Transfer Techniques & Immobilization

AKA- Physical Assistance

NMMT 3100 - Introduction To Radiologic Patient Care

Regina Garrard BSNMT, RT (N)
Objectives

 Identify various types of “physical assistance”

 Define the terms of proper body mechanics
 Understand their importance in the transfer process
 Learn the basics of proper lifting and transfer
techniques
 Explain the types of Wheelchair transfers
 Explain standard stretcher transfer techniques
 Identify obstacles and hazards associated with transfers
 Effective use of Immobilization techniques and devices
Physical Assistance
 Patient Transfers
 Assistance with undressing/dressing
 Other types of assistance
 Securing patient property
 Elimination needs
 Directions
Physical Assistance
Body Mechanics
 Good Body Mechanics
 Accomplished when you perform task efficiently, safely,
and with little energy as possible
 General Suggestions http://healthandfit
 Provide a broad base of support ness101.com/wp-
content/uploads/2
 Work at a comfortable height
008/05/lifting-
 When lifting, bend your knees and pic.jpg
keep your back straight
 Keep your load well balanced and
close to your body
 Roll or push heavy objects to avoid lifting

Proper Lifting Technique Video

http://www.youtube.com/watch?v=O34RzoBLYxo
BIOMECHANICS - The study of the laws of physics, specifically
the laws of mechanics, as they apply to living bodies at rest and in motion.
BACK INJURY
Types of Patients

 Ambulatory
 Able to walk on one's own

 Non-ambulatory
 Not able to walk; bed ridden

 And somewhere in between

Principles for Safe Transfer

 Check the patient’s chart for restriction on movement or diagnoses that would
need to be considered during transfer

 Let the patient do as much of the work as they are physically able to do

 Use a wide base of support for your stability

 Hold the patient’s center of gravity close to your center of gravity

 Lift with your legs, avoid back bending and trunk twisting during transfer

 Never lift more than you can, Ask for assistance when needed

 Watch the patient for any adverse affects from the move such as orthostatic
hypotension, pain or displacement of accessories or attachments
Types of Transfers
 Wheelchair Transfers
 Standby Assisted Transfer
 Assisted Standing Pivot Transfer
 Two-Person Lift
 Hydraulic Lift Transfer

 Stretcher (cart) Transfers

Wheelchair Transfers

 Remove footrests out of the way

Standby
Assisted  Lock the wheelchair
Transfer  Position wheelchair (45 degree angle)
 Determine the level of assistance required
 Instruct the patient in single-step commands
 Provide a stepstool if needed
 Monitor patient for any physiologic
symptoms that may indicate “orthostatic
hypotension”
Wheelchair Transfers cont'd

 Patients who can bear weight but need a higher

Assisted level of assistance
Standing  Remove footrests out of the way
Lock the wheelchair
Pivot 

 Position wheelchair as before with patient’s stronger

Transfer side closest to the table
 Use transfer belt if available
 Using appropriate body mechanics, assist patient to
a standing position
 Monitor patient for any signs of orthostatic
hypotension
 As a unit, pivot toward the table and assist patient
into a sitting position.
 Assisted Standing Pivot Transfer

http://youtu.be/riUyl8vJxBo
Wheelchair Transfers cont'd

 Patient’s who are unable to bear weight

Two-
 Lock wheelchair, swing away or remove leg rests,
Person and remove armrests
Lift  Verbally plan out the transfer procedure
 Have patient cross arms over chest
 Stronger person - Reach under the patient’s axillae
grasping the patient’s crossed forearms
 The second person - squat in front of the patient
cradling their thighs and claves
 On command, lift the patient clearing the wheelchair
and move as a unit to the desired destination
Two- Person Lift

http://youtu.be/jMNOFCuiqLI
Wheelchair Transfers cont'd

 Patients too heavy to lift manually

Hydraulic
 Familiarize yourself with equipment and
Lift practice prior to using on a patient
 Place transfer sling underneath the patient
 Connect transfer sling to the device
 Gently raise the patient clearing the wheel
chair and move it out of the way
 Carefully position patient on the table and
disconnect the sling from the lift
 Leave the sling underneath the patient if
possible
 Move the lift to proceed with imaging
Hydraulic Lift

https://youtu.be/LyAZDXg3QPA
http://youtu.be/JIsr6dHg2dQ
 Stretcher Transfers

 Patients who are unable to travel upright

 May be done with or without a moving device
 A minimum of three people is recommended to execute a stretcher to
table transfer
 Position the stretcher along side the table (on the least affected side
when possible)
 Lock the stretcher and lower the side rails
 Position the moving device according to “that” devices instructions
 Move the patient onto the table following the instructions for the
device you are using
 Remove the device from under the patient, again, using the instructions
for the device you are using
 Return the patient to the stretcher using the same steps in reverse
Stretcher Transfers

http://youtu.be/30CffwVhqxQ
https://youtu.be/IFHriQpQB50
https://youtu.be/AUSJ-9O8XYo
https://youtu.be/bwcpHKZtiM4
Additional Transfer Videos

http://youtu.be/DIPqoyhyGQY

http://youtu.be/NYzMmYA-dJY
Transferring Patients: “Special Considerations”
Assistance with Undressing/Dressing

 Ambulatory Patients
 Show them where the dressing area is
 Explain how you want them to undress
 How to put on the gown
 Where to put their personal items
 Non-ambulatory Patients
 Allow family members to assist them if available
 Maintain patient’s privacy and dignity at all times
 May need special assistance if they have IV fluids etc.
Other Types of Physical Assistance Elimination Needs
Assistance with Elimination Needs

 Ambulatory Patients
 Assist to the restroom and point out “call” light
 Wait outside and check on the patient periodically
 Check medical record to see if output needs to be
collected or recorded
Assistance with Elimination Needs cont’d

 Non-ambulatory patients
 Bedpans-used for defecation and female urination
 Standard and fracture
o Put smaller end toward feet (standard Bedpan)
o Have patient bend knees and raise hips. If unable to raise hips,
roll patient to one side and place underneath hips
o Raise them semi-upright, if possible
o Give them toilet tissue and keep them covered
o Provide privacy, but don’t leave patient totally unattended
o Use gloves and dispose of contents (if not collecting)
o Assisted with cleaning if needed
Assistance with Elimination Needs cont’d

 Urinals
 Male and Female
o Provide patient with the urinal and sit them up if needed or
possible; or on their side
o Provide assistance with using the urinal if needed
o Provide privacy but do not leave patient unattended
o Check medical record to see if output needs to be collected or
recorded; if not
o Use gloves to dispose of contents

http://www.youtube.com/watch?v=zWTANcRXT1Y
http://youtu.be/dPA8lXZ26pA
POSITIONING AND
IMMOBILIZATION TECHNIQUES

NOT Just For X-ray!

Applications

 Minimize motion

 Increase accuracy

 Reduce exposure

 Patient comfort
Positioning and Immobilization devices

 Positioning sponges

 Velcro straps

 Restraints
 Commercial
 Noncommercial

 Immobilization Devices