BODY MECHANIC, POSITIONING, TURNING, MOVING,AND TRANSFERING PATIENTS

Objectives of lecture By the end of lecture you be able to : demonstrate good body mechanic Demonstrate good lifting techniques Identifying proper positioning Explain transfer and move residents

THE IMPORTANCE OF ACTIVITY INCREASES MUSCLE STRENGTH MAINTAINS BODY FLEXIBILITY IMPROVES RESPIRATORY FUNCTION PREVENTS POOLING OF FLUID IN THE LUNGS IMPROVES CIRCULATION HELPS MAINTAIN HEALTHY SKIN PROMOTES EFFECTIVE ELIMINATION AIDS DIGESTION RELIEVES STRESS

COMPLICATIONS OF BEDREST EVERY BODY SYSTEM IS AFFECTED CONTRACTURE AN ABNORMAL SHORTENING OF THE MUSCLE DUE TO LACK OF USE. THE MUSCLE IS FIXED INTO POSITION, IS DEFORMED, AND CANNOT STRETCH. THE PERSON WITH A CONTRACTURE IS PERMANENTLY DISABLED

ATROPHY ATROPHY – A DECREASE IN SIZE OR A WASTING AWAY OF MUSCLE TISSUE. CAUSED BY LACK OF USE

DECUBITUS ULCER A BREAKDOWN IN SKIN TISSUE THAT OCCURS WHEN BLOODFLOW TO AN AREA IS INTERRUPTED

MORE DECUBITI

BODY MECHANICS USING THE BODY IN AN EFFICIENT AND CAREFUL WAY. IT IS EFFICIENT USE OF THE BODY AS AMACHINE AND AS AMEAN OF LOCOMOTION USING GOOD POSTURE AND BALANCE USING THE STRONGEST AND LARGEST MUSCLES FOR WORK

Purpose of body mechanics To use the body in an efficient & safe way Practice body mechanics at all times EVERYONE should use – even residents & families Protects employee & resident

BASE OF SUPPORT THE AREA ON WHICH AN OBJECT RESTS A GOOD BASE OF SUPPORT IS NEEDED FOR BALANCE WHEN LIFTING YOUR FEET ARE YOUR BASE OF SUPPORT STAND WITH YOUR FEET APART FOR A WIDER BASE OF SUPPORT AND MORE BALANCE

BEND YOUR KNEES AND SQUAT TO LIFT A HEAVY OBJECT DO NOT BEND FROM YOUR WAIST

WEARING A BACK SUPPORT WILL HELP YOU TO USE GOOD BODY MECHANICS WHEN LIFTING HEAVY PATIENTS.

For good body mechanics: Bend your knees and squat to lift a heavy object. Hold items close to your body and base of support. Have a wide base of support. Use your larger and stronger muscles. Avoid unnecessary bending and reaching. Face your work area.

Push, slide, or pull heavy objects when you can. Turn your whole body when changing direction of movement. Work with smooth and even movements. Do not lean over a person to give care. Bend your hips and knees to lift heavy objects from the floor. Do not lift objects higher than chest level. Get help from a co-worker if the person cannot assist with turning or moving. Use assist equipment and devices when possible.

BODY ALIGNMENT DEFINED AS POSITIONING BODY PARTS IN RELATION TO EACH OTHER TO MAINTAIN CORRECT BODY POSTURE CORRECT ALIGNMENT HELPS PATIENT FEEL MORE COMFORTABLE AND PREVENTS FATIQUE

BODY ALIGNMENT THE TRUNK OF THE PERSON SHOULD BE IN A STRAIGHT LINE WHEN THE PATIENT IS LYING DOWN

PROPER POSITIONING IN A CHAIR THE PATIENT IN A CHAIR SHOULD SIT UP STRAIGHT THE BACKS OF HIS KNEES SHOULD BE SLIGHTLY AWAY FROM THE SEAT OF THE CHAIR HIS LOWER BACK SHOULD REST AGAINST THE BACK OF THE CHAIR HIS FEET SHOULD EITHER REST ON THE FLOOR OR ON A STOOL

