Transfers Part 2 Flashcards
What are two purposes with transfers?
- To improve functional independence
- To simply get from one surface to another
When choosing a transfer what should you consider?
- Patient diagnosis
- Condition
- Precautions
- PLOF
- Current functional level
Who is a slide-board transfer best for?
- Paraplegia or hemiplegia
- Bariatric
- Post amputation
- Bilateral weight bearing restrictions
What are the considerations with a slide board transfer?
- LE weakness
- Flaccidity
- Sensation loss
- Traumatic or non-traumatic injury
How should you preform a slide board transfer? (step by step)
- Assist your patient in scooting to the EOB or starting surface
- Position yourself in front of the patient and block the patients knees
- Position the slide board under the patients hip and ensure stable placement
- Instruct your patient to place one hand on the board; the other can assist with pushing off
- While holding onto the gait belt, rock your patient forward thee times to help life his bottom. Your patient can help push up as able. Move approximately halfway across the board. Assist with guiding your patient’s legs as needed
- Repeat step 5 until your patient is seated on the intended transfer surface
- Remove the board and assist your patient in scooting as needed
T/F: During a slide board transfer your patient should not actually be sliding.
True (there should be a lift each time)
What are anterior hip precautions?
- No adduction
- No external rotation
- No extension past 30; no excessive extension
What kinds of patients might you see with anterior hip precautions?
- Total hip arthroplasty
- Partial hip arthroplasty
- ORIF
- Surgical oncology, plastic surgery, polytrauma, etc
What are posterior hip precautions?
- No adduction
- No internal rotation
- No hip flexion past 90
- You can also use abduction pillow
What kind of patients will you see with posterior hip precautions?
- Total hip arthroplasty
- Partial hip arthroplasty
- ORIF
- Surgical oncology, plastic surgery, polytrauma
What side should you transfer to for someone with hip precautions?
Transfer to the unaffected limb with the unaffected limb closest to the target to allow for pivot
With hip precautions you should have the patient stand with physical assistance with an assistive device and _____ or _____ to the target.
Step or pivot
Before initiating a transfer for someone with hip precautions you should have the patient do what?
Weight shift to the affected limb to test for pain and weight bearing tolerance
The patient with hip precautions should be able to provide what percentage of physical effort during the transfer?
25-75%
What are spinal precautions?
BLT:
- No bending greater than 90 degrees at the waist (hip flexion)
- No lifting greater than 10 lbs (usually 8 lbs is recommended)
- No twisting (trunk rotation, lateral flexion)
What are sternal precautions?
- No Lifting (more than 10 lbs)
- No Pushing (more than 10 lbs)
- No Pulling (more than 10 lbs)
- Hold a pillow against the chest in the first 48 hours
- When getting in and out of bed or a chair, keep arms close to sides
- Do not reach backwards with both arms at the same time
- Hold a pillow across the chest when coughing, sneezing, or doing breathing exercises
- Do not let others push or pull patients arms when helping them move
What patients might you see with spinal precautions?
- Lumbar, thoracic, or cervical surgeries
- Discectomy, fusion, laminectomy
- Anterior and/or posterior approach
- Bracing: TLSO, LSO
What kinds of patients might have sternal precautions? (Provide these patients with a cardiac pillow)
- CABG
- Additional cardiopulmonary surgeries
What are the 4 kinds of weight bearing precautions?
- Non-weight bearing (NWB): No weight
- Partial weight bearing (PWB): percentage is given
- Toe-touch weight bearing (TTWB): balance only on toes/ big toe. do not distribute weight through heel
- Weight bearing as tolerated (WBAT): full weight as tolerated by the patient
What are cognitive considerations/ precautions?
- Patient and therapist safety
- Patient orientation, compliance, command following
- Limit new and unfamiliar equipment
What kind of patients might you encounter with cognitive alterations?
- Neurologic injury
- Neurodegenerative conditions
- Acute considerations: UTI, lab value imbalance, delirium
What kind of training should you be giving caregivers?
- Caregiver abilities should ALWAYS be a consideration
- Allow for caregiver to observe and practice with your assistance
- Discuss home environment and simulate as able
- Discuss a routine and caregiver schedule
- Patience and confidence
