Unit 2
Chapter 13 & 14
Transfer and Immobilization
Techniques
Methods of Patient Care
1
Transfer Techniques
Chapter 13
Methods of Patient Care
2
Radiographer
Responsibilities







Put the patient at ease
Decrease level of embarrassment
Set the tone for the patient’s experience
Respect the patient’s right to privacy
Protect patient and staff from injury
Use necessary restraints safely
Adhere to rules of radiation safety, fire safety,
and use and disposal of hazardous chemicals
Methods of Patient Care
3
Care of Patient’s
Belongings
Describe to patient what clothing/items
must be removed for exam
 Show the patient where he/she may
change, and how to put on hospital
gown
 Show patient where he/she may keep
belongings (locker, belongings bag)

Methods of Patient Care
4
Care of Patient’s Belongings
Understand patient’s concern about
leaving items behind
 Place small items (rings, necklaces,
earrings) in container marked with
patient’s identification data
 Document items removed/returned
 Every item is of value, respect patient’s
property

Methods of Patient Care
5
Body Mechanics
Back injuries from moving & lifting
patients are the leading cause of injury
to health care workers
 Biomechanics- branch of science that
applies the law of physics to living
creatures.

– Understanding can help prevent injury
Methods of Patient Care
6
Base of Support

Base of Support is the
foundation on which a body
rests.
– IE. The feet and the space
between the feet when standing
– Wide=Stable (BEST)
– Narrow=Unstable

Good posture
 Body is in alignment, with all parts
in balance
 Permits bones & joints to work at
maximum efficiency with a minimal
amount of strain on joints, tendons,
ligaments, & muscles
 Aids body systems to work
efficiently
Methods of Patient Care
7
Center of
Gravity
Center of Gravity – the hypothetical
point at which all mass appears to be
concentrated.
 Stability can be achieved when the
center of gravity is over the base of
support.

Methods of Patient Care
8
Mobility vs. Stability Muscles

Mobility muscles
– located in limbs
– In transfer used
for lifting

Stability muscles
– located in torso
– In transfer used
for support
Methods of Patient Care
9
Body Mechanics

Guidelines for picking up or lifting heavy
objects (patients)






Let the patient do as much as possible
Check chart for precautions/patient assessment
Widen base of support
Bend from the knees, not from the waist
Pull rather than push
Balance the weight over both feet; stand close to
the patient when bending knees
 Don’t twist body; change foot position instead
 Make sure floor area is clear of objects
 Never move a patient without enough assistance
to prevent injury to yourself & the patient
Methods of Patient Care
10
Moving & Transferring Patients
Establish the correct identity of the
patient
 Request pertinent information regarding
the patient’s ability to follow directions
 Request information concerning the
patient’s ability to ambulate & any
precautions to be taken concerning the
patient’s mobility

Methods of Patient Care
11
Assessing the Patient’s Mobility

Must use critical
thinking & problem
solving to plan most
effective manner of
moving patient
 Expected outcome –
move patient without
causing additional pain
or injury to the patient
or to yourself
 Use interviewing &
assessment skills
Methods of Patient Care
12
Assessing the Patient’s Mobility
Patient’s general condition
 Range of motion & weight-bearing
ability
 Patient’s strength & endurance
 Patient’s ability to maintain balance
 Patient’s ability to understand what is
expected during the transfer
 Patient’s acceptance of the move
 Patient’s medication history

Methods of Patient Care
13
Moving & Transferring Patients

Greet & identify patient
and provide an
explanation of what is to
occur
 Move the patient to the
department according to
the necessary restrictions
 Upon returning, notify
nurse that patient has
returned
 Ask for assistance if
needed
Methods of Patient Care
14
Moving & Transferring Patients

Assist the patient to bed





Always lock wheels
Assist patient from wheelchair
Place patient’s bed in lowest position
Side rails raised
Put call button within reach
Methods of Patient Care
15
Assessing the Patient’s Mobility

Rules for moving patients
 Give only the assistance that the patient
needs for comfort & safety
 Always transfer a patient across the
shortest distance
 Lock all wheels on beds, carts &
wheelchairs before the move begins
 Generally, it is better to move a patient
toward his or her stronger side while
assisting on the patient’s weaker side
Methods of Patient Care
16
Methods of Moving Patients

Cart (aka. Stretcher or gurney)

Wheelchair

Ambulation (walking)
Methods of Patient Care
17
Wheelchair Transfers
1.
2.
3.
4.
Standby assist
Assisted standing pivot
Two-person lift
Hydraulic lift
Methods of Patient Care
18
Wheelchair

Never allow a patient to get off a table
or onto a wheelchair without some
assistance
 Patient may not be as strong as they think
 Sudden movement may cause dizziness
 Orthostatic hypotension

Always transfer towards the strong side
Methods of Patient Care
19
Wheelchair – standby assist

From supine position
 Have patient turn to the side towards you with
knees flexed
 Place yourself in front of patient with one arm
under shoulder and other across the knees
 If patient can assist, have him push with upper
arm when told to do so
 On count of three, move or help patient to sitting
position
 Allow patient to sit on edge to get sense of
balance
Methods of Patient Care
20
Wheelchair
 Stand at the patient’s side and take the
patient’s arm to help
 Put table or bed at lowest position
 Provide step stool
 Position wheelchair at a 45-degree angle
to the table.
 Move foot rests out of the way.
 Place locked wheelchair close enough so
that patient can be seated in the chair with
one pivot
Methods of Patient Care
21
Wheelchair – 2-person lift

Stronger person lifts the patient’s torso
– Directs the lift
Other person lifts patient’s feet.
 Lock wheelchair; Remove arm and leg
rests and if possible
 Have patient cross arms across chest

