1. Tulane University - Office of Environmental Health & Safety (OEHS) Manual Handling & Safe Lifting Tulane Emergency Medical Service August 2011

2. Training Content Introduction Overall Objective Manual Handling Back Stats and Facts Why Back Injury Occurs Common Causes of Injury Prevention Proper Lifting Techniques Body Management Conclusions Tulane University - Office of Environmental Health & Safety (OEHS)

3. Overall Objectives Provide sufficient understanding and knowledge of manual handling, the risks involved and the control measures available. Reduce lost working days through injury. Protect the back, one of the most important parts of the body. Tulane University - Office of Environmental Health & Safety (OEHS)

4. Manual Handling Manual handling refers to any activity requiring a person to use any part of their muscular or skeletal system in their interactions with their work environment. It includes the following activities: –Lifting, Putting Down, Pushing, Pulling, Carrying or Moving Tulane University - Office of Environmental Health & Safety (OEHS)

5. Several major body parts the hands, wrists, shoulders, and neck, are affected by force, awkward posture, and repetitive motion due to manual handing operations. The one part of the body that is of particular interest for this training and is particularly vulnerable to manual handling injuries is the back. To prevent back injuries lets get a better understanding of it, how it’s affected, and factors that may contribute to its injury. Manual Handling Tulane University - Office of Environmental Health & Safety (OEHS)

6. Back Stats According to the Bureau of Labor Statistics sprains and strains was the leading nature of injury and illness in every major industry sector in 2005. The part of the body most affected by work incidents was the trunk, including the shoulder and back. This accounted for 35 percent of all cases. While overall injuries to the trunk decreased by 4 percent from 2004, of the injuries or illnesses to the trunk, those involving the back accounted for 63 percent. Reference: http://stats.bls.gov/news.release/archives/osh2_11172006.pdfhttp://stats.bls.gov/news.release/archives/osh2_11172006.pdf Tulane University - Office of Environmental Health & Safety (OEHS)

7. Back Facts Back injuries cause loss of work and cost billions of dollars per year Centers for Disease Control: Low back pain occurs with the same frequency in people with sedentary occupations as those in heavy labor occupations. The National Institute of Occupational Safety and Health established that while an individual may experience back problems due to lifting –Non-occupational Factors Physical Fitness Level Strength Posture Tulane University - Office of Environmental Health & Safety (OEHS)

8. The lower part of the back holds most of the body’s weight. Every time you bend over, lift a heavy object, or sit leaning forward, you put stress on your spine. Over time, the discs between your vertebrae can start to wear out and become damaged. Why Back Injury Occurs Tulane University - Office of Environmental Health & Safety (OEHS)

9. Why Caregivers Have High Risk for Injury Patient handling tasks are unpredictable. The patient is asymmetric, bulky, and can not be held close to the body. The amount of assistance a patient can offer varies at any given point in time. Much of the patient care is completed on a horizontal plane, using the weaker muscles of the arms. Tulane University - Office of Environmental Health & Safety (OEHS)

10. Cumulative Injury Most of the injuries sustained by caregiver, are cumulative. Associated with repeated episodes of patient lifting and strenuous patient care activities. Often impossible to pinpoint one occupational activity which caused the muscular skeletal stress. Tulane University - Office of Environmental Health & Safety (OEHS)

11. Common Causes of Injury Forceful Exertions –Lifting or Transferring Heavy Patients –Unexpected or Abrupt Forceful Motions –Stopping Patient Falls –Lifting Patients Off the Floor Tulane University - Office of Environmental Health & Safety (OEHS)

12. Common Causes of Injury Awkward Position or Posture –Repeated bending, twisting, reaching or holding prolonged fixed positions Repetition Tulane University - Office of Environmental Health & Safety (OEHS)

13. Common Causes of Injury Working in awkward, uncomfortable positions… Tulane University - Office of Environmental Health & Safety (OEHS)

14. Common Causes of Injury Sitting or standing for prolonged periods of time… Tulane University - Office of Environmental Health & Safety (OEHS)

15. Common Causes of Injury Stress - Tense muscles are more susceptible to strains and spasms.

16. Common Causes of Injury “Overdoing It” Don't be afraid to say, "This is too heavy for me to lift alone." It's important to recognize your own physical limitations and abilities. Many people have injured their backs because they were afraid to ask for help. Tulane University - Office of Environmental Health & Safety (OEHS)

