Transfers Part 2

Question 1

What are two purposes with transfers?

Answer 1

• To improve functional independence
• To simply get from one surface to another

Question 2

When choosing a transfer what should you consider?

Answer 2

• Patient diagnosis
• Condition
• Precautions
• PLOF
• Current functional level

Question 3

Who is a slide-board transfer best for?

Answer 3

• Paraplegia or hemiplegia
• Bariatric
• Post amputation
• Bilateral weight bearing restrictions

Question 4

What are the considerations with a slide board transfer?

Answer 4

• LE weakness
• Flaccidity
• Sensation loss
• Traumatic or non-traumatic injury

Question 5

How should you preform a slide board transfer? (step by step)

Answer 5

1. Assist your patient in scooting to the EOB or starting surface
2. Position yourself in front of the patient and block the patients knees
3. Position the slide board under the patients hip and ensure stable placement
4. Instruct your patient to place one hand on the board; the other can assist with pushing off
5. 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
6. Repeat step 5 until your patient is seated on the intended transfer surface
7. Remove the board and assist your patient in scooting as needed

Question 6

T/F: During a slide board transfer your patient should not actually be sliding.

Answer 6

True (there should be a lift each time)

Question 7

What are anterior hip precautions?

Answer 7

• No adduction
• No external rotation
• No extension past 30; no excessive extension

Question 8

What kinds of patients might you see with anterior hip precautions?

Answer 8

• Total hip arthroplasty
• Partial hip arthroplasty
• ORIF
• Surgical oncology, plastic surgery, polytrauma, etc

Question 9

What are posterior hip precautions?

Answer 9

• No adduction
• No internal rotation
• No hip flexion past 90
• You can also use abduction pillow

Question 10

What kind of patients will you see with posterior hip precautions?

Answer 10

• Total hip arthroplasty
• Partial hip arthroplasty
• ORIF
• Surgical oncology, plastic surgery, polytrauma

Question 11

What side should you transfer to for someone with hip precautions?

Answer 11

Transfer to the unaffected limb with the unaffected limb closest to the target to allow for pivot

Question 12

With hip precautions you should have the patient stand with physical assistance with an assistive device and _____ or _____ to the target.

Answer 12

Step or pivot

Question 13

Before initiating a transfer for someone with hip precautions you should have the patient do what?

Answer 13

Weight shift to the affected limb to test for pain and weight bearing tolerance

Question 14

The patient with hip precautions should be able to provide what percentage of physical effort during the transfer?

Answer 14

25-75%

Question 15

What are spinal precautions?

Answer 15

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)

Question 16

What are sternal precautions?

Answer 16

• 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

Question 16

What patients might you see with spinal precautions?

Answer 16

• Lumbar, thoracic, or cervical surgeries
• Discectomy, fusion, laminectomy
• Anterior and/or posterior approach
• Bracing: TLSO, LSO

Question 16

What kinds of patients might have sternal precautions? (Provide these patients with a cardiac pillow)

Answer 16

• CABG
• Additional cardiopulmonary surgeries

Question 17

What are the 4 kinds of weight bearing precautions?

Answer 17

• 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

Question 18

What are cognitive considerations/ precautions?

Answer 18

• Patient and therapist safety
• Patient orientation, compliance, command following
• Limit new and unfamiliar equipment

Question 19

What kind of patients might you encounter with cognitive alterations?

Answer 19

• Neurologic injury
• Neurodegenerative conditions
• Acute considerations: UTI, lab value imbalance, delirium

Question 20

What kind of training should you be giving caregivers?

Answer 20

• 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