1. BODY MECHANIC, POSITIONING, TURNING, MOVING,AND TRANSFERING PATIENTS

2. Objectives of lecture By the end of lecture you be able to :
demonstrate good body mechanic
Demonstrate good lifting techniques
Identifying proper positioning
Explain transfer and move residents

3. THE IMPORTANCE OF ACTIVITY
INCREASES MUSCLE STRENGTH
MAINTAINS BODY FLEXIBILITY
IMPROVES RESPIRATORY FUNCTION
PREVENTS POOLING OF FLUID IN THE LUNGS
IMPROVES CIRCULATION
HELPS MAINTAIN HEALTHY SKIN
PROMOTES EFFECTIVE ELIMINATION
AIDS DIGESTION
RELIEVES STRESS

4. COMPLICATIONS OF BEDREST
EVERY BODY SYSTEM IS AFFECTED
CONTRACTURE
AN ABNORMAL SHORTENING OF THE MUSCLE DUE TO LACK OF USE.
THE MUSCLE IS FIXED INTO POSITION, IS DEFORMED, AND CANNOT STRETCH.
THE PERSON WITH A CONTRACTURE IS PERMANENTLY DISABLED

5. ATROPHY
ATROPHY – A DECREASE IN SIZE OR A WASTING AWAY OF MUSCLE TISSUE.
CAUSED BY LACK OF USE

6. DECUBITUS ULCER
A BREAKDOWN IN SKIN TISSUE THAT OCCURS WHEN BLOODFLOW TO AN AREA IS INTERRUPTED

7. MORE DECUBITI

8. BODY MECHANICS USING THE BODY IN AN EFFICIENT AND CAREFUL WAY.
IT IS EFFICIENT USE OF THE BODY AS AMACHINE AND AS AMEAN OF LOCOMOTION
USING GOOD POSTURE AND BALANCE
USING THE STRONGEST AND LARGEST MUSCLES FOR WORK

9. Purpose of body mechanics
To use the body in an efficient & safe way
Practice body mechanics at all times
EVERYONE should use – even residents & families
Protects employee & resident

10. BASE OF SUPPORT THE AREA ON WHICH AN OBJECT RESTS
A GOOD BASE OF SUPPORT IS NEEDED FOR BALANCE WHEN LIFTING
YOUR FEET ARE YOUR BASE OF SUPPORT
STAND WITH YOUR FEET APART FOR A WIDER BASE OF SUPPORT AND MORE BALANCE

11. BEND YOUR KNEES AND SQUAT TO LIFT A HEAVY OBJECT
DO NOT BEND FROM YOUR WAIST

12. WEARING A BACK SUPPORT WILL HELP YOU TO USE GOOD BODY MECHANICS WHEN LIFTING HEAVY PATIENTS.

13. For good body mechanics:
Bend your knees and squat to lift a heavy object.
Hold items close to your body and base of support.
Have a wide base of support.
Use your larger and stronger muscles.
Avoid unnecessary bending and reaching.
Face your work area.

14. Push, slide, or pull heavy objects when you can.
Turn your whole body when changing direction of movement.
Work with smooth and even movements.
Do not lean over a person to give care.
Bend your hips and knees to lift heavy objects from the floor.
Do not lift objects higher than chest level.
Get help from a co-worker if the person cannot assist with turning or moving.
Use assist equipment and devices when possible.

15. BODY ALIGNMENT
DEFINED AS POSITIONING BODY PARTS IN RELATION TO EACH OTHER TO MAINTAIN CORRECT BODY POSTURE
CORRECT ALIGNMENT HELPS PATIENT FEEL MORE COMFORTABLE AND PREVENTS FATIQUE

16. BODY ALIGNMENT
THE TRUNK OF THE PERSON SHOULD BE IN A STRAIGHT LINE WHEN THE PATIENT IS LYING DOWN

17. PROPER POSITIONING IN A CHAIR
THE PATIENT IN A CHAIR SHOULD SIT UP STRAIGHT
THE BACKS OF HIS KNEES
SHOULD BE SLIGHTLY AWAY
FROM THE SEAT OF
THE CHAIR
HIS LOWER BACK SHOULD REST AGAINST THE BACK OF THE CHAIR
HIS FEET SHOULD EITHER REST ON THE FLOOR OR ON A STOOL

