transfer from a vehicle to a walker
- Slide the car seat back as far as it will go to allow maximum space to lift the legs out
2.Check the seat back is fully upright
3.Ensure the patient’s walker is close by but out of the carer’s way
4.Ask the patient to lift their legs out of the car. It is generally easier to move in small movements and move one leg at a time. If they have difficulty doing this, you can place a scrunched‑up slide sheet under the buttocks to reduce friction
5.Get them to move forward until their feet are flat on the ground
6.The patient will need to hold on to something as they stand. They can push using the car seat or backrest. Alternatively, wind the window down and the client can use the door for support while the carer uses their body weight to prop the door for safety*
7.Once standing, the client transfers their hands to the walker (with brakes applied
Transfer from vehicle to a WC
- Slide the car seat back as far as it will go to allow maximum space to lift the legs out
- Check that the seat back is fully upright
- Ensure the client’s wheelchair is close by but out of the carer’s way
- Ask the client to lift their legs out of the car. It is generally easier to move in small movements and move one leg at a time. If they have difficulty doing this, you can place a scrunched‑up slide sheet under the buttocks to reduce friction
- Get them to move forward until their feet are flat on the ground
- Move wheelchair into position parallel to side of the vehicle (with brakes applied)
- Client reaches across and places one hand on outer arm of wheelchair. They can push up with their hands on the car seat and the wheelchair arm
- Client steps around to sit in the wheelchair.
Wheelchair brakes
Anti tippers
Legrests
Armrests
Type of the cushion
WC brakes: should be functional so that the WC does not slide during transfers
Anti tippers: for also encouraged for client starting out with the WC
Leg rest: should be swiveled away or removed
Armrests: that can be removed or folded up are more versatile
The type of cushion: including it’s firmness and thickness can also make transfers easier or more difficult
Decision
Full mechanical life ( floor or ceiling)
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Sit to stand mechanical lift
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One person transfer with gait belt
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Independent
Manual WC
Are defined as WC propelled by the user or pushed by another person
WC is appropriate when it’s
• can be obtained and maintained and services sustained in the country at an affordable cost
•meets the user’s needs and environmental conditions
• provides proper fit and postural support
• is safe and durable
• is available in the country
The six basic measurement
A- seat width
B- seat depth
C- floor to seat height
D- seat back height
E- armrests height
F- backrest width
A- seat width and consideration
In seated position measures the widest distance from hip to hip
Add on 1 to 2 inches to this measurement to allow a space btw the arm rest and each side of the hip
Consideration: •The 1¼ - 2 inches added to the measurement allows room for clothing such as coats and prevents skin irritation between the thighs and the armrests.
•If the wheelchair is too wide, it will be more difficult to propel, fit through doorways, and will not provide adequate postural support.
B- seat depth and consideration
In a seated position measure the distance along the thigh from the back of the hip to the knee
Subtract 1-2 inches from measurement to allow space btw the back of the knee and the WC
Considerations:
• If the seat depth is too long it may cause skin irritation and breakdown on back of the knees as well as poor postural support.
• If the seat depth is too short, there will be less support under the thighs may increase pressure on the buttocks
C- floor to seat height and consideration
While started measures the distance from fold of the back of the knee to the bottom of the heel. Add on 2 inches to allow for the footrest rest to clear the floor
Considerations:
•If the floor to seat height is too high:
o The wheelchair will be difficult to fit underneath desks
o The feet will be unable to touch the floor when footrests are removed, making transfers and foot propulsion difficult
o The wheelchair will also be more difficult to propel
o The wheelchair will be at increased risk of tipping
• A floor to seat height that is too low will cause the footrests to hit the floor and increase pressure on the buttocks when the feet are on the floor
