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Tell us about yourself!  Name  Worksite Responsibilities in hazard assessment Information on musculoskeletal injuries (MSI) and prevention Principles.

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Presentation on theme: "Tell us about yourself!  Name  Worksite Responsibilities in hazard assessment Information on musculoskeletal injuries (MSI) and prevention Principles."— Presentation transcript:

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2 Tell us about yourself!  Name  Worksite

3 Responsibilities in hazard assessment Information on musculoskeletal injuries (MSI) and prevention Principles of Good Body Mechanics Three areas of assessment Safe client moving techniques

4  Workforce needs  Safe care for clients and healthcare workers  Occupational Health and Safety Legislation

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8 Biological Hazard Physical Hazard Chemical Hazard Psychological Hazard

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12 We believe: YOU are as important as the client A change is needed YOU already have the skills and knowledge required YOU are the key to safety

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16 No Unsafe Lift Minimal Physical Effort Maximum Equipment Use Client Participation

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19 three for the top three for the top three for the bottom three for the bottom elbows tucked in elbows tucked in safe effective grip safe effective grip comfort zone comfort zone weight transfer weight transfer 6 Checkpoints

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21  Damage to the various structures involved in producing force for movement of the human body, such as soft tissue  Immediate onset of signs and symptoms  Gradual onset of signs and symptoms

22  Caused by lifting, pulling or pushing activities that exceed the range of motion or strength of muscles, tendons and ligaments.  Caused by prolonged activities that exceed the endurance of the muscles.  Caused by activities involving repeated gripping, reaching, bending or twisting that exceed soft tissue capacity

23  To understand body mechanics we must first understand the structures that support us  Our muscular system uses levers to develop force

24  The purpose of the back musculature is to maintain intervertabral stability  Back angle is maintained by the hip extensors  Rigidity of the spine is maintained by the erector and trunk muscles

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26 Inflammation Pain Swelling Numbness and/or Tingling Decreased ROM Weakness

27  work without warming up?  bend at the waist to lift loads?  move or lift heavy loads?  pull objects?  twist when turning or lifting?  slouch when walking or standing?  do repetitive actions?  ever not get enough sleep?  have poor nutrition and hydration patterns?  experience stress?...are you at Risk?

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30 1.Use your brain not your back 2.Listen to your body 3.Maintain three natural curves 4.Use strong thigh muscles 5.Hands in a safe effective grip 6.Keep the load close 7.Maintain a proper stance 8.Use a weight transfer

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33  A systematic process, one we do all the time, most often subconsciously.  Gathering information to identify risk, analyze the information, make a decision on a solution(s) to eliminate or manage the risk, and then evaluate it.  Using your skill at assessing the situation. This will ultimately result in you making a good decision.

34 Physical status Emotional status Training/experience Communication Workload

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36 Room/Area Color/Lighting Noise/Distractions Working Surfaces Equipment

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38 Communication Cognitive Emotional/Behavioral Medical Functional Assessment

39 Cognitive Emotional/Behavioral Communication Client Medical

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43 Communication is key! Command!

44 Transfer Belts – Used for guiding, not lifting Helping client get up/ sit down Transferring between resting surfaces Support guiding when walking with client Applied to waist snug enough to allow for both hands to be placed under belt Use palms up grip Position feet/ legs outside clients stance to maintain stable base Keep arms close to body, bend at hips and keep back in neutral position Pivot feet to turn not twisting back Assisting Client from Floor with Transfer Belt Assist client to seating position Apply transfer belt to clients waist Block clients feet with knees bent Using palms up grip, grasp belt for stability and guidance Stand up using legs to assist with lift, guide client to standing position Maintain communication with client and partner to ensure safety throughout move

45 A client may fall unexpectedly for any number of reasons. If the client starts to fall, the worker: Will guide the fall only if within a distance that permits assistance, Does not try to stop the fall Must not work against gravity by: o Holding the client up o Stopping the client from sliding off a chair o Attempting to drag the client back to the client’s original position

46 Assisted/Guided Fall Procedure The worker moves in as close as possible to the client The worker grasps the client (if safely possible) and guides/slides the client gently to the floor by quickly bending at the hips and knees while keeping the trunk upright (maintaining the three natural curves of the spine) If the client is unable to get up on their own, the worker ensures that the client is made comfortable on the floor until: The necessary equipment and/or assistance is obtained to move the client from the floor.

