Positioning And Draping And Bed Mobility Power Point

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Positioning And Draping And Bed Mobility Power Point

  1. 1. October 7, 2005 PTA 110 Positioning Draping Bed Mobility
  2. 2. Positioning  Why do we spend time on positioning?  Patient comfort/decrease pain  Support and stability to pt’s trunk & extremities  Prevent development of pressure sores  Prevent joint contractures  To have easier access to area being treated  Decrease edema  Increased function
  3. 3. Positioning  The most comfortable for the pt may not be the best for them  May need to be positioned to aid in the treatment of a specific diagnoses or condition  What about restraints?
  4. 4. Considerations with positioning  Who is at risk?  Elderly  Those unable to change their own position  Those with decreased sensation  Those who may be unable to communicate their discomfort
  5. 5. Pressure Points To Consider
  6. 6. When do we change position  Medicare standards = common practice standards  Change every 2 hours  At the conclusion of treatment  Check with nursing on preference
  7. 7. What do we use  Pillows  blankets  Heel protectors  Splints, slings & braces  Seat cushions  Wedges  Others??
  8. 8. Standard Positions  Supine  Prone  Side- lying  Semi-fowler  Sitting
  9. 9. Standard Positions  Supine  Pillow under head to keep c-spine neutral  Small pillow or towel roll for cervical support  Support under popliteal space to ↓ lumbar lordosis  Ankle support to relieve pressure on calcaneus  Support under elbows to relieve pressure on bony prominence
  10. 10. Supine Position
  11. 11. Standard Positions  Prone  Pillow under head  Pillow under lower abdomen to ↓ lumbar lordosis  Rolled towel under anterior shoulder to adduct (retract) scapula  Towel roll/pillow/bolster under ankles to relieve stress on hamstrings, also allows pelvis and lumbar spine to stay relaxed
  12. 12. Prone Position
  13. 13. Standard Positions  Sidelying  Pt in center of bed – not near edge  Head, trunk, pelvis in alignment  LE’s are flexed at hip & knee with pillows btwn legs & top Le slightly forward of bottom LE  Pillow at chest &/or back for to prevent pt from rolling  Pillow under top arm to keep chest open
  14. 14. Sidelying Position
  15. 15. Standard Positions  Semi-fowler  Head of bed is lifted 30° - can use pillow, wedge or bolster as well  Pillow under popliteal space  Used for breathing, eating, visiting  For a Fowler position head of bed is 45°
  16. 16. Semi-Fowler Position
  17. 17. Standard Positions  Sitting  Variety of seated positions  Straight, recumbent, semi-recumbent  Remember to soften bony prominences  Arms and legs supported (head if necessary)  Elbows at 90°
  18. 18. Draping 5 minute Break
  19. 19. Draping  Reasons for draping pt’s:  Privacy/modesty/dignity  Warmth  Hygiene How do you feel at the Dr’s office with no clothes on????
  20. 20. Draping  If you need pt to change to gown – leave room – knock before re-entering  If pt needs assistance suggest it, ask permission before helping them  Only area being treated is exposed, the rest of the pt is covered  Gown, blanket, sheet, towel  Pt comfort is the key to working on difficult areas
  21. 21. Draping  Be sure you keep legal considerations in mind  What is the policy of the facility on door being closed, slightly open? Curtains?  Inappropriate comments or touch mean different things to different people  Protect yourself by being professional at all times
  22. 22. Bed Mobility  What are the goals of bed mobility?  How do we define bed mobility?  How will patients benefit from bed mobility prior to a transfer activity?  Why do we teach bed mobility?
  23. 23. Most Common Movements Of Bed Mobility:  Turning from supine to sidelying position and returning.  Supine to prone positioning and returning.  Moving in bed-upward, downward, side to side.  Rolling  Bridging exercises  Moving from lying to sitting EOB.
  24. 24. How do you actively involve the patient in bed mobility instruction?
  25. 25. What are some ways/techniques you can use to reduce the patient’s and your energy expenditure during bed mobility activities?
  26. 26. Bed Mobility Exercises  Bed Mobility exercises don’t always have to be done in bed.  A patient can greatly benefit from bed mobility work on a mat table. Why would that be?  Examples of bed mobility exercises we will cover today in lab are on pages 132-140.
  27. 27. Modifications to bed mobility  On Wednesday Jamie will cover bed mobility for the orthopedic patient and how precautions alter how bed mobility is instructed for these types of patients.

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