RESTORATIVE EQUIPMENT DESIGNED TO HELP THE PATIENT MAINTAIN CORRECT BODY ALIGNMENT AND PREVENT COMPLICATIONS BED CRADLE KEEPS THE WEIGHT OF THE LINENS FROM PRESSING ON THE PATIENT’S BODY

FOOT BOARD KEEP THE FOOT IN A NATURAL POSITION TO PREVENT FOOT DROP (PLANTER FLEXION)

HELPS PREVENT FOOTDROP FOOT DROP BOOT HELPS PREVENT FOOTDROP

HAND ROLL PERMITS THE HAND TO FLEX SLIGHTLY AND PREVENTS CONTRACTURES OF THE FINGERS

POSITIONING AND TURNING ASSISTING IN POSITIONING AND TURNING IF THE PATIENT IS UNABLE TO CHANGE POSITION INDEPENDENTLY , YOU WILL NEED TO ASSIST . PATIENTS NEED TO BE TURNED EVERY TWO HOURS.

BASIC BODY POSITIONS Lateral position

Fowler’s position is a semi‑sitting position. The spine is kept straight. The head is supported with a small pillow. The arms are supported with pillows. The supine (dorsal recumbent) position is the back‑lying position. The bed is flat. The head and shoulders are supported on a pillow. Arms and hands are at the sides.

Lateral position (side-lying) Prone position The person lies on the abdomen with the head turned to one side. The bed is flat. Small pillows are placed under the head, abdomen, and lower legs. Arms are flexed at the elbows with the hands near the head. Lateral position (side-lying) A pillow is under the head and neck. The upper leg, ankle, and thigh are supported with pillows. A pillow is positioned against the person’s back. A small pillow is under the upper arm and hand.

ORTHOPNEIC POSITION FREQUENTLY USED BY PATIENTS WITH RESPIRATORY PROBLEMS HELPS EXPAND THE CHEST AND LUNGS TO ALLOW MORE OXYGEN TO ENTER

MOVING PERSONS IN BED Protect the skin when moving the person. Friction is the rubbing of one surface against another. Shearing is when the skin sticks to a surface while muscles slide in the direction the body is moving. To reduce friction and shearing: Roll the person or use assist devices. Use a lift sheet (turning sheet), turning pad, large incontinence product, slide board, or slide sheet.

OCCURS WHEN THE PATIENT SLIDES DOWN IN BED SHEARING THE SKIN STICKS TO THE SURFACE BUT THE INTERNAL STRUCTURES ( BONE AND MUSCLE ) SLIDE IN THE DIRECTION THE BODY IS MOVING OCCURS WHEN THE PATIENT SLIDES DOWN IN BED

RAISING THE PATIENT'S SHOULDERS

RAISING THE SHOULDERS WITH TWO HELPERS

ASSISTING A PATIENT TO MOVE UP IN BED IF THE PATIENT CAN ASSIST: HAVE THE PATIENT GRASP THE HEADBOARD AND BEND HIS KNEES PLACE YOUR FOREARMS UNDER HIS SHOULDERS AND KNEES LIFT AT THE COUNT OF THREE

MOVING UP IN BED IF THE PATIENT HAS A TRAPEZE ON THE BED HAVE THE PATIENT GRASP THE TRAPEZE AND BEND AT THE KNEES

USING A LIFT SHEET A LIFT SHEET MAKES LIFTING EASIER HELPS PREVENT FRICTION AGAINST THE PATIENT’S SKIN TAKES TWO WORKERS TO LIFT IF PATIENT CAN HELP HAVE HIM BEND HIS KNEES USE FOR PERSONS WHO CAN NOT HELP WITH THE MOVE

THE PERSON IS MOVED IN SEGMENTS MOVING A PATIENT TO THE SIDE OF THE BED THE PERSON IS MOVED IN SEGMENTS

TURNING A PATIENT

PROPER POSITIONING FOR LATERAL POSITION

LOGROLLING A PATIENT WHO HAS A SPINAL INJURY OR SPINAL SURGERY MUST BE KEPT IN GOOD BODY ALIGNMENT WHEN TURNING. USING A LIFT SHEET THE PERSON IS TURNED IN ONE MOTION. IT TAKES 2 OR 3 PERSONS TO SAFELY LOGROLL A PATIENT.

