pivot transfers

what are transfers?

safe and controlled movement of a patietn from one surface to another

what are the types of pivot transfers?

• dependent

• hoyer lift

• assisted

• indipendent

• lateral transfers

• vertical

• squat pivot

• stand pivot

• transfer boar

what is a gait belt

• transfer belt, walking belt

• safety device used fo rmobility stkills

• typically used during transfers and gait

• many facilites have guidelines of when to use

• helps reduce the risk of injury to the patient and clinician

what do gait belts do for patients?

• prevent patient from falling

• assist patient if falling

• prevent clinician from grabbing body parts

what are indiciations you might use a gait betl?

• weak patietns

• unstable patients

• fall risk

• unsure of funcitonal ability

• facility guidelines

what are the guidelines to fitting a gait belt

• snug - if the patient slides downward or fall, the belt is prevent from sliding upward on the patietn

• generally place at the narrow part of the waist jst above the pelvis

• upward movement of the belt will be limited by the wider rib cage

• avoid acute surgical incisions and lines and tubes

• CCDD

when do you fit a gait belt

• typically applied and remove while the patient is seated

• after stnading, adjustment typically needed

• buckled should be in front and slightly to one side

• placed over clothing not bare skin

• metal teeth in front and metla flap closer to the patient

• should be able to slide two fingesr between the belt adn patient’s clothing

what are the guidelines to gripping a gait belt

• always be held with a supinated or underhand grip

• slips more easily out of pronated or pinching grip

• never warp loose belt around wrist to snug the fit because injury to the wrist and hand is likely if the patients falls

who are canididates for pivot transfers

• able to bear weight safely through 1 LE

• respond to instructions

• follow cueing

where is the main action taking place in pivot transfers?

through the feet

how are pivot transfers usually named?

based in direction of hios to target surface

how do patients stand piviot? (one sentence)

patient stands erect, turns, sits

how do patients squat pivot? (one sentence)

partial erect posture during the turn

how do prepare the enviornment for a pivot transfer?

• set up enviornment

• ensure appropriate footwear

• remove obstacles, including legrest and armrest if possible

• equalize surface heights

• secure both surfaces

what are the different ways you move forward in a chair

• up and forward lift

• alternate weight shifting

• forward hip slide

• AMAP/ANAP

what should you keep in mind for feet during pivot transfers

• foot position

• non slip footwear or shoes

• beneath center of mass

  • far back as possible

  • remaining flat

• prepared for directional change

  • lead foot slightly forward and slight angle

what do you say to prepare a patient for a forward trunk lean?

• bring your nose over your toes

• make your forehead touch my hand

• CCDD

what are some things to keep in mind with hand placement for arms and hands

• can differ from squat pivot and stand pivot

• encourage patient to push down on arm rest

• patients hands posterior to trunk

• dont want to leave arms/hands hanging free

what are the downsides to leaving patients arms hanigng free

can hald clinician’s forearms or hips

instead of allowing a patients hand sot hang free, what can they do?

• cross arms in front of chest

• patinets can use stronger arm to hold weaker arm in front of chest

what should you be careful of

• the fear grip

• do not allow patient to place hands around neck

• the rigid locked arm that wont move

what should a clinicians foot position be?

• front of patient with hips and knees flexed

• wide BOS

• feet staggered, slightly mimicking patient's foot position

• inner foot (near target surface) slightly posterior

• outer foot slightly anterior

what should a clinicians hand placement be?

• graps gait belt underhand, either side of patients lumbar spine’

• without gait belt - under patients hios

• promotes extension when standing

• CCDD

what are the basic components to any pivot transfer

• rising

• pivoting

• sitting

what are the basic component to squat pivot transfers

• lift shift and lower

• discrete portions with pauses

what are the basic components to stand pivot transfers?

• stand, turn and sit

• continous

why should you block the patients knees

• to provide LE support

• prevent falls

• provide stability

• can block one or both knees

how should you help a patient rise?

• patient pushes down thorugh the feet and arms

• clinician leans posteriorly and grps the gait belt

• patient leans forward

what should you do if a patient is dizzy upon standing?

• immedeatly stop and ask them to rest

• wait 5 minutes

• retake vitals

how do you aid a patient to sit, what part of the body does it require them to use?

• requires kip flexion similair to rising

• trunk lean forward

• patient reaches for the arm rests or target seating surface

• clinician leverages body weight against the knees helping with controlled lowering

when is a transfer complete?

• patient secure and comfortable

• replace wheelchair armrests and legrests

• place feet on footplates

• positioned properly in bed

• can reach emergency call button

• access to other important items