Methods of Patient Care
22
Wheelchair – Hydraulic lifts
Used for heavy
patients
 Requires use of
a sling

Methods of Patient Care
23
Cart (Stretcher, gurney)
Bed to Cart; Cart to table
 Position cart alongside bed/table
 Patient’s strong (or less affected side)
towards the direction of the transfer
 Lock the wheels in place
 Let patient assist if possible
 Use moving devices as available

Methods of Patient Care
24
Cart
(Stretcher, gurney)

Moving devices include:
– Draw sheets or bed sheets*
– Sheets of plastic*
– Canvas or plastic over
rollers*
– Slide board*

Reducing Friction*
 Requires 3 or more
“lifters”*
– Mechanical lifts
Methods of Patient Care
25
Cart
(Stretcher, gurney)

Sheet transfer
 To place sheet
• Fold sheet in half
lengthwise
• Turn patient onto his side
away from you, place sheet
under patient with fold
against patient’s back
• Turn patient towards you,
have an assistant unfold
sheet beneath patient
• Return patient to a supine
position
Methods of Patient Care
26
Cart
(Stretcher, gurney)
 To transfer
 3 – 4 people are
needed
 1 person needed to
support head
 Roll sheet at the side of
the patient so hands
can easily grasp it
 Transfer patient in
unison
Methods of Patient Care
27
Cart
(Stretcher, gurney)

Sliding board transfer




< 150 #s - 2 people
150 – 375 #s – 4
375 – 500#s – 6
500 #s – requires
mechanical lift
Methods of Patient Care
28
Cart (Stretcher, gurney)

Sliding board transfer
 Move the patient to the edge of the bed
 Move the cart up against bed, lock the
wheels
 Assist the patient to turn onto his or her
side, away from the cart, and place slider
board under the sheet
 Place the sheet over the board, and allow
the patient to roll back onto the board
Methods of Patient Care
29
Cart (Stretcher, gurney)
 Slide patient with slide board onto cart
 Assist patient to roll after from the bed,
remove slide board
 Place sheet under patient, allow patient to
lie flat again
Methods of Patient Care
30
Log Roll

Necessary to turn a patient without flexing his
or her neck or back
 Requires 5 people




Two assist with maintaining alignment of the torso
Two assist with the feet
One immobilizes head & neck
Roll patient in one unit in unison
Methods of Patient Care
31
Mechanical Lift






Several different types of lifts available
Decreases number of work-related back
injuries
Should be used as much as possible
Needs a minimum of 2 people when
moving patients
Must be used for patients > 500 #s
Takes time to set up and move patient,
but prevents injuries
Methods of Patient Care
32
Mechanical Lift
Methods of Patient Care
33
Immobilization
Techniques
Chapter 14
Methods of Patient Care
34
Use of Immobilizers & Restraints

Immobilization - A method or device used to
minimize movement or assist in positioning a
patient accurately
– Reduces motion/improves radiographic quality
– Reduces radiation exposure by reducing repeats
– Keeps patient safe.

Simple vs complex methods/devices
 Examples of simple:
– positioning sponges
– Sandbags

Examples of complex:
– Backboard
– Pigg-o-stat
Methods of Patient Care
35
Use of Immobilizers

Examples of simple:
–
–
–
–
–

positioning sponges
Velcro straps
Tape
Sandbags
Head clamps
Examples of complex:
–
–
–
–
–
Backboard
cervical collars
Splints
Sheets/mummy
Pigg-o-stat
Methods of Patient Care
36
Use of Immobilizers & Restraints

Restraints – a device which restricts the
freedom of patient movement
– Used to restrict movement
– Used to protect the patient
– Can only be ordered by a physician

Examples:
– Straps
– Posies
– Velcro straps
Methods of Patient Care
37
Use of Immobilizers & Restraints
Effective communication –
most effective method of
avoiding the need to
restrain/immobilize an
adult patient
 Reasons for application of
immobilizers

 To control movement
 Remind a patient who is
sedated or confused to
remain in a particular
position
 To prevent patient injury
Methods of Patient Care
38
Use of Immobilizers & Restraints
Never leave immobilized/restrained
patients alone
 Reassure patients that restraints are not
a punishment.
 Restraints (not immobilizers) can only
be ordered by a physician.

Methods of Patient Care
39
Use of Restraints

Rules for application for restraints
 Patient must be allowed as much mobility
as safely possible
 Areas of the body where immobilizers are
applied must be padded to prevent injury to
the skin beneath the device
 Normal anatomic position must be
maintained
Methods of Patient Care
40
Use of Restraints
Restraints must be easy to remove
quickly if necessary
 Neither circulation nor respiration must
be impaired by the restraint
 Restraints must be removed every 2
hours
 After removal, the joints affected by the
immobilizer must be put through range
of motion

Methods of Patient Care
41
Use of Restraints

Any use of restraints requires
documentation of:
– the type of used,
– the time is was applied and removed,
– the reason for its application, and
– an assessment of the patient at each stage
Methods of Patient Care
42
Sponsored by:

This workforce solution was funded by a grant awarded under the President’s CommunityBased Job Training Grants as implemented by the U.S. Department of Labor’s Employment
and Training Administration. The solution was created by the grantee and does not
necessarily reflect the official position of the U.S. Department of Labor. The Department of
Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with
respect to such information, including any information on linked sites and including, but not
limited to, accuracy of the information or it’s completeness, timeliness, usefulness,
adequacy, continued availability, or ownership. This solution is copyrighted by the institution
that created it. Internal use by an organization and/or personal use by an individual for noncommercial purposes is permissible. All other uses require the prior authorization of the
copyright owner.
Methods of Patient Care
43