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52  Reposition Up in Bed  Reposition Side to Side in Bed

53 to use Command word the primary worker directs the move to always raise the height of working surface to tallest worker

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57  Client Health Information  Functional Assessment  Assigning a Logo

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59  Completed by the Regulated Health Professional upon inpatient admission  Choose a time when the client is at their best. If possible, avoid times when the client is in pain, uncooperative, tired or feeling unwell.  Repeated any time there are significant changes (improvement or decline) in functional ability  Record will be located in the chart

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62 Independent Transfer Criteria Can bear their body weight through part or parts of their body Is cooperative, predictable and reliable in physical and mental performance Can safely relocate themselves with or without the use of assistive devices

63 Minimum Assistance Transfer Criteria Can bear their body weight through part or parts of their body Is cooperative, predictable and reliable in physical and mental performance Can safely relocate themselves with or without the use of assistive devices May require verbal or physical cues May require minimal assistance with equipment and/or personal items

64 Criteria Can bear their body weight through part or parts of their body Is cooperative, predictable and reliable in physical and mental performance Can maintain balance when walking/shuffling feet and/or pivoting Requires one worker to provide hands-on assistance to move One-person Transfer with Belt

65 Two-person Transfer with Belt Criteria Can bear their body weight through part or parts of their body Is cooperative, predictable and reliable in physical and mental performance Requires two workers to provide hands- on assistance to move Has difficulty maintaining balance while walking/shuffling feet and/or pivoting

66 Criteria Is unable to stand for 15 seconds but has partial weight bearing abilities through part or parts of the body May be unpredictable and/or unreliable in physical and mental performance Is able to keep at least one arm outside the harness Sit/Stand Lift Two workers are required to operate a mechanical lift

67 Criteria Cannot bear their own body weight May be unpredictable and/or unreliable in physical and mental performance May be unable to follow instructions due to cognitive or physical disability May be uncooperative in behavior May be unable to maintain sitting position Total Lift Two workers are required to operate a mechanical lift

68 Criteria Confined to bed by physician’s order or nature of their medical condition Bed Rest

69  Used in select areas only or if client admission is less than 24 hours  May be changed after each Functional Assessment  Documentation is required with Logo change  Use regular Logos as soon as client stabilizes

70  Logo placement  Number of Logos  Client needs more or less help than Logo indicates  Logo is assigned following completion of the Functional Assessment Record

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72 SafeClientHandling

73 Excessive Vibrations Prolonged Sitting Acute and Chronic Symptoms: Discomfort/pain to neck, lower back, shoulders and lower extremities Headache Nausea Abdominal pain Fatigue Vertigo Hunched shoulders Lumbar scoliosis Disc disease Herniated discs Nerve irritation

74 Adjust seat properly to avoid lower back strain and impeding blood flow to lower extremities due to pressure on buttocks and legs Adjust seat to avoid over stretching to reach pedals Monitor your position – don’t use arm rests if it causes sideways leaning Remove wallet to straighten sitting position Utilize lumbar rolls to support the spines natural curvature

75 Pay close attention to body mechanics especially during the first 2-3 mins after exiting ambulance as tendons and discs are at high risk for injury at that time Walk and stretch between calls or whenever possible to replenish blood flow to muscles and stretch hamstrings and hip flexors Whenever possible perform a gentle back extension immediately after exiting the vehicle and use micro break strategies as able Avoid going home and sitting on the couch after a long shift behind the wheel

76 Core Stability Flexibility Aerobic Conditioning

77 EMS involves significant physical activity by staff. Improper or lack of stretching prior to commencing physical activity significantly increases the risk of strains. Historically, sprains and strains have been a leading cause of injury in EMS. Particularly back, neck and shoulder strains.

78 Stretching should last for minutes for full effectiveness Must include all body parts necessary for the task to improve flexibility It should be done:  at the beginning of the shift  before any physically demanding task, and  when muscles feel cold or stiff

79 Use smooth, gentle, and controlled movements Do stretches within your comfort zone Breathe naturally and relax Hold stretches for seconds Use proper posture: » head upright » joints loose and relaxed » stomach in » feet shoulder width apart » knees slightly bent

80 Don’t bounce or force stretches Don’t hold your breath Don’t lock your knees or elbows Know your own limits!

81 We lift a lot of weight with our leg and compensate with our backs

82 Our backs and necks face the challenges or lifting, driving and being sedentary. Stretching is important.

83 We use our chest, arms and hands to lift; sometimes with prolonged grips. Stretching can both be a warm up and rest from these activities

84 Periodic breaks or interruptions that give the muscles an immediate rest from the activity they have been performing. Includes: -Alternating work activities to distribute stress to other regions while improving circulation -Performing counter-balancing stretches

85 Microbreaks: -Restore blood flow to working muscles -Enhance recovery rates from forceful or static loads -Re-establishes balance in the muscoskeletal system -Allows for a mental break -Reduces the chances of injury by reducing wear and tear

86 -Last only a few seconds -Performed frequently through day -Following awkward, static or sustained postures Incorporates movements that: -Counterbalance activities -Stimulate circulation -Reduce muscle loads

87 General Principles Workers must: Inspect and prepare equipment prior to use for cleanliness, any wear & tear or flaws Use correct body mechanics and postures during procedures (follow the 6 Checkpoints) Communicate appropriately and effectively to client and other workers throughout the moving technique Ensure safety, comfort and dignity of the client during and after procedures. Select primary worker to lead a two-person move while workers perform the move together

88 Get as close as possible to equipment to avoid excessive reaching Remove items that are in the way Slide object to the edge before lifting Distribute load evenly on both sides of body Take only necessary equipment Load on stretcher if possible Remove obstacles wherever appropriate Use micro breaks to counteract static postures

