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Semester 2 PM Exam 7 > Transfers and Body Mechanics > Flashcards

Transfers and Body Mechanics Flashcards

1
Q

Why do we need to transfer a patient

A

Permit them to function in new environment
Allow access to equipment
Allow for ADLs
Inc level of independence

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2
Q

Guidelines

A 
Pt and PT safety must not be compromised
Pt must be informed
Therapist at pt head is in charge
Plan ahead
Adjust bed to convenient height
Lock wheels
Use gait belt
Transfer toward strong side
Recheck equipment
Perform transfer
Assure pt safety in new position
Reasses entire transfer
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3
Q

What is meant by body mechanics

A

How you move
The use of one’s body to produce motion that is safe, energy conserving anatomically and physiologically efficient and maintains the bodys balance and control

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4
Q

Body mechanics and lifting -

A

Reach level by bending hips and knees - NOT back
Lift with legs using quads and glutes
Keep load close
Maintain good base of support
DO NOT lift and twist - move feet instead

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5
Q

Types of lifts

A 
Deep squat
Power lift
Straight leg lift
Golfers lift
Half kneel lift
Traditional lift
Stoop lift
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6
Q

Deep Squat

A

Hips below the knees

Not used that often

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7
Q

Power lift

A

Not common unless fucntional for pt
Load is higher and hips are above the knees
Extending knees and hips and lifting load at same time

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8
Q

Straight leg lift

A

lighter loads

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9
Q

Golfers lift

A

To get down to pick up a small object
One leg straight and back leg kicks out a little
keep back stright

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10
Q

Half kneel lift

A

Keeping load close the entire time
Lighter loads
No knee problems

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11
Q

Traditional lift

A

Hips are parallel with knees

Start to lift a little and then extend knees and hips to lift the rest of load

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12
Q

Stoop lift

A

Bend down with back straight and then go ahead and extend legs while keeping arms straight
Picking something up at side

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13
Q

Equipment considerations

A
  1. Proper bed height

2. Wheelchair (armrests, foot rests, locks/brakes, position)

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14
Q

Proper bed height - bed to chair.. the chair should be

A

an inch or two below the bed height

Always want to transfer to a lower surface

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15
Q

Position of chair transfering to

A

You want it at a 45 degree angle to the bed and almost touching the bed

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16
Q

Components of proper posture and body mechanics - Standing

A

Weight is equally distributed btw the feet, look at spine and make sure it is straight
If pt is standing for a long time it is ok to have them place one foot on a stool or something but they need to keep hips neutral

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17
Q

Components of proper posture and body mechanics - Sitting

A 
Hips at 90
Knees at 90
Elbows should be at 90
Wrists can be in slight extension
Monitor needs to be 10 degrees below eye level
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18
Q

Components of proper posture and body mechanics - lying down

A

Pillows - just enough to take up space behind neck
Should have pillows under their knees (if side, btw knees with knees flexed a bit and pillow to fill space btw shoulder and head and spine in neutral)

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19
Q

Safe patient handling and movement

A

OSHA recommends manual lifting of patients and residents be minimized in all cases and eliminated when feasible - ZERO lift policy
If patient isn’t helping you, you need to get a manual lift

20
Q

Types of transfers

A

Dependent
Assisted
Independent

21
Q

Dependent Transfer

A 
Minimal to no assistance from patient
Recumbent Draw Sheet (slide)
Recumbent Three person lift/carry
Dependent stand-pivot
Hydraulic Lift (Hoyer Lift)
22
Q

Assisted Transfer

A 
Requires patient participation
Two person lift
Stand-pivot
Slide board
Sitting assisted lateral lift transfer
23
Q

Independent

A

Stand-pivot
Sliding board
Sitting lateral/push up

24
Q

Draw sheet slide

A 
dependent 
Can you chuck pads or draw sheet
Need at least two people
shoulder and mid thigh
Someone count to pull tight
Someone count to slide up/down
Pt should cross arms
If patient can lift their head, have them do it - if not then need to have sheet higher up to protect head
25
Q

Slide boards

A

dependent
Put it under sheet and have it over the two beds
Do not ever leave the board under the patient

26
Q

Recumbent three person carry

A

Dependent
Person at head is the counter
Everyone have hands under the patient and if patient can lift head, have them - if not person needs to be at head
Strongest or tallest usually at head

27
Q

dependent stand pivot transfer - from chair to bed

A

Have them scoot forward in chair - or you get them more forward
If they can push from chair - let them, if not you need to stand them up (gait belt)
Make sure both legs touching ground if can, pivot and then sit - take off belt and lay down

28
Q

Hoyer lift

A

Dependent
Used only when patient can literally do nothing
Now some people use it to help lift people so that they can do more activity

29
Q

Two person lift (from chair to bed)

A

Assisted
Chair is parallel to the bed - need chair without arm rests
Pt puts arms across chest
person in back can put hands on gait belt or around the patient
Count to three, take step and move over the chair

30
Q

Assisted Stand - chair to bed

A

Same as other but less dependent on therapist helping

31
Q

Slide Board

A

Assisted
Used for highly functioning neuro, maybe with poor balance
Place board from chair to bed and they slide
Going from high to low

32
Q

Sitting Lateral Lift Transfer - chair to bed

A

For more independent, WB on both legs
Lift buns up a little, move over and sit down
Best with chair w/o arm rests

33
Q

You just received an order for transfers and gait training on a patient in acute care hospital, what do you do?

A

Make sure they have an order in the chart

Think about their disease process, if you need assistive devices, how independent are they, make sure they are oriented

34
Q

What do we need to look at with chart review

A 
Diagnosis
WB status
Vitals
O2 sat
HgB (NOT below 8)
White count
Pain level and if taking meds - work with them 30 min to an hour after having taken pain med
35
Q

Walking into the room - what do you need to be aware of

A

You need to have your gait belt and any assistive devices

Look to see where everything is - IV poles, bed, chair, catheter, foot wear, take in an extra gown too just in case

36
Q

Treatment

A

Bed mobility

Transfers

37
Q

Tx - Bed mobility

A

Have them show you how they move
Moving up in bed
Moving side to side - have them cross one arm over and other above head, one leg crossed over other, remove glasses, turn head to side going to

38
Q

Tx - transfers

A

Supine to sit

Sit to stand - feet flat on ground

39
Q

Upone completion of transfer what do you do

A

Reasses

Did it go well, do you need o simplify, assistive device

40
Q

Documentation of functional activity

A 
assistance level
how many people
what positions
how did they respond to cues
how many times did they transfer
assistive device or no
Nursing was notified that patient is now safely in the chair with call light in hand or whatever
Document that you used a gait belt too
41
Q

Special Considerations

A 
Paraplegic/quadriplegic
Hemiplegics
Burns
THR
Non WB transfers
Amputees
42
Q

Paraplegic/Quadriplegic

A

Need o be focused on skin because they wont tell you if something hurts
Will be more dependent
Educate family or care givers
Make sure no wrinkles in sheet

43
Q

Hemiplegics

A

Challenged on how many cues can be used and understood
Transfer to strong side to begin with
Will need to log roll

44
Q

Burns

A

Be aware with transfers because dont want to shear skin

45
Q

THR

A

ELbows and then hands to get up, may or may not need to have shoulder back

46
Q

Nonweightbearing transfers

A

Transfer to non involved side because they are Non WB on other side
Make sure they have good footwear
Always put involved leg into rest first

47
Q

Amputees

A

Pillows are crucial
Always want a flat pillow - putting them into any flexion at knee could cancel them from getting a prosthesis because of contractures

Semester 2 PM Exam 7 (8 decks)

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