Important: If a seriously ill patient needs to be moved over considerable distances, then the doctor must choose the type of transportation!
Selecting the method of moving the patient.
The type of transportation (determined by the doctor) and the way the patient is placed on the stretcher depends on the disease and its location. It is necessary to move the patient in bed, on a stretcher, in a wheelchair, as well as in the hands of one or two assistants (in the absence of means for transportation) with the utmost care and safety.
Capture of Rautek. This method is most often used in first aid. Rautek's grip allows you to lift and move critically ill patients. It happens that the patient, having fallen, lies on the floor. The capture of Rautek will allow, by lifting, seating or laying down the fallen.
Description of actions performed by one person.
- Approach the patient from behind and sit down.
- Support the back of the head and shoulders of the patient with both hands.
- Move the patient to a sitting position with one gentle pumping motion.
- To prevent the patient from falling again, support his back with his knees.
- Take the patient from behind by the armpits.
- Apply the so-called "monkey grip", covering the carpal joint with one hand, the patient's forearm with the other so that his arm is bent.
- The thumbs of the nurse are directed upwards.
- Gradually straightening up, lift the patient with you, supporting him with your hips.
This position allows you to move the patient back or seat him on a chair or the edge of the bed. Immobilized patients must be transported in a wheelchair or on a stretcher.
Transferring the patient to the stretcher from the bed.
Place the stretcher perpendicular to the bed so that the head of the stretcher fits the foot of the bed.
Bring the patient under the arms as follows: one person should bring his hands under the shoulder blades and the head of the patient, the second brings his hands under the pelvis and upper thighs, the third - under the lower leg and middle part of the thighs. When carrying out transportation by two people, one should bring his hands under the shoulder blades and neck of the patient, the other - under the knees and lower back.
Having coordinated the movements, simultaneously lift the patient, turn 90 degrees to the stretcher and lay him on them.
Transportation of the patient on a stretcher.
The patient is carried slowly and without shaking, the step should be short, out of step.
On the stairs, the patient should be lowered forward with their feet, raising the foot end of the stretcher and lowering the head end so that the stretcher is in a horizontal position. The one walking behind carries a stretcher on his shoulders, the one walking in front - on straightened arms.
Up the stairs, the patient is carried head first, the horizontal position of the stretcher is also observed. The one walking behind carries a stretcher on his shoulders, the one walking in front holds the handles of the stretcher on his arms straightened at the elbows.
Transferring the patient from the stretcher to the bed.
Set the head end of the stretcher perpendicular to the foot edge of the bed. Parallel to the bed, the stretcher should be placed if the area of \u200b\u200bthe room is small.
Having coordinated the movements, simultaneously lift the patient, turn with him 90 degrees towards the bed. In case of parallel setting of the stretcher, turn 180 degrees. Lay the patient on the bed.
If the stretcher is located close to the bed, then holding the stretcher at its level, two or three of us pull the patient on the sheet to the edge of the stretcher, slightly lift him up and put him on the bed.
Lifting the patient from the front and leading him with support from behind.
The following is carried out:- Approach the patient from the front, to the healthy side of the body.
- Place your feet in front of the patient's feet. To prevent the patient from slipping, the heels must be connected at an acute angle.
- Take the patient with both hands under the armpits.
- Pull it up slowly.
- Open the feet when the patient is firmly on his feet.
- Change hands.
- Change position by approaching the patient from behind.
- Grab him with the "monkey grip" from behind.
- The patient takes a step with his healthy leg.
Lifting the patient from the side and leading him with support from the side.
If the patient has unilateral paralysis, the nurse may act alone.
The following is carried out:- Approach the patient from the non-paralyzed side.
- Place your leg at an angle in front of the patient's healthy leg to prevent slipping.
- On the non-paralyzed side, take the patient's armpit with one hand.
- With the other hand, grab the patient's back and put your hand behind the armpit.
- Carefully lift the patient from the chair and help him straighten up.