18. RESTORATIVE EQUIPMENT
DESIGNED TO HELP THE PATIENT MAINTAIN CORRECT BODY ALIGNMENT AND PREVENT COMPLICATIONS
BED CRADLE
KEEPS THE WEIGHT OF THE LINENS FROM PRESSING ON THE PATIENT’S BODY

19. FOOT BOARD
KEEP THE FOOT IN A NATURAL POSITION TO PREVENT FOOT DROP (PLANTER FLEXION)

20. HELPS PREVENT FOOTDROP
FOOT DROP BOOT
HELPS PREVENT FOOTDROP

21. HAND ROLL
PERMITS THE HAND TO FLEX SLIGHTLY AND PREVENTS CONTRACTURES OF THE FINGERS

22. POSITIONING AND TURNING
ASSISTING IN
POSITIONING AND TURNING
IF THE PATIENT IS UNABLE TO CHANGE POSITION INDEPENDENTLY , YOU WILL NEED TO ASSIST .
PATIENTS NEED TO BE TURNED EVERY TWO HOURS.

23. BASIC BODY POSITIONS
Lateral position

24. Fowler’s position is a semi‑sitting position.
The spine is kept straight.
The head is supported with a small pillow.
The arms are supported with pillows.
The supine (dorsal recumbent) position is the back‑lying position.
The bed is flat.
The head and shoulders are supported on a pillow.
Arms and hands are at the sides.

25. Lateral position (side-lying)
Prone position
The person lies on the abdomen with the head turned to one side.
The bed is flat.
Small pillows are placed under the head, abdomen, and lower legs.
Arms are flexed at the elbows with the hands near the head.
Lateral position (side-lying)
A pillow is under the head and neck.
The upper leg, ankle, and thigh are supported with pillows.
A pillow is positioned against the person’s back.
A small pillow is under the upper arm and hand.

26. ORTHOPNEIC POSITION
FREQUENTLY USED BY PATIENTS WITH RESPIRATORY PROBLEMS
HELPS EXPAND THE CHEST AND LUNGS TO ALLOW MORE OXYGEN TO ENTER

27. MOVING PERSONS IN BED Protect the skin when moving the person.
Friction is the rubbing of one surface against another.
Shearing is when the skin sticks to a surface while muscles slide in the direction the body is moving.
To reduce friction and shearing:
Roll the person or use assist devices.
Use a lift sheet (turning sheet), turning pad, large incontinence product, slide board, or slide sheet.

28. OCCURS WHEN THE PATIENT SLIDES DOWN IN BED
SHEARING
THE SKIN STICKS TO THE SURFACE BUT THE INTERNAL STRUCTURES ( BONE AND MUSCLE ) SLIDE IN THE DIRECTION THE BODY IS MOVING
OCCURS WHEN THE PATIENT SLIDES DOWN IN BED

29. RAISING THE
PATIENT'S SHOULDERS

30. RAISING THE SHOULDERS
WITH TWO HELPERS

31. ASSISTING A PATIENT TO MOVE UP IN BED
IF THE PATIENT CAN ASSIST:
HAVE THE PATIENT GRASP THE HEADBOARD AND BEND HIS KNEES
PLACE YOUR FOREARMS UNDER HIS SHOULDERS AND KNEES
LIFT AT THE COUNT OF THREE

32. MOVING UP IN BED
IF THE PATIENT HAS A TRAPEZE ON THE BED HAVE THE PATIENT GRASP THE TRAPEZE AND BEND AT THE KNEES

33. USING A LIFT SHEET A LIFT SHEET MAKES LIFTING EASIER
HELPS PREVENT FRICTION AGAINST THE PATIENT’S SKIN
TAKES TWO WORKERS TO LIFT
IF PATIENT CAN HELP HAVE HIM BEND HIS KNEES
USE FOR PERSONS WHO CAN NOT HELP WITH THE MOVE

34. THE PERSON IS MOVED IN SEGMENTS
MOVING A PATIENT TO
THE SIDE OF THE BED
THE PERSON IS MOVED IN SEGMENTS

35. TURNING A PATIENT

36. PROPER POSITIONING FOR LATERAL POSITION

37. LOGROLLING
A PATIENT WHO HAS A SPINAL INJURY OR SPINAL SURGERY MUST BE KEPT IN GOOD BODY ALIGNMENT WHEN TURNING.
USING A LIFT SHEET THE PERSON IS TURNED IN ONE MOTION.
IT TAKES 2 OR 3 PERSONS TO SAFELY LOGROLL A PATIENT.