89 three for the top three for the top three for the bottom three for the bottom elbows tucked in elbows tucked in safe effective grip safe effective grip comfort zone comfort zone weight transfer weight transfer 6 Checkpoints

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91 Always Two person handling requirement (minimum) Always palms up grip (biceps) Communication – actions, levels etc. Assessment and awareness of surfaces for moving stretcher Guiding/ steering is done by front person usually with one hand to avoid twisting with load If pulling is required use both arms and walk backwards

92 Use a wide, balanced stance not less than shoulder width apart Position yourself as close to the load as possible Keep feet flat on floor; don’t raise up onto your toes Bend at your hips to lower yourself and to keep your back in a strong and neutral posture; the knees will bend slightly If you need to squat fully to the ground to perform your lift, try offsetting your legs with the strongest leg forward Contract your abdominal muscles Lift the head first then the hips when rising up, in order to keep the back straight

93 Consider a two-stage approach for lifts that begin below knuckle height; lift from the lowest position to an intermediate height, then reposition and lift to the final height Pivot with feet instead of twisting with your back Use palms up grip/ to use biceps

94 Identify the primary worker Primary worker explains procedure to the client Both workers will place themselves on either end of the stretcher. Tallest worker at the head The handles of the stretcher are grasped with palms up The primary worker will instruct the other worker(s) that they will lift the stretcher into a loading position by using the command words”1-2-3-Lift” During the lift the worker on the foot end of the stretcher while gripping the handle will pull the release trigger to lower the legs of the stretcher

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96 Identify the primary worker Primary worker explains procedure to the client Both workers will place themselves on either end of the Scoop Stretcher Both workers will ready themselves by getting into a lifting position and grasping the handles of the Scoop Stretcher with palms up

97 The primary worker will instruct the other worker(s) that they will lift the scoop stretcher by using the command words”1-2-3-Lift” Client should be lifted onto a stretcher for transport. The stretcher should be at waist height in the comfort zone of the tallest worker and have the wheels locked when possible

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99 Use a spotter to communicate location of steps and other hazards Use as many staff as possible to do action safely Taller person at foot end to maintain load in comfort zone Use stair chair whenever possible when doing stairs

100 Identify the primary worker Primary worker explains procedure to the client Both workers will place themselves on either end of the Stair Chair. The taller of the two workers should be at the foot end to maintain load in comfort zone Assist client onto the Stair Chair both workers will ready themselves by getting into a lifting position and grasping the handles of the Stair Chair with palms up

101 When both workers and client are ready, the primary worker will instruct the other worker(s) that they will tilt the client into position by using the command words” Tilt” Once the client is tilted back ready to go up or down the stair the primary worker will instruct the other worker(s) that they will lift the Stair Chair by using the command words”1-2-3-Lift”

102 It’s Your Move – Safe Client Handling does not recommend manual lifting. However, there are some situations where manual client handling and moving is required. A manual lift is appropriate: for the client whose medical treatment or quality of life is being compromised due to their position on a particular surface in an evacuation situation (e.g., due to a fire or chemical spill) in an emergency situation where a clear airway is vital to the client’s survival in a disaster situation where several victims are involved, and decisions are being made as to transportation and delivery of clients to specific areas and/or treatment surfaces/centres

103 A transfer sheet, rescue seat, lift sheet, back board or spine board should be used if available and if time permits during a manual lift

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105 -It constructed of tough reinforced vinyl that is easy to clean and resists blood and bodily fluids. -Four handles assist in moving patient short distances -The Rescue Seat can remain underneath the patient when placed onto cot to avoid additional transfer. -The rescue seat can frequently be used in place of an extremity lift/carry. -Weight limit of 350lbs/159kgs

106 -Special ordered by AHS to ensure a 1000lbs carrying capacity -Has multiple hand holds to facilitate additional staff to assist with lifting -Can be used for bariatric patients, confined space rescue or basic floor to cot lifts

107 Procedure for manual lift, supine, from floor to stretcher While kneeling on the floor, the workers Log Roll the client on to a secure lift sheet, emergency evacuation blanket, canvas stretcher or rigid full-length board with grip handles The four workers position themselves two on each side and near the corners of the client’s body. The tallest two workers should be near the head of the client so that the client’s head remains elevated throughout the lift It is critical that workers use good body mechanics during an emergency manual lift.

108 Kneeling on one knee, each worker grasps the sheet using a palms-up grip with wrists properly aligned and rolls it as closely as possible to the client and/or grasps the board appropriately The primary worker counts “1-2-3-Lift” and everyone stands on the “Lift” command The workers move in unison to position the client over the stretcher. On the primary worker’s count of “1-2-3-Down,” the team lowers the client on to the stretcher As time allows, and as appropriate, the assistive device is removed from under the client by Log Rolling the client from side to side

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110 Communication is key! Command!

111  Questions  Evaluations  Certificates  Additional Resources  Updates

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