- After making sure that the patient is standing confidently, remove the leg.
- Move the chair away from the patient with the other foot.
- Remove the hand holding the patient's armpit on the healthy side. Go to the patient from behind.
- Support the patient's armpits with both hands.
- Ask him to take a step forward with his good leg.
- The nurse pushes his immobilized leg with her foot.
- Continuing the movement in this way, bring the patient to the bed or chair.
Sitting the patient in a wheelchair.
Equipment: wheelchair, pillow, mattress, sheets.
Sequencing:
1. Determine how the patient's bed is located in the ward.
Read about how to prepare yourself and the surgeon for the upcoming operation.
3. Place the wheelchair close to the patient's bed; one nurse should stand on the side
wheelchairs, the other - from the side of the bed.
4. Ask the patient to help healthcare workers move from bed to stretcher.
Put the patient's pillow from the bed on the stretcher, follow the position of the patient's hands
(hands should lie along the body; if the patient is obese, then place your hands on the front of the thigh).
6. Cover the patient with a sheet or blanket and tuck the ends under the mattress on the gurney.
7. Transport the patient to the operating room, one nurse - At the head, the other - at the foot end of the gurney.
Note. In the preoperative room, the patient takes off his clothes. The patient is transferred from the ward gurney to the operating room gurney in the same way as from bed to gurney.
Transferring a patient from wheelchair to operating table and vice versa
Sequencing:
1. Explain to the patient the course of the upcoming manipulation.
2. Bring the gurney with the patient into the operating room.
h. Place the gurney close to the operating table (head end to head end).
4. Get up from the side of the gurney for two nurses (from the surgical department) and from the side of the table - for two operating sisters.
5. Bring both hands to the forearm towards each other:
those standing at the head of the patient put their right hand under the neck and shoulders of the patient, the left hand under the chest (the hands of the nurses should join under the patient); standing at the lower extremities of the patient, put the right hand under the pelvis, the left hand under the patient's knees (the hands of the nurses should join under the patient).
6. Transfer the patient to the count of "three" (the command is given by one of the nurses). All four lift the patient and transfer them from the gurney to the operating table.
Note. The patient is also transferred from the operating table to a stretcher.
The patient after surgery may remain for some time in a state of anesthesia or, being conscious, experience pain. When starting to shift the patient, it is necessary to know in which area the operation was performed, and also to remember about the delivered dropper or drainage.
Transferring a patient from a wheelchair to a bed after surgery
Sequencing:1. Determine how the patient's bed is located in the ward (the wheelchair is located in relation to the bed: at an angle, parallel, sequentially, close).
2. Explain to the patient the course of the upcoming manipulation.
h. Choose one of the proposed methods for positioning the wheelchair in relation to the bed. Leave enough space to stand between the bed and the wheelchair.
4. Prepare the patient's bed.
Note. If the operation was performed under local anesthesia, you need to put a pillow at the head. If under general anesthesia, remove the pillow. The patient should be without a pillow for 6-8 hours.
5. Stand between the bed and the gurney for three nurses. Bring hands under the patient to the forearm:
the nurse standing at the head of the patient puts her right hand under the neck and shoulders of the patient,
left - covers the opposite hand of the patient, as if hugging him;
a nurse standing in the middle puts her right hand under the patient's shoulder blades, her left hand under the lumbar region;
a nurse standing at the patient's pelvis puts her right hand under the lumbar region, the left hand under the patient's knees.
6. Transfer the patient from the wheelchair to: the bed on the count of "three" (one of the sisters gives the command).
The nurse at the head turns around and the paramedics carry the patient in their arms.
7. Carefully place the patient on the bed, cover with heat and take the gurney out of the room.
Note. If the patient has a drain tube or other devices, another person is required to hold the drain.
Shoulder lift. The method is used to move a patient who is able to sit.