38. ASSISTING TO DANGLE
DANGLING REFERS TO SITTING ON THE SIDE OF THE BED WITH THE FEET HANGING DOWN

39. DO NOT LEAVE THE PATIENT ALONE WHEN DANGLING.
HAVE THE PATIENT COUGH, DEEP BREATHE, AND EXERCISE THEIR LEG MUSCLES WHEN DANGLING.
IF THE PATIENT BECOMES DIZZY LIE HIM DOWN.
CHECK THE PERSON’S PULSE AND RESPIRATIONS

40. ASSISTING THE PATIENT
TO TRANSFER

41. DO NOT ALLOW THE PERSON TO PUT HIS ARMS AROUND YOUR NECK
MAKE SURE YOU LOCK THE WHEELS ON THE BED AND WHEELCHAIR

43. RULES FOR GAIT BELT / TRANSFER BELT
APPLY THE BELT AROUND THE PERSON’S WAIST, OVER THE CLOTHING.
TIGHTEN THE BELT SO IT IS SNUG. IT SHOULD NOT CAUSE DISCOMFORT OR IMPAIR BREATHING. YOU SHOULD BE ABLE TO SLIDE YOUR OPEN HAND UNDER THE BELT.
PLACE THE BUCKLE SLIGHTLY OFF CENTER IN THE FRONT.
DO NOT USE WITH PATIENTS WITH FRACTURED RIBS, ABDOMINAL SURGERY, OR HAVING BREATHING DIFFICULTIES

45. NOTE THE POSITION OF THE CNA’S HANDS ON THE GAIT BELT
NOTE HIS USE OF PROPER BODY MECHANICS
NOTE THE PLACEMENT OF HIS KNEES AGAINST THE KNEES OF THE PATIENT

46. YOU NEED AT LEAST 2 STAFF MEMBERS TO SAFELY USE A MECHANICAL LIFT
ALSO CALLED
HOYER LIFT
USED TO TRANSFER PATIENTS WHO ARE PARALYZED, VERY HEAVY, OR DIFFICULT TO MOVE
YOU NEED AT LEAST 2 STAFF MEMBERS TO SAFELY USE A MECHANICAL LIFT

50. MANY FACILITIES HAVE “NO LIFT” POLICIES.
A SPECIAL LIFT IS USED TO STAND AND MOVE RESIDENTS IF YOUR FACILITY HAS THIS RESTRICTION.

51. PARALYZED PERSONS USE A TRANSFER BOARD FOR TRANSFER FROM WHEELCHAIR TO BED

52. THE WHEELCHAIR IS PLACED AT A RIGHT ANGLE TO THE TOLIET

53. TRANSFER FROM BED TO STRETCHER TAKES 4 OR MORE STAFF
USE A LIFT SHEET OR SLED TO PULL PATIENT OVER ONTO CART

55. REPOSITIONING A RESIDENT IN A WHEELCHAIR
LOCK THE WHEELS AND MOVE THE FOOTRESTS OUT OF THE WAY
DO NOT PULL THE RESIDENT UP BY THE ARMS
TO AVOID INJURY TO THE RESIDENT USE TWO STAFF MEMBERS

56. SAFETY MEASURES WITH WHEELCHAIRS
ALWAYS LOCK THE BRAKES WHEN TRANSFERRING
CLEAN THE WHEELCHAIR ON A REGULAR BASIS
MOVE THE FOOTRESTS OUT OF THE WAY WHEN TRANSFERRING

57. CARDIAC CHAIR
GERI-CHAIR

58. BACK INTO THE ELEVATOR SO THE PATIENT FACES THE FRONT
BACK DOWN A RAMP WITH A WHEELCHAIR

59. TRANSFER THE PATIENT FEET FIRST DOWN A RAMP
ENTER THE ELEVATOR HEAD FIRST