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Body mechanics:

(moving a patient)
04:03:2010

0bjectives:
Carry out a full assessment of the environment,
the patient, and other helpers before moving or
changing a patients position.
Apply the basic principle of, and guide-lines for
body mechanics, that will enable him\her to move
and change the position of patients with different
degrees of helplessness.
Evaluate the patient on an ongoing basic regarding
safety, comfort and mobility needs, and report on
these aspects

Basic principles of
body:

Good body alignment not only contribute to the ones outer


appearance-it also promotes health and prevent back injuries.
A broad base of support ensure stability.
A nurse who is fit runs less risk of back injuries than one who is
unfit.
Warming up exercises can prevent muscle injuries.
Keep the back straight and bend the knees
The nurse must not over-exert herself in an attempt to keep
patient erect.
The nurse must prepare him\herself physically and psychologically
before lifting a heavy object or a patient
The nurse must use her own weight to overcome the weight of the
patient or object.
Movement should be smooth and rhythmic
The working surface must be at a comfortable level

Procedure for transferring


a patient from the bed to
a wheelchair

Action
Push the wheelchair to the side of the bed and lock the brakes.
Remove the armrest nearest the bed
Push back the footplate
Help the patient into a sitting position with his legs dangling over the edge of the
bed.
Make sure that the patient is not dizzy
Ask the patient to move forward and sit on the edge of the bed. He should lean
forward from the hips and put the foot of the strongest leg behind the other
Ask the patient to place his arms on your shoulders
Place your hands on both sides of his chest or behind her scapulae
Flex your hips, knees and ankles and stand with one foot in front of the other
Contract your abdominal, gluteal, femoral and arm muscles
Count to three while you and the patient stand up together.
Help the patient to sit deep in the wheelchair
Replace the armrest and footplate.

Procedure for helping a


patient from a wheelchair
to the bed.

Action
Push the wheelchair to the bed with its front forming a slight angle with
the bed.
Lock the brakes and push the footplate back
Remove the armrest nearest the bed
The taller nurse stands behind the wheelchair with one foot in front of the
other. Bend the front knee
Ask the patient to fold his arms across his chest while the nurse places her
arms an in his axillae, firmly grasping his arms
The other nurse stands at the side of the wheelchair with the armrest in
place, also with one foot in front of the other. Place one arm under the
patients thighs and support his lower back your other arm.
Both nurse contract their abdominal, gluteal, femoral and arm muscles
Count to three and lift the patient simultaneously, while moving to the bed
Position the patient on the bed and position comfortably .

Procedure for one nurse to


help a patient onto a
bedpan

Put the bedpan on the stool at the foot of the bed and remove the cover.
The patient may lie on back with two pillows or supine. Pull down his pants
and fold down the bedclothes without completely exposing the patient
Stand at the right side of the bed opposite the patients buttocks
Broaden your base of support by placing the left foot in front of the right
Ask the patient to flex his knees and pull his legs as close as possible to his
trunk
Place your left hand under the patients sacrum with the palm uppermost,
while resting the forearm on the bed
Place the bedpan on the bed next to the patient and ask him to dig in his
heels and lift his buttocks when you have counted to three.
Contract your abdominal, gluteal , femoral and arm muscle
Count to three, bend your knees and sink down
Push the bedpan into the position with your right hand

Procedure for transferring


a patient from a stretcher
to a stretcher

Action
Three persons are needed to transfer an adult patient horizontally
The tallest person takes the head and shoulders (upper thorax).
The shortest one takes the legs and the middle one the trunk ( the
heaviest part of the body).
The stretcher or trolley must be at the same level as the bed and
is placed at the right angle to the bed, head almost at foot of the
bed.
Check to make sure the brakes of the trolley and bed are on
Co-ordinated movements of the helpers are essential.
All three of them stand at the side where the trolley has been
pushed at right angles to the foot of the bed, facing the patient.
Feet nearest the patients feet in front. Fold the patients arms
on his chest.

Carrying methods and log


roll

By: Mr. GJ Thamae

Objectives:
The objectives of the log roll
procedure is to maintain correct
anatomical alignment in order to
prevent the possibility of further,
catastrophic neurological injury and
the prevention of pressure sores.

Procedure:
The log rolling procedure is implemented at
various stages of the trauma patients\ the
casualty management\interventions include the
following:
As part of the primary and secondary survey to
examine the casualtys back
As part of bed to bed transfer
To apply a cervical collar or pressure area care
To facilitate chest physiotherapy

What is required????
1staff member to hold the casualtys head
2 staff members to support the chest,
abdomen and lower limbs. An additional
staff member may be also required when
log rolling trauma casualtys who are obese,
tall, or have lower limb injuries
1 staff member to perform the required
procedure ( e.g. assessment of the
patients back.

Steps:1
Explain the procedure to the patient
regardless of conscious state and ask
the patient to lie still, and refrain
from assisting. Ensure that the collar
is well fitting prior to
commencement.

Step 2
. If applicable, ensure that devices
such as indwelling catheters,
intercostal catheters, ventilator
tubing etc. are repositioned to
prevent overextension and possible
dislodgement during repositioning.

Step:3
If the patient is intubated or has a
tracheostomy tube, airway suctioning
prior to log rolling is suggested, to
prevent coughing which may cause
possible anatomical malalignment during
the log rolling procedure.

Step:4
The bed must be positioned at a
suitable height for the head holder
and assistants.

step:5
The patient must be supine and
anatomically aligned prior to
commencement of log rolling
procedure.

Step:6
The patients proximal arm must be
adducted slightly to avoid rolling onto
monitoring devices eg. arterial or
peripheral intravenous lines. The
patients distal arm should be extended
in alignment with the thorax and
abdomen or bent over the patients
chest if appropriate ie. if the arm is
uninjured. A pillow should be placed
between the patients legs

Step:07
Assistant 1, the assistant supporting
the patients upper body, places one
hand over the patients shoulder to
support the posterior chest area, and
the other hand around the patients
hips.

Step:08
Assistant 2, the assistant supporting
the patients abdomen and lower
limbs, overlaps with assistant 1 to
place one hand under the patients
back, and the other hand over the
patients thighs .

Step:09
On direction from the head holder,
the patient is turned in anatomical
alignment in one smooth action.

Pictures:

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