Session 3 Lab Guide (Students) PDF

Session 3: Lab Activities ========================= ### Learning Goal: Safely and effectively utilize foundational intervention strategies when working with non-complex patients Positioning and Draping ======================= ### Objectives in Short-Term Positioning ![Diagram, schematic Descript...

Session 3: Lab Activities ========================= ### Learning Goal: Safely and effectively utilize foundational intervention strategies when working with non-complex patients Positioning and Draping ======================= ### Objectives in Short-Term Positioning  Old Key with solid fill**[Beginning Sessions: 4 Must Dos:]** 1. **Wash hands** 2. **Introduce Self** 3. **Confirm DOB** 4. **Obtain permission to treat** **[Finalizing Your Positioning: ]** 1. **Step back and check for safety, comfort, and access** 2. **Ask if there is anything else you can do to make you more comfortable** 3. **Provide a call button for safety** ### Objectives of Draping - Maximize Comfort and Dignity - Normal clothing as possible (ask pt to come in the clothes you need them to) - Provide privacy for changing and request permission to reenter the room - Include a chaperone if requested or necessary - Communicate clearly and specifically the why, where, what and how - Observe pt's non-verbals - Keep feet covered for warmth and protection but NO SOCKS if they are up moving around - Old Key with solid fillKey Points to Remember For Draping: - **BEFORE** - Plan ahead: collect your linens - Cover the surface - Provide privacy to change - Introduce yourself and communicate, obtain consent and permission - **DURING** - Initially provide coverage and only expose areas as necessary - Layer linens, secure edges, and continually adjust the linens - Instill trust and security with pt through confident draping - **AFTER** - Provide clean linens to remove gels - Provide privacy to change - Dispose of linens properly Short Term Positioning ====================== ### Supine - Considerations: - Spinal Alignment: if possible, legs can be on a bolster or pillows to reduce strain on the lumbar spine and keep spine in a neutral alignment (only if it doesn't impact access!) - Ensure the pt has a means to call for help ### Sidelying - Considerations: - Positioning: the pt may be in pure sidelying if that is appropriate - Ensure that the pt is able to comfortably maintain the position, may need pillows for support to relax - Ensure the pt has a means to call for help - If the pt is on the EOB you must guard them o rmove them further into the bed ### ### Prone - Considerations: - If you are on a high-low table with a face cut out use it! - If you don't have a face cut out you need to decide if turning the head is appropriate or if you want to create a towel U - Ensure the pt has a means to call for help - If you cannot see the pt's face determine how you are going to communicate ### Sitting - Considerations: - Have feet supported on the floor - If seated in a chair with a back a lumbar support may support better spinal alignment - Ensure the pt has a means to call for help - Do not leave a pt unattended at the EOB unless you are 100% confident they are safe Applying Concepts of Positioning and Draping to Patient Care ============================================================ Welcome to our GWPT Rocks Clinic! You have a full caseload today. Be sure to introduce yourselves appropriately and obtain permission to treat before starting your session. 1. A soccer player s/p hamstring strain. Position and drape appropriately for a Left hamstring stretch. 2. Pt with R rotator cuff impingement. Pt has a history of COPD and cannot lay supine. Position and drape appropriately for a Right shoulder intervention (must have access to all planes of shoulder motion). 3. Pt s/p MVA with whiplash and significant cervical pain. Position and drape appropriately for manual treatment of cervical region. 4. Pt s/p L anterior pectoralis strain. Position and drape appropriately for soft tissue mobilization of the pectoralis muscle. 5. Pt who is 7 months pregnant with lower back pain and you want to teach their spouse how to perform soft tissue massage to the lower back. 6. A lacrosse player complaining of pain in the mid-thoracic region. Your plan is to perform some spinal mobilization to the mid thoracic spine and ribs. Summary ======= +-----------------------------------+-----------------------------------+ | **[Short-Term | **[Draping]** | | Positioning]** | | +===================================+===================================+ | **Key Points to Remember:** | **Key Points to Remember:** | | | | | **Short-term considerations: | **Draping considerations: Access, | | Safety, Comfort, and Access** | Modesty, Comfort, Warmth, | | | Dignity** | +-----------------------------------+-----------------------------------+ | **[Short Term Positioning | - Plan Ahead! | | Checklist]** | | | | - Maintain patient dignity, | | - Patient **safety** | modesty and comfort. | | | | | - Good spinal **alignment** | - **Secure edges** of the | | | linens for modesty. | | - **Accessibility** of | | | necessary areas of the body | - Walk around the plinth rather | | | than lean over. | | - Trunk and extremities | | | supported for **comfort** | - Employ a confident touch. | | | | | - Positioned well within | - Watch for signs of | | **environment** (line of | discomfort, unease. | | sight, communication, etc.) | | | | - Ask permission and explain | | - **Special needs** | what you are going to do and | | accommodated | why. | | | | | - Has a **means to | - Any patient may be a survivor | | communicate** or call for | of trauma or abuse; watch for | | help | signs of discomfort. | | | | | | - ***Be aware that prone and | | | supine can be psychologically | | | vulnerable positions!