CHAPTER ELEVEN

1
CHAPTER ELEVEN USING BODY MECHANICS
2
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

3
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
4
ATROPHY
ATROPHY A DECREASE IN SIZE OR A WASTING AWAY OF
MUSCLE TISSUE. CAUSED BY LACK OF USE
5
DECUBITUS ULCER
A BREAKDOWN IN SKIN TISSUE THAT OCCURS WHEN
BLOODFLOW TO AN AREA IS INTERRUPTED
6
MORE DECUBITI
7
BODY MECHANICS

• USING THE BODY IN AN EFFICIENT AND CAREFUL WAY.
• USING GOOD POSTURE AND BALANCE
• USING THE STRONGEST AND LARGEST MUSCLES FOR WORK

8
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
9
BEND YOUR KNEES AND SQUAT TO LIFT A HEAVY
OBJECT DO NOT BEND FROM YOUR WAIST
10
WEARING A BACK SUPPORT WILL HELP YOU TO USE GOOD
BODY MECHANICS WHEN LIFTING HEAVY PATIENTS.
11

• 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.

12

• 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.

13
BODY ALIGNMENT
THE TRUNK OF THE PERSON SHOULD BE IN A STRAIGHT
LINE WHEN THE PATIENT IS LYING DOWN
14
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
15
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 PATIENTS BODY
16
FOOT BOARD KEEP THE FOOT IN A NATURAL POSITION TO
PREVENT FOOT DROP (PLANTER FLEXION)
17
FOOT DROP BOOT HELPS PREVENT FOOTDROP
18
HAND ROLL PERMITS THE HAND TO FLEX SLIGHTLY AND
PREVENTS CONTRACTURES OF THE FINGERS
19
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.

20
BASIC BODY POSITIONS
Lateral position
21

• Fowlers 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.

22

• 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 persons back.
• A small pillow is under the upper arm and hand.

23
ORTHOPNEIC POSITION FREQUENTLY USED BY PATIENTS
WITH RESPIRATORY PROBLEMS HELPS EXPAND THE CHEST
AND LUNGS TO ALLOW MORE OXYGEN TO ENTER
24
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.

25
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
26
RAISING THE PATIENT'S SHOULDERS
27
RAISING THE SHOULDERS WITH TWO HELPERS
28
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
29
MOVING UP IN BED
IF THE PATIENT HAS A TRAPEZE ON THE BED HAVE THE
PATIENT GRASP THE TRAPEZE AND BEND AT THE KNEES
30
USING A LIFT SHEET
A LIFT SHEET MAKES LIFTING EASIER HELPS PREVENT
FRICTION AGAINST THE PATIENTS 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
31
MOVING A PATIENT TO THE SIDE OF THE BED
THE PERSON IS MOVED IN SEGMENTS
32
TURNING A PATIENT
33
PROPER POSITIONING FOR LATERAL POSITION
34
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.
35
ASSISTING TO DANGLE
DANGLING REFERS TO SITTING ON THE SIDE OF THE BED
WITH THE FEET HANGING DOWN
36
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 PERSONS PULSE AND RESPIRATIONS
37
ASSISTING THE PATIENT TO TRANSFER
38

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

39
(No Transcript)
40
RULES FOR GAIT BELT / TRANSFER BELT

• APPLY THE BELT AROUND THE PERSONS 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

41
(No Transcript)
42
NOTE THE POSITION OF THE CNAS HANDS ON THE GAIT
BELT NOTE HIS USE OF PROPER BODY MECHANICS NOTE
THE PLACEMENT OF HIS KNEES AGAINST THE KNEES OF
THE PATIENT
43
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
44
(No Transcript)
45
(No Transcript)
46
(No Transcript)
47
MANY FACILITIES HAVE NO LIFT POLICIES. A
SPECIAL LIFT IS USED TO STAND AND MOVE RESIDENTS
IF YOUR FACILITY HAS THIS RESTRICTION.
48
PARALYZED PERSONS USE A TRANSFER BOARD FOR
TRANSFER FROM WHEELCHAIR TO BED
49
THE WHEELCHAIR IS PLACED AT A RIGHT ANGLE TO THE
TOLIET
50
TRANSFER FROM BED TO STRETCHER
TAKES 4 OR MORE STAFF USE A LIFT SHEET OR SLED
TO PULL PATIENT OVER ONTO CART
51
(No Transcript)
52

• 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

53
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

54
CARDIAC CHAIR
GERI-CHAIR
55
BACK INTO THE ELEVATOR SO THE PATIENT FACES THE
FRONT
BACK DOWN A RAMP WITH A WHEELCHAIR
56
TRANSFER THE PATIENT FEET FIRST DOWN A RAMP
ENTER THE ELEVATOR HEAD FIRST
57
(No Transcript)