Questions and Answers
What is the sequence of transfers in the Transfer Hierarchy?
Assess the situation first to determine the type of transfer?
Check chart first, consider patient diagnosis, consult with PT, assess patient's participation and functional status.
The steps to ensure a safe transfer involve locking the _____ on everything.
brakes
What should be used for a safe transfer?
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What are considerations for special populations during transfers?
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What is non-weight bearing (NWB) status?
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What are orthopedic precautions with a focus on posterior approach or complex hip fracture?
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What is a key cardiac precaution to follow?
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What should be the focus of respiratory precautions?
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Why is it important to explain to the patient what you are doing during a transfer?
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What types of transfers are mentioned?
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Study Notes
Functional Transfers: ADL Transfer Techniques
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Transfer Hierarchy: Ranges from dependent transfers, such as lifting, to modified stand pivot and stand step pivot using assistive devices, ultimately achieving transfers without devices.
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Assessing Transfer Type: Review medical charts, consider patient diagnosis and precautions, consult with PT, evaluate patient's ability to assist, and assess physical strength and endurance.
Safe Transfer Practices
- Understand all medical precautions and weight-bearing statuses; utilize a gait belt for safety.
- Lock all equipment brakes before commencing transfer.
- Explain the transfer process clearly to the patient.
- Use appropriate assistive devices and ensure non-slip footwear is worn.
- Lower bed height to match wheelchair for easier transfer.
- Seek help or use mechanical lifts if unsure.
Body Mechanics Essentials
- Analyze the situation before starting the transfer.
- Keep loads close to body and maintain good posture.
- Bend at the knees and maintain a shoulder-width stance for stability.
- Avoid twisting the back; shuffle feet to change direction.
Special Patient Considerations
- Out-of-Bed Orders: Confirm medical clearance to prevent risks like orthostatic hypotension from prolonged bed rest.
- Conditions: Monitor spinal cord injury patients for hypotension; adapt techniques for patients post-CVA, TBI, or orthopedic surgeries, focusing on safety and support for affected limbs.
Weight Bearing (WB) Status
- Categories include: NWB (0%), TTWB (10-15%), PWB (30%), 50% WB, WBAT (up to tolerance), and FWB (75-100%).
Orthopedic Precautions
- Hip Precautions: Avoid bending at the hip past 90 degrees, crossing legs, or applying weight on the operated leg. Use assistive devices as necessary.
- Knee Precautions: Do not twist or pivot, and maintain appropriate positioning in bed.
- Humeral Fractures: Non-weight bearing on the affected side; secure with a sling and avoid any range of motion unless directed by a physician.
Cardiac Precautions
- Monitor for symptoms like shortness of breath and dizziness; manage ascensions from supine to standing gradually to prevent hypotension.
- Immediate reporting to healthcare professionals if cardiac symptoms occur.
Respiratory Precautions
- Administer supplemental oxygen and monitor oxygen saturation.
- Promote energy conservation strategies for functional tasks.
Gait Belts
- Securely explain the purpose of the gait belt to the patient.
- Ensure proper placement of the belt, being mindful of any medical devices present.
Types of Transfers
- Various transfer techniques include Stand Pivot, Modified Stand Pivot, Squat Pivot, Slide Board, and Lateral Transfers, each suited to different patient needs.
Stand Pivot Transfer Technique
- When two caregivers assist, both should use a gait belt and prepare to block the patient's knees for stability during the transfer.
Slide Board Transfers
- Best for individuals unable to weight bear; ideal for those with paraplegia or pelvic fractures.
Modified Stand Pivot Transfers
- Involves a patient not fully standing; requires similar preparation to standard pivot transfers.
Lateral Transfer Technique
- Patients scoot to another surface without the use of a board; necessary to ensure all brakes are locked and help is competent.
Wheelchair Transfers
- To the Floor: Prepare for potential slips; assists stretching or activities.
- Bumping Stairs: Required when ramps are unavailable; proceed carefully to avoid injury.
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Description
This quiz covers essential concepts in safe transfer techniques within the healthcare setting. It addresses the transfer hierarchy, safety measures, and specific considerations for vulnerable populations. Test your knowledge on non-weight bearing statuses and necessary precautions for effective patient handling.