ASSISTING TO DANGLE DANGLING REFERS TO SITTING ON THE SIDE OF THE BED WITH THE FEET HANGING DOWN

DO NOT LEAVE THE PATIENT ALONE WHEN DANGLING. HAVE THE PATIENT COUGH, DEEP BREATHE, AND EXERCISE THEIR LEG MUSCLES WHEN DANGLING. IF THE PATIENT BECOMES DIZZY LIE HIM DOWN. CHECK THE PERSON’S PULSE AND RESPIRATIONS

ASSISTING THE PATIENT TO TRANSFER

DO NOT ALLOW THE PERSON TO PUT HIS ARMS AROUND YOUR NECK MAKE SURE YOU LOCK THE WHEELS ON THE BED AND WHEELCHAIR

RULES FOR GAIT BELT / TRANSFER BELT APPLY THE BELT AROUND THE PERSON’S WAIST, OVER THE CLOTHING. TIGHTEN THE BELT SO IT IS SNUG. IT SHOULD NOT CAUSE DISCOMFORT OR IMPAIR BREATHING. YOU SHOULD BE ABLE TO SLIDE YOUR OPEN HAND UNDER THE BELT. PLACE THE BUCKLE SLIGHTLY OFF CENTER IN THE FRONT. DO NOT USE WITH PATIENTS WITH FRACTURED RIBS, ABDOMINAL SURGERY, OR HAVING BREATHING DIFFICULTIES

NOTE THE POSITION OF THE CNA’S HANDS ON THE GAIT BELT NOTE HIS USE OF PROPER BODY MECHANICS NOTE THE PLACEMENT OF HIS KNEES AGAINST THE KNEES OF THE PATIENT

YOU NEED AT LEAST 2 STAFF MEMBERS TO SAFELY USE A MECHANICAL LIFT ALSO CALLED HOYER LIFT USED TO TRANSFER PATIENTS WHO ARE PARALYZED, VERY HEAVY, OR DIFFICULT TO MOVE YOU NEED AT LEAST 2 STAFF MEMBERS TO SAFELY USE A MECHANICAL LIFT

MANY FACILITIES HAVE “NO LIFT” POLICIES. A SPECIAL LIFT IS USED TO STAND AND MOVE RESIDENTS IF YOUR FACILITY HAS THIS RESTRICTION.

PARALYZED PERSONS USE A TRANSFER BOARD FOR TRANSFER FROM WHEELCHAIR TO BED

THE WHEELCHAIR IS PLACED AT A RIGHT ANGLE TO THE TOLIET

TRANSFER FROM BED TO STRETCHER TAKES 4 OR MORE STAFF USE A LIFT SHEET OR SLED TO PULL PATIENT OVER ONTO CART

REPOSITIONING A RESIDENT IN A WHEELCHAIR LOCK THE WHEELS AND MOVE THE FOOTRESTS OUT OF THE WAY DO NOT PULL THE RESIDENT UP BY THE ARMS TO AVOID INJURY TO THE RESIDENT USE TWO STAFF MEMBERS

SAFETY MEASURES WITH WHEELCHAIRS ALWAYS LOCK THE BRAKES WHEN TRANSFERRING CLEAN THE WHEELCHAIR ON A REGULAR BASIS MOVE THE FOOTRESTS OUT OF THE WAY WHEN TRANSFERRING

CARDIAC CHAIR GERI-CHAIR

BACK INTO THE ELEVATOR SO THE PATIENT FACES THE FRONT BACK DOWN A RAMP WITH A WHEELCHAIR

TRANSFER THE PATIENT FEET FIRST DOWN A RAMP ENTER THE ELEVATOR HEAD FIRST