Chapter 13: Safe Patient Movement and Handling Techniques

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Body Mechanics
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Body Mechanics
The purpose of a patient transfer is to safely move a patient from one place to another
Safety involves both the PATIENT and the PEOPLE doing transfer
The application of proper lifting and transfer techniques increases job safety
Radiologic imaging professionals who use proper transfer techniques can reduce their injuries and minimize low back pain
Base of Support
Fundamental to good patient handling techniques are the concepts of the base of support, center of gravity, and mobility and stability muscles
The base of support is the foundation on which a body rests
Base of support is the area between the feet, including the plantar surface area, in a standing position
Base of Support 2
A wider stance improves your base of support
Standing with both feet flat on the floor improves the base of support
Standing with feet apart to increase the base of support improves stability
Standing on "tiptoes" decreases surface in contact with the floor and narrows the base of support
Center of Gravity
A hypothetical point area of the body where the mass of the body is centered; gravity works from this area
Typically at level of second sacral segment
Holding heavy objects close to your center of gravity permits easier and safer transfer
Stability can be achieved when a body's center of gravity is over its base of support
Good Body Mechanics
Use good posture
Always keep your body's line of balance close to your center of gravity (below waistline)
Hold object close to body
Bend your knees
Don't twist your trunk
Push rather than pull
Muscles and Transfers
Extremity muscles are classified as MOBILITY MUSCLES.
Muscles of the torso are STABILITY MUSCLES.
For effective patient transfers and handling technologists should use MOBILITY MUSCLES for lifting and STABILITY POSTURAL MUSCLES for support
Transfer Techniques Require Teamwork!
Someone needs to take charge of the transfer
Reviews procedures with team members
Calls the play
Establishes timing of play
Synchronizes play events
Lifting Principles 1
~Lifting should be done by bending and straightening the knees
~The back should be kept straight or in a position of slightly increased lumbar lordosis
~Allow ample time, and handle patients gently
~Always inform the patient of what you are going to do and how you intend to proceed
~When performing a transfer, let patients do as much of the work as possible
~Before executing the transfer, check the patient's chart and verify whether he or she has a restricted weight-bearing status.
~Patients with cognitive impairments, such as dementia, may overestimate their transfer abilities and require assistance.
Lifting Principles 2
~Execute the transfer slowly enough for the patient to feel secure
~The patients center of gravity should be held close to the transfers center of gravity
~Taking a TRANSFER BELT is a good practice when planning to perform transfers
~Avoid loose clothing on the patient
~Let patients perform as much of the transfer as they can
~When lifting patients, keep the back stationary and let the legs do all of the lifting
~Twisting should be avoided
~After the patient is standing help him or her to pivot around to a bed or x-ray table and to sit down.
Orthostatic Hypotension
A sudden drop in blood pressure caused by a change in a patient's body position
More pronounced in patient's who have been bedridden for extended periods
Symptoms of Orthostatic HypotensionDizziness Fainting Blurred vision Slurred speechHow would you minimize Orthostatic Hypotension?Have the patient stand slowly Encourage the patient to talk during the transfer by asking simple questions DO NOT send a symptomatic patient away and risk having the patient faint on the way to his or her roomSkin Damage from TransfersCan occur in as little as 1 to 2 hours May occur going from one surface type to a different surface type Caused by several mechanical factorsWheelchair TransfersDetermine patient's strong and weak sides Always position the patient so that he or she transfers toward the strong side Lock wheelchair locks and move footrests out of the way Four types of wheelchair transfers ~Standby Assist ~Assisted Standing Pivot ~Two-Person Lift ~Hydraulic LiftStandby-AssistUsed for patients who have the ability to transfer from a wheelchair to a table on their own Provide movement instructions to the patient continually during transferAssisted Standing Pivot TransferFor patients who cannot transfer independently but can bear weight on their legs, a standing pivot technique is usedTwo-Person LiftUsed on patients who are light weight and cannot bear weight on their lower extremitiesHydraulic Lift TechniquesUsed for heavy patients Familiarize yourself thoroughly with lift operations before using this type of lift Patients need to be seated on a lift sling before using this type of lift Sending a patient back to the ward to return sitting on a sling is better than risking injury to the patient, the transfer or both by attempting transfer without using a sling Communication is critical to lift successCart (Stretcher) TransfersMake sure cart wheels are locked and immovable Allow patient to assist with move based on the patients ability and condition Cart transfers usually require three people Use transfer aids-draw sheet, sliding board For the actual lateral transfer, both transfer surfaces must be side to side, as close as possible, and at the same heightPatient Transfer with Draw SheetThe transfer personnel should never kneel or stand on the radiographic table to perform this type of transferPatient Positioning ConsiderationsTalk with the patient and explain what you are going to do Let the patient assist as much as possible Check with patient before any move is attempted Provide positioning sponges to help the patient maintain correct positioning Avoid standing or kneeling on the rad. table Work as a transfer team!Radiographic PositioningAlways turn patient toward you Use positioning aids-sponges, blocks, boards, tape,etc.What are the common recumbent patient positions?Supine Prone Lateral Sims Fowler