17. Common Causes of Injuries Poor physical condition Your stomach muscles provide a lot of the support needed by your back. If you have weak, flabby stomach muscles, and are overweight your back may not get all the support it needs, especially when you're lifting or carrying heavy objects. Good physical condition in general is important for preventing strains, sprains, and other injuries. Tulane University - Office of Environmental Health & Safety (OEHS)

18. Prevention The best way to prevent back injuries is to develop habits that reduce the strain placed on the back. Tulane University - Office of Environmental Health & Safety (OEHS)

19. Proper Patient Lifting Assessment Criteria for Patient Movement –Patient’s height and weight –Distance to be moved –Amount of assistance provided by patient (functional, mental, cognitive ability) –Patient’s balance and ability to bear weight –Patient’s physical condition –Patient’s level of fatigue and cooperation Tulane University - Office of Environmental Health & Safety (OEHS)

20. General Guidelines for Lifting and Moving Patients Use assist devices or equipment when available and appropriate for the activity –Use slides and lateral transfers instead of manual lifting Get Patients to Help as Much as Possible –Give Clear, Simple Instructions Adequate Time for Response Tulane University - Office of Environmental Health & Safety (OEHS)

21. General Guidelines for Lifting and Moving Patients Know Your Limits and Do Not Exceed Them Get help Whenever Possible –Use teamwork Mentally Plan and Prepare –Consider routes of travel and obstructions –Clear Out Paths Tulane University - Office of Environmental Health & Safety (OEHS)

22. General Guidelines for Lifting and Moving Patients Use (or modify) beds or other surfaces to keep work tasks at the correct height –The best zone for lifting is between your shoulders and your waist. Make sure brakes hold properly and apply them firmly on beds and gurneys Tulane University - Office of Environmental Health & Safety (OEHS)

23. General Guidelines for Lifting and Moving Patients Use upright, neutral working postures and proper body mechanics –Bend your legs, not your back –Use your legs to do the work When lifting or moving the patient always face them Do not twist when turning. –Pick up your feet –Pivot your whole body in the direction of the move Tulane University - Office of Environmental Health & Safety (OEHS)

24. General Guidelines for Lifting and Moving Patients Keep the person you are moving as close to the body as possible. Keep handholds between your waist and shoulders Move the person towards you –Never Away From You Use a wide, balanced stance with one foot slightly ahead of the other Tulane University - Office of Environmental Health & Safety (OEHS)

25. General Guidelines for Lifting and Moving Patients Lower the person slowly by bending your legs: Not Your Back Return to an erect position as soon as possible Use smooth movements and do not jerk. When lifting with others, coordinate lifts by counting down and synchronizing the lift Tulane University - Office of Environmental Health & Safety (OEHS)

26. It's important to know your body's limitations, and it's important to be aware of your body position at all times. Learn to recognize those situations where your back is most a risk: bending, lifting, reaching, twisting, etc. Then take measures to avoid an injury. Management tips include: Stretch first, slow down, rest your back, sleep on a firm mattress, get in shape. Body Management Tulane University - Office of Environmental Health & Safety (OEHS)

27. Remember Practicing good lifting technique does not enable you to lift more than you could before. It means that, whatever your individual capabilities, your chances of injury are reduced. Good technique is just one of a number of control measures, within the hierarchy of control, that the employer has to put in place to reduce manual handling risks. Management of the body can help to reduce the amount of strain to the back. Tulane University - Office of Environmental Health & Safety (OEHS)

28. In Conclusion Manual handling activities which include pulling, pushing, carrying, and lifting can lead to injury of the body, especially the back. –Know your own limits. –Avoid lifting if possible or use devices to assist with lifting. –Practice safe lifting techniques-put training into action at work as well as home. Prevent injury by developing habits that reduce the strain placed on the back. –Manage and maintain a fit, healthy body. –Immediately report any injury to your supervisor. Tulane University - Office of Environmental Health & Safety (OEHS)

29. Tulane University Office of Environmental Health & Safety (OEHS) http://www.som.tulane.edu/oehs Kim Chapital – Manager, Occupational Health (504) 988-2870 / kchapit@tulane.edu http://www.som.tulane.edu/oehskchapit@tulane.edu If unable to proceed to quiz, type the link below into your browser https://pandora.tcs.tulane.edu/ehs/enterssn.cfm?testnum=113 Proceed to Quiz