A chair or boat seat is placed close to the bed. Help the patient to sit up, legs hanging freely from the bed, close to the edge of the bed. Together with another nurse, a wrist grip is used to keep the hips closer to the buttocks. They put their shoulders under the shoulders of the patient, he puts his hands on the backs of the nurses.
Place the supporting arm on the bed behind the patient's buttocks, bending it at the elbow; legs apart, knees bent. Then one of the nurses gives the command to lift the patient. The knees and elbow are extended until the body is straightened. When carrying to a chair, support the patient's back with their free hand. Place the supporting hand on the armrest or chair seat and lower the patient by bending the knees and elbow. This must be done at the same time as another nurse. The chair should not tilt back under the pressure of the helping hand. One of the nurses can support the back of the chair for safety reasons.
Lifting through the hand. The method is used to transport a patient from a bed to a chair or boat seat without armrests or a backrest.
Set the height of the bed equal to the height of the chair. Help the patient to sit up. One of the nurses stands with one knee on the bed behind the patient and grabs through her arm. Move the patient to the edge of the bed, leaving his legs in the middle. Continue to support the patient, but now stand on the floor with both feet directly behind him while he is at an angle to the side of the bed. -.. >
The role of the second nurse is to place the chair comfortably and close to the bed, without allowing too much space between them, but not too close, so that the patient does not elbow into the bed when he is lowered into the chair. They stand on the side of the bed, put one leg forward, put their hands under the patient's legs, and prepare to pull them towards themselves. The nurse behind the patient gives the command to rise. The patient's legs are dragged to the edge of the bed while the nurse standing behind the patient lifts the patient's torso off the edge of the bed. Both nurses squat gently to lower the patient into a chair.
Transfer of the patient by one person. Lifting with swing. The technique is used to help the patient get up and move to another place, provided that he can participate in the movement and control the position of the head and hands.
You can reduce the effort to lift the patient by gently rocking the patient. They begin by helping him move to the edge, gently rocking him from side to side and alternately moving his legs forward. The patient's knees are at a 90° angle, knees and feet together. They stand with one foot next to the patient and the other in front of him, fixing his knees. In this position, you can:
help the patient to stand up;
move its floor at a 90" angle from a chair to a wheelchair;
turn it 180" from the wheelchair.
In any case, the rocking is carried out according to the same principle: they rhythmically begin to move, moving their body weight back and forth, keeping the patient close to themselves. By doing this, a rocking impulse is transmitted to the patient. There is no need to lift the patient: with the help of body mass, enough kinetic energy is accumulated to move. Do a few preparatory swings to set the rhythm; then they move more intensively, stimulate the patient, and the movement is made.
Underarm grips or pelvis or waist-strap techniques can be used to help the patient stand up or move them from a 90° sitting position to another position.
To transfer a patient from a wheelchair to a toilet seat, move both seats together, corner to corner, block the wheels, and remove the backrests.
To transfer a patient from a functional height-adjustable bed to a chair, place the chair next to the bed so that there is no space between them. If possible, lower the bed and move the patient as previously described.
M3
Grab with a raised elbow. This is the optimal technique for peg, paving the patient at 90 or 180°. At the same time, the movements of the patient are well controlled. With the correct implementation of this technique, the patient will feel comfortable. Moving 180° will require more energy to swing.
Transferring a patient from bed to wheelchair. The method is used when lifting a patient from a bed to a wheelchair and vice versa only in the absence of a lifting mechanism or a stretcher and auxiliary means for smoothly rolling the patient from one surface to another.
Position the wheelchair at an angle of at least 60° to the bed. If possible, set the bed to its maximum height and put the wheelchair and bed on the brake.
Nurses should stand on the side of the gurney that faces the bed, facing the patient, with the strongest nurse in the center. Put one leg forward, bend it at the knee and stand as close to the bed as possible. Put the other leg back to maintain balance. Gently place your hands up to the elbow under the patient. The nurse at the patient's head lifts the patient's head and supports the shoulders and upper back. The nurse in the center supports the lower back and buttocks, while the third nurse supports the lower legs and legs. If the patient is very heavy, more people may be needed and the load may need to be redistributed.