*** | | | | | | - Be aware of potential | | | cultural preferences. | | | | | | - Provide chaperones when | | | appropriate. | +-----------------------------------+-----------------------------------+ ### Additional Cases for Practice 1. **Your patient is a female swimmer who has rotator cuff impingement. You will be doing soft tissue mobilization to her Right anterior shoulder.** 2. **Your patient sustained significant injuries in an MVA and has adhered scars on his abdomen. You wish to do scar massage to the scar that extends from his umbilicus to his Left ASIS.** 3. **Your pt has LBP from poor body mechanics in their job as a UPS delivery person. You will be doing mobilizations to their lumbar spine; they are obese and have difficulty breathing when in prone.** 4. **Your patient is a college pitcher who has very tight pectoralis muscles. You will be doing stretching and soft tissue mobilization of the Right shoulder.** 5. **Your patient is pregnant with significant LBP. You will be performing massage to her lumbar and thoracic spine.** 6. **Your patient is a s/p MVA who sustained a whiplash injury and has significant neck pain and cervical headaches. You will be doing massage and manual therapy to treat their cervical region.** ST Positioning and Draping Summary Questions ============================================ 1. 1^st^ 3 things you do when seeing a patient? 2. How do the goals for ST positioning differ? 3. Why is it important to properly drape your patient? 4. What are potential options for short-term positioning in supine? 5. How do you "complete the position"? 6. What are the potential are the downsides of being in the Fowler's Position? 7. How may culture impact your decisions about draping with a patient? **Documentation** - **Needed for several reasons** - **Legal reasons** - **Communicate with other practitioners** - **Track project** - **Insurance** - **Measure pain** - **At the end of documentation, sign name, credentials, and date** **Here are the answers to your questions about patient evaluation, positioning, and draping:** **1. \*\*First 3 Things to Do When Seeing a Patient\*\*:** **- \*\*Introduce Yourself\*\*: Introduce yourself and your role to establish rapport.** **- \*\*Confirm Patient Identity\*\*: Verify the patient's name and other identifiers (e.g., birthdate) to ensure correct identification.** **- \*\*Explain Purpose of Visit\*\*: Describe what you'll be doing during the session to set expectations and obtain informed consent.** **2. \*\*How Goals for Short-Term (ST) Positioning Differ\*\*:** **- ST positioning focuses on \*\*comfort, alignment, and easy access\*\* for quick interventions, such as assessments, brief treatments, or exercise sessions. Unlike long-term positioning, it prioritizes temporary stability and quick adjustment rather than sustained protection from pressure injuries or contractures.** **3. \*\*Importance of Properly Draping Your Patient\*\*:** **- Proper draping \*\*preserves patient dignity and modesty\*\*, maintains warmth, and provides physical and emotional comfort. It also respects privacy and is important for maintaining a professional therapeutic relationship.** **4. \*\*Potential Options for Short-Term Positioning in Supine\*\*:** **- \*\*Pillow Placement\*\*: Under the head, knees, and arms for support and alignment.** **- \*\*Leg Support\*\*: Rolled towel or small bolster under the knees to alleviate back strain.** **- \*\*Arm Support\*\*: Small pillows at the patient's sides to support arms and shoulders.** **5. \*\*How to "Complete the Position"\*\*:** **- To complete the position, \*\*double-check alignment and comfort\*\*, ensure draping is secure, and confirm that any support devices (pillows, bolsters) are appropriately placed. Finally, ask the patient if they feel comfortable or need adjustments.** **6. \*\*Potential Downsides of Fowler's Position\*\*:** **- \*\*Increased Pressure Risk\*\*: Fowler's position (typically with the head elevated 45-60 degrees) increases pressure on the sacrum and heels.** **- \*\*Risk of Sliding/Shearing\*\*: The semi-upright position can cause the patient to slide down, creating shear forces that can damage skin integrity.** **- \*\*Respiratory Implications\*\*: High Fowler's position may impact respiratory function if prolonged, as the abdominal organs can compress against the diaphragm.** **7. \*\*Impact of Culture on Draping Decisions\*\*:** **- Cultural considerations, such as beliefs about \*\*modesty, gender preferences\*\*, or specific attire requirements, may influence how you approach draping. For instance, some patients may prefer more coverage or same-gender providers due to religious or cultural beliefs. Being aware and sensitive to these preferences fosters a respectful and therapeutic environment.** **These guidelines help ensure respectful, safe, and effective patient handling and positioning. Let me know if you'd like more specific techniques or further clarification!**