3Learning ObjectivesBy the end of this Lecture the student will be able to:Describe the trolley design and its basic componentsList the basic safety factors that must be considered when moving a patient.List and identify principles of body mechanics.Identify the components of lifting techniques.Determine the amount of assistance involved with the transferDiscus correct manner of transferring patient:A- from wheelchair to x-ray tableB- from x-ray table to wheelchairC- from stretcher to tableD- from table to stretcher8. Explain the safety precautions when examining patients with Foleycatheter, IV bottle, and chest drainage system.
4Lecture .1 Primary care of emergency patient Transference to and handling techniques
5DefinitionAccident; is especially harmful event ,caused unintentionally or which happen unexpectedly and causes injury or trauma to the body.Emergency; is situation in which the condition of a patient or sudden change in medical status requires immediate action
6Emergency in radiology department -Emergency actions on the part of the radiologictechnologist as a whole have the objectives ofpreserving life , avoiding further harm to the patient ,and obtaining appropriate medical assistance asquickly as possible.-The radiologic technologist must be able to recognizeemergency situations ,to maintain a calm and confidentpresence ,and to take appropriate action.
7General Principles General Principles General Principles Although most patients are sent to the radiology department only after they have been stabilized ,some patients are not stable ,and the status of other may change while they are in the departmentThe technologist should keep in mind the following actions when working with patients in emergency situations:1- Ensure an open airway .2-Control bleeding.3-Observe closely for any indication of shock to prevent or treat.4- Attend to wounds or fractures .5- provide emotional support .6-Continualy re evaluate and follow up the patient .
8Basic trolley designThe trolley used for transport patient must have certain characteristics to make it suitable for severe injured patients , this include:-A variable height adjustmentA drip stand holderA mean of tilt the trolley topAn oxygen bottle holderBrakes on the wheelsA radiolucent rubber covered foam mattress capable of being detached to slide across onto an x-ray tableAn adjustable backrest which can be inclined at various anglesA side rests which can be raised and lowered as necessary.
9Principle for safe patient transfer 1.Check chart for precaution before transfer to minimize patient pain2. Let the patient do as much of the transfer as possible.3. Use wide base of support for your stability.4. Hold the patient with a transfer belt around the waist .5. Avoid trunk twisting during transfer .6. Watch the patient for signs emergency , and take precaution tominimize its effects .
10Principle for safe patient transfer 1. Check chart for precaution before transferto minimize patient pain .
11Principle for safe patient transfer 2. Let the patient do as much of the transferas possible to minimize trauma to the patient and avoid stress on the technologist.
12Principle for safe patient transfer 3. Use wide base of support for your stability.Using Proper Body MechanicsThe safest way of lifting and moving things is use these principles of body mechanics:Center of gravity (pelvic area) S2.Base of support (the feet).Body alignment (patient centerOf gravity Close to your owncenter of gravity).
13Principle for safe patient transfer 4. Hold the patient with a transfer belt aroundthe waist to minimize stress on the patient shoulder. .
14Principle for safe patient transfer 5. Avoid trunk twisting during transfer
15Principle for safe patient transfer 6. Watch the patient for signs of any emergencyand take precaution to minimize its effects.
16Principles of Body Mechanics Avoid unnecessary bending.Avoid unnecessary lifting.When lifting, face the object you are moving.When changing direction of movement, turn your whole body.Use your strongest muscles to accomplish work.Use your thighs and hips by bending knees when lifting.Use both arms to lift.
17Body mechanics Advantages Of Proper Body Mechanics Using the body’s major moveable parts (head, trunk, arms, and legs) is an efficient manner to maintain balance, conserve energy, and avoid strain and injury while performing work.Advantages Of Proper Body MechanicsPrevent injuryReduce energy consumptionComponents Of Good Body MechanicsPostureThe alignment of head, trunk, arms, and legsThe proper alignment of the bodyCoordination of body movement
18A- Wheelchair transfer Mechanic of liftingA- Wheelchair transferStandby assist transferTow persons lift techniqueHydraulic lift techniquesAssisted standing pivot transfer
19Standby assist transfer For patient have ability to transfer from a wheelchair to table on their own .1- Position the wheelchair at a 45 degree angleto table2- Move the wheelchair footrest out of the way .3- Be sure that the wheelchair is locked .Then instruct the patient to:4- Sit on the edge of the wheelchair seat .5- Push down on the arms of the chair to assistin rising6- Stand up slowly .7- Reach out and hold onto the table with thehand close to the table .8- Hold onto the table with both hand and sitdown .
20Two Persons LiftFor patient cannot bear weight on their lower extremities.
21For patients are too heavy to lift manually Hydraulic lift techniques:For patients are too heavy to lift manually
22Assisted standing pivot transfer For patient who cannot transfer independently
23B- Cart transfer (stretcher 1- cart to table with moving devicePosition the cart close to long side of the table and then secured (locks and sand bags)patient rolled away from tableThe moving device(thin sheets of plastic ,polyster..) is placed halfway under the patientPatient returned to supine positionThe sheet device is then used to slowly move the patient onto the table
242- cart to table with out moving device ( three people need in transfer)Roll up the draw sheet(2) on both side of the patientOne use to support the patient head and upper body and other support the leg (table side)The third person support the patient pelvic from the cart sideThe patient hands crossed over the chest to avoid injury
253-Hydraulic lift techniques For patients who are too heavy to lift manually
26Caring of Patients with Foley catheter For a patient with a Foley catheter, during the radiological examination place the drainage bag and tubing below the level of the bladder to maintain the gravity flow of urine.Note:Placement of the tubing or bag above or level with the bladderwill allow backflow of urine into the bladder. This reflux ofurine can increase the chance of urinary tract infection (UTI).Caring of Patients with IV bottlesIt is recommended that the IV bottle be kept 18 to 20 in above the level of the vein.Note:If the bottle is too high, the pressure of the IV fluid can cause it to pass through the vein into surrounding tissues, causing a painful and potentially harmful condition.If the IV bottle is too low, blood may return through the needle into the tubing, form a clot, and obstruct the flow of IV fluid.
27Caring of Patients with chest drains system Chest tubes are used to remove air, blood, or fluid from the pleuralcavity.When examining a patient with a chest drainage system it shouldalways be kept below the level of the patient's chest.The technologist must take care that the tubes of the chest drainageunit do not kink and do not get caught on radiographic equipment.The unit must remain below the level of the chest in order to workproperly.
28Frank M. Pierson: Principles & Techniques ReferencesFrank M. Pierson: Principles & Techniquesof Patient Care, Saunders;4 edition 2007Adler &Carlton :Introduction to Radiograph And patient CareUseful websites