The patient is raised in two steps: first, they gently roll to the edge of the bed, then they lift it and transfer it to a stretcher. When one of the nurses gives the command, the weight of the body is transferred from the forward leg to the backward leg in order to smoothly roll the patient to the edge of the bed. Pause to change the grip of the patient and their own posture for the lift itself. At the second command (coordination of movements is crucial), the patient is rolled over, pressed to the chest and lifted. (The closer the nurse holds the patient to herself during lifting and the straighter she stands, the less physical stress she experiences.) Then they move back. One of the nurses holding her legs takes wider steps while everyone else stands parallel to the gurney. At the third command, the legs are bent at the knees and the patient is carefully lowered onto the gurney.
Health care workers are injured when they release one hand in a series of lifting actions, such as placing a vessel on a patient. You should always try to find another person who will perform an additional procedure.
Transferring the patient to a chair or wheelchair. Place a chair or wheelchair by the patient's bed next to
oboe and make sure they are well positioned and will not budge or fall off in the process of moving.
They help the patient to sit on the edge of the bed, for which he is offered to lie on his side facing the nurse and bend his knees. This position allows you to easily hang the patient's legs over the edge of the bed.
With one hand, gently support the patient under the back and pull up. If the patient is able, he can support himself by leaning his hand on the bed.
You should never pull the patient by the hand, especially the affected one. This will not only weaken the ligamentous apparatus of the shoulder joint and lead to dislocation, which is highly undesirable, but will not help to move the patient.
After the patient has taken a vertical position, he is allowed to sit quietly for some time - he will be able to get used to the sitting position and his blood pressure will stabilize, which may change in response to a change in body position.
They stand directly in front of the patient, then come close to him, so that the knees rest on his knees. Crouching a little and bending their knees, they grab the patient by the waist and offer him to hold on to his shoulders or neck.
Count aloud to three and at the expense of "three" straighten up with the patient. Continuing to rest their knees on him, they take a break. Ask the patient to help fix the legs in a standing position.
After a break, the patient is told that he will turn at the same time as the nurse.
When turning, always look at the patient's face, do not bend. As soon as the back of the knees (popliteal region) of the patient has touched the chair (wheelchair), he is gently lowered into the seat.
To turn a lying patient and reduce the load on the back of a nurse, a special bedding is used. To do this, an ordinary sheet is folded two or three times, placed along the bed under the shoulders and hips of the patient. This allows you to change the position of the patient without lifting him. To turn the patient from the back to any side, stand on the opposite side of the bed from the direction of rotation and put the corresponding arm and leg of the patient on the other arm and leg, then pull the bedding and carefully turn the patient to the desired side. It is important to remember that the patient should remain in the middle of the bed. To fix this position, special pads and foam pads are used.
If it becomes necessary to lift the patient, this manipulation should be performed only by two people, holding the edges of the bedding on both sides. But there are situations when the patient needs
complete without anyone's help. If you follow the above recommendations, you can significantly reduce the risk of injury to both the patient and the nurse.
If the patient is able to communicate, before the manipulation he is told about the intended actions. Immediately before lifting the patient and during the manipulation, the legs are bent at the knees so that the center of gravity of the body is as low as possible. In this position, part of the load is redistributed from the muscles of the back and spine to the muscles of the thighs, which are quite hardy and less prone to injury. To increase the area of \u200b\u200bsupport, the legs are placed shoulder-width apart.
Immediately before lifting the patient, a deep breath is taken, then the abdominal muscles are strongly strained and exhaled during the manipulation. Breathing should not be held. Before starting the action, count up to three: this usually helps the patient to coordinate his movements with the movements of the nurse, to perform them in the same rhythm. In the course of the manipulation, the patient is told what and when he needs to do in order to facilitate the lifting process.