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Chapter 13: Safe Patient Movement and Handling Techniques

Objectives (1 of 2)

  • Injury Reduction Factors: Identify four factors contributing to reduced injuries during patient handling and explain their significance.

  • Body Mechanics Definition: Understand key concepts of body mechanics relevant to patient movement.

  • Orthostatic Hypotension: Describe the causes, signs, symptoms, and treatments associated with orthostatic hypotension.

  • Lifting and Transfer Principles: Learn the basic principles of safe lifting and transfer techniques.

Objectives (2 of 2)

  • Wheelchair-to-Bed Transfers: Illustrate or explain four methods of transferring patients from a wheelchair to a bed.

  • Cart Transfer Procedure: Provide an explanation or demonstration of transferring a patient using a standard cart procedure.

  • Standard Patient Positions: Identify five standard positions for patients.

  • Medical Equipment Impact: List commonly attached medical equipment and describe its influence on patient movement.

Body Mechanics

  • Safety in Transfers: The primary goal of patient transfers is to ensure safety for both the patient and the transferring personnel.

  • Proper Technique Importance: Utilizing proper lifting and transfer techniques enhances safety and reduces injury risk, especially for radiologic imaging professionals.

Good Body Mechanics

  • Posture: Maintain good posture throughout lifting and transferring.

  • Center of Gravity: Keep the body's line of balance close to the center of gravity, which is located below the waistline.

  • Object Handling: Hold objects close to the body for stability and safety.

  • Knee Bending: Bend at the knees to lift rather than using the back.

  • Avoid Twisting: Prevent back injuries by avoiding twisting movements.

  • Pushing vs. Pulling: It is safer to push rather than pull loads when transferring patients.

Proper Patient Handling Requirements

  • Base of Support: Establish a strong base of support for effective transfers.

  • Awareness of Gravity: Recognize and utilize your center of gravity.

  • Correct Muscle Use: Engage appropriate muscles for lifting and maintaining stability during transfers.

Base of Support

Importance

  • Stability Foundation: A wide base of support is crucial for maintaining balance and stability during transfers.

Techniques to Enhance Base of Support

  • Foot Positioning: Stand with feet flat on the ground and apart to enhance stability.

  • Stance Variations: Increasing the distance between feet improves the base of support.

Center of Gravity

Definition

  • Hypothetical Point: The center of gravity refers to a theoretical point in the body where mass is concentrated, traditionally at the second sacral segment (S-2).

Stability Concept

  • Holding heavy items near the center of gravity facilitates easier and safer movement, enhancing stability during transfers.

Muscles and Transfers

  • Mobility Muscles: Extremity muscles, such as the biceps brachii and hamstrings, are designated as mobility muscles for lifting.

  • Stability Muscles: Torso muscles, including the rectus abdominis and erector spinae, are crucial for maintaining stability during patient handling.

Lifting Principles (1 of 4)

  • Knee Technique: Always lift by bending and straightening your knees while keeping your back straight.

  • Gentle Handling: Handle patients gently and allow sufficient time for transfers.

  • Patient Communication: Inform patients about the transfer process to enhance their understanding and cooperation.

Lifting Principles (2 of 4)

  • Patient Assistance: Encourage patients to perform as much of the transfer as they are able to enhance their comfort and cooperation.

  • Check Medical History: Always verify a patient’s weight-bearing restrictions before a transfer.

Lifting Principles (3 of 4)

  • Slow Transfers: Execute transfers slowly, securing the patient's center of gravity close to the mover's center of gravity for safety.

  • Use of Transfer Belts: Employ transfer belts to secure patients effectively during movement.

Lifting Principles (4 of 4)

  • Avoid Twisting: Keep the back stable and avoid twisting during lifts.

  • Patient Pivoting: Assist the patient in pivoting to a chair or table following standing to ensure safe seating.

Orthostatic Hypotension (1 of 2)

  • Condition Definition: A sudden decrease in blood pressure due to changes in body position, more severe in bedridden patients.

  • Symptoms: Includes dizziness, fainting, blurred vision, and slurred speech.

Orthostatic Hypotension (2 of 2)

  • Minimizing Risks: To mitigate effects, patients should be encouraged to stand slowly.

  • Communication During Transfer: Involve the patient in conversation during transfers to maintain their engagement and focus.

Transfer Techniques Require Teamwork!

  • Team Leadership: Designate someone to lead the transfer process, controlling timing and synchronization of events.

Wheelchair Transfers

  • Patient Strong/Weak Sides: Identify and position the patient to transfer towards their stronger side.

  • Transfer Types: Include standby assist, assisted standing pivot, two-person lift, and hydraulic lift.

Standby-Assist Transfer

  • Patient Independence: Applicable for patients capable of transferring themselves; provide continuous instructions during the process.

Assisted Standing Pivot Transfer

  • Execution Steps: Utilize a transfer belt for safety, with the assistant guiding the patient from the wheelchair to the table while maintaining a proper posture.

Two-Person Lift

  • Team Coordination: Involves two caregivers supporting and transferring the patient simultaneously, ensuring coordinated efforts.

Hydraulic Lifts

  • Purpose: Used for patients who are too heavy for manual lifting, using hydraulic fluid for support.

  • Features: Familiarize with adjustable bases and other standard features critical for safe operation.

Hydraulic Lift Techniques

  • Preparation: Confirm that patients are properly seated or reclined on the lift sling before use.

Cart Transfers

  • Preparation Steps: Ensure cart wheels are locked and patient transfer surfaces are side by side and level for effective moving.

Cart-to-Table Transfer Technique**

  • Device Use: Often employs a transfer assist device to facilitate safe lateral transfer from a cart to a table.

Patient Transfer with Draw Sheet

  • Team Support: Involve multiple caregivers ensuring support at the upper body, pelvic girdle, and legs to facilitate safe movement during table transfers.

Skin Damage from Transfers

  • Vulnerability: Skin damage can occur rapidly, especially in elderly patients, due to mechanical factors associated with transfers.

Common Recumbent Patient Positions

  • Positions Identified: Supine, prone, lateral (including Sims’, Fowler's, and variations) to ensure optimal patient care and comfort.

Patient Positioning Considerations

  • Communication: Constantly engage with the patient regarding their movements and comfort.

  • Team Approach: Work collaboratively with team members during patient transfers and positioning to enhance safety.

Conclusion

  • Teamwork and Communication: Effective communication with both patients and team members is essential for safe transfers.

  • Safety Practices: Utilize broad support bases and correct techniques, ensuring patients can assist wherever possible.