بسم الله الرحمن الرحيم Course Title : A/E Radiography Level : 8 Course No : RAD 422 lecture hours/week : 2 Lec Timing :Sunday (11-10) Instructor : Essam Eltom

Primary care of emergency patient ( Patient transfer). The emergency Trolley :contents & uses Types of injuries &fractures complications and management Shock, Types causes & management Injuries especially blunt trauma to chest and abdomen. Head & spine injuries, Types, complications, and management The acute chest, causes and radiographic investigations The acute abdomen,causes and radiographic management. Acute medical conditions investigated with isotopes Low back-ache Emergencies in obstetrical practice Efficiency of different modalities in the management of trauma. Topical outline

Primary care of emergency patient Transference to and handling techniques Lecture.1

References  Frank M. Pierson: Principles & Techniques of Patient Care, Saunders;4 edition /learnzone/1_emertrans/emertrans.htm Useful websites

1.Describe the trolley design and its basic components 2.List the basic safety factors that must be considered when moving a patient. 3.List and identify principles of body mechanics. 4.Identify the components of lifting techniques. 5.Determine the amount of assistance involved with the transfer 6.Discus correct manner of transferring patient: A- from wheelchair to x-ray table B- from x-ray table to wheelchair C- from stretcher to table D- from table to stretcher 8. Explain the safety precautions when examining patients with Foley catheter, IV bottle, and chest drainage system. By the end of this Lecture the student will be able to: Learning Objectives

1.A mean of tilt the trolley top 2.A variable height adjustment 3.A drip stand holder 4.An oxygen bottle holder 5.Brakes on the wheels 6.A radiolucent rubber covered foam mattress capable of being detached to slide across onto an x-ray table 7. An adjustable backrest which can be inclined at various angles 8. A side rests which can be raised and lowered as necessary. The trolley used for transport patient must have certain characteristics to make it suitable for severe injured patients, this include:-

Principle for safe patient transfer 1. Check chart for precaution before transfer to minimize patient pain.

Principle for safe patient transfer 2. Let the patient do as much of the transfer as possible.

The safest way of lifting and moving things is to use these principles of body mechanics: –Center of gravity (pelvic area). –Base of support (the feet). –Body alignment. Using Proper Body Mechanics Principle for safe patient transfer 3. Use wide base of support for your stability.

Principle for safe patient transfer 4. Hold the patient with a transfer belt around the waist.

Principle for safe patient transfer 5. Avoid trunk twisting during transfer

Principle for safe patient transfer Watch the patient for signs of any emergency and take precaution to minimize its effects.

Principle for safe patient transfer 2. Let the patient do as much of the transfer as possible. 1.Check chart for precaution before transfer to minimize patient pain 3. Use wide base of support for your stability. 4. Hold the patient with a transfer belt around the waist. 5. Avoid trunk twisting during transfer. 6. Watch the patient for signs emergency, and take precaution to minimize its effects.

Using the body’s major moveable parts (head, trunk, arms, and legs) in an efficient manner to maintain balance, conserve energy, and avoid strain and injury while performing work. Body mechanics Advantages Of Proper Body Mechanics Prevent injury Reduce energy consumption

Posture The alignment of head, trunk, arms, and legs The proper alignment of the body Coordination of body movement Components Of Good Body Mechanics

Avoid unnecessary bending. Avoid unnecessary lifting. When lifting, face the object you are moving. When changing direction of movement, turn your whole body. Use your strongest muscles to accomplish work. Use your thighs and hips by bending knees when lifting. Use both arms to lift. Principles of Body Mechanics

Move smoothly, avoid movements that are jerky. Hold heavy objects close to the body or stand close to the person or object being moved. If you hold the object away from the body, strain is placed on the muscles of the lower arms. Get assistance if the person or object is too heavy. Increase your base of support by placing your feet slightly apart (eight to ten inches works well for most people). Avoid lifting heavy items above the head. Principles of Body Mechanics

A- Wheelchair transfer Tow persons lift technique Standby assist transfer Hydraulic lift techniques Assisted standing pivot transfer B- Cart transfer (stretcher ) Mechanic of lifting

Standby assist transfer For patient have ability to transfer from a wheelchair to table on their own. 1- Position the wheelchair at a 45 degree angle to table 2- Move the wheelchair footrest out of the way. 3- Be sure that the wheelchair is locked. Then instruct the patient to: 4- Sit on the edge of the wheelchair seat. 5- Push down on the arms of the chair to assist in rising 6- Stand up slowly. 7- Reach out and hold onto the table with the hand close to the table. 8- Hold onto the table with both hand and sit down.

Two Persons Lift For patient cannot bear weight on their lower extremities.

Hydraulic lift techniques : For patients are too heavy to lift manually

Assisted standing pivot transfer For patient who cannot transfer independently

 It is recommended that the IV bottle be kept 18 to 20 in above the level of the vein. Note:  If the bottle is too high, the pressure of the IV fluid can cause it to pass through the vein into surrounding tissues, causing a painful and potentially harmful condition. If the IV bottle is too low, blood may return through the needle into the tubing, form a clot, and obstruct the flow of IV fluid.  For a patient with a Foley catheter, during the radiological examination place the drainage bag and tubing below the level of the bladder to maintain the gravity flow of urine. Note:  Placement of the tubing or bag above or level with the bladder will allow backflow of urine into the bladder. This reflux of urine can increase the chance of urinary tract infection (UTI). Caring of Patients with Foley catheter Caring of Patients with IV bottles

 Chest tubes are used to remove air, blood, or fluid from the pleural cavity.  When examining a patient with a chest drainage system it should always be kept below the level of the patient's chest.  The technologist must take care that the tubes of the chest drainage unit do not kink and do not get caught on radiographic equipment.  The unit must remain below the level of the chest in order to work properly. Caring of Patients with chest drains system

The End – Thank You