Chapter 13 Safe Patient Movement and Handling Techniques

According to experts in work-related injuries, the medical imaging specialty of _______________ has the highest percentage of work injuries, with an incidence as high as 99%, after only three years of employment.

• interventional imaging

• 
  sonography

• MR scanning

• mammography

Answer explanation

Sonographers especially suffer from work-related musculoskeletal disorders (WRMSDs) which range from minor discomfort to career-ending disability. While performing their professional tasks, sonographers are injured at an increasing and alarming rate. Recent studies document 90-99% of sonographers with more than 3 years of experience report scanning in pain daily and 20% will suffer career-ending injuries.

Work-related musculoskeletal disorders (WRMSDs) generally result from:

• work circumstances that are beyond the control and/or understanding of the employee.

• a single work-related event that exceeds one’s lifting capability.

• strenuous athletic activities at department social gatherings.

• repetitive tissue trauma events that tend to be cumulative as a function of time.

Answer explanation

WRMSDs are painful conditions affecting the muscles, nerves, ligaments, tendons, and/or bursas of the body. These types of injuries typically develop from cumulative repetitive trauma and are the leading cause of long-term absences among healthcare professionals.

According to the U.S. Department of Labor, one of the most common work-related injuries for healthcare workers, resulting in lost work time and disability is

• emotional exhaustion from working high stress patient care areas.

• needle sticks with uncapped needles.

• strains, sprains, and musculoskeletal injuries.

• electrical shocks from poorly insulated electronic devices.

Answer explanation

The US Department of Labor Statistics cites sprains, strains, and other musculoskeletal injuries and disorders as the leading causes of disability for people in the health care industry, estimating the involvement of over 600,000 employees at a cost of $50 billion every year.

Mobility muscles differ from stability muscles in that

• stability muscles are located in the knees and ankles.

• stability muscles are involved in digestion and body homeostasis.

• mobility muscles are located in the arms and legs.

• mobility muscles provide postural support.

Answer explanation

Mobility muscles are found in the limbs. Typically, these muscles have long white tendons and cross two or more joints. Examples include the biceps muscles that flex the elbows and the hamstring muscles that flex the knees. Stability muscles are found in the torso. Typically, stability muscles are large expanses of red muscle belly and provide postural support.

When lifting patients, it is important to

• lift with your back and save your leg strength.

• use the strong muscles of your upper arms to improve lifting ergonomics.

• twist at the waist to improve your center of gravity.

• 
  keep your back stationary and lift with your legs.

Answer explanation

When lifting a patient, the technologist should stand with his or her feet apart to increase the base of support. When lifting patients, keep your back stationary, avoid twisting, and let your legs do all of the lifting.

When transferring a patient from a wheelchair to a radiographic table,

• break the transfer into a series of simultaneous movements and commands.
  

• do not let the patient do any weight-bearing movements.

• transfer the patient toward their weak side.

• allow the patient to help with the transfer if it is safe based upon their capabilities.

Answer explanation

Some patients have the ability to transfer from a wheelchair to a table on their own. Position the wheelchair at a 45-degree angle to the table. Talk to the patient before he or she moves to determine how much, if any, assistance is required. Divide the transfer into single-step components and talk the patient through each step.

When positioning a patient in a rolling motion transfer,

• roll the patient toward his or her weak side.

• never roll a patient because it creates postural hypotension.

• ask the patient which way he or she wants to be rolled.

• always move the patient toward you.

Answer explanation

To minimize trauma and discomfort for the patient, take an extra moment to make sure that the patient is ready to make the move. When moving a patient, always roll the patient toward you. Provide positioning sponges to support the patient comfortably in the desired position.

If a patient cannot assist with a cart-to-table transfer,

• a draw sheet or transfer assist device should be used.

• disregard the transfer and do a portable examination with the patient on the cart.

• ask one other colleague to help you do the lifting.

• None of these are appropriate.

Answer explanation

If the patient can assist with the transfer, then all that may be required is stabilization of the cart and support for the involved body part. If the patient cannot assist, then a moving device or draw sheet should be used. Three people usually perform a cart-to-table transfer.

All of the following are related except

• log roll assist.

• standby assist.

• assisted standing pivot.

• hydraulic lift.

Answer explanation

Radiologic technologists use four types of wheelchair transfers: (1) standby assist, (2) assisted standing pivot, (3) two-person lift, and (4) hydraulic lift. Log roll assist is not a wheelchair transfer.

When performing a two-person lift of a patient from a wheelchair, it is important to

• lift the patient as a unit, with his or her arms crossed and legs straight.

• ask the patient to put his or her arms up over his or her head.

• 
  lift the patient over the arm rest of the wheelchair.

• 
  bend over from the back and lift the patient’s legs with your partner.

Answer explanation

Begin by locking the wheelchair wheels, removing the armrests, and swinging away or removing the leg rests. Ask the patient to cross their arms over their chest. The stronger person stands behind the patient, reaches under the patient’s axillae, and grasps the patient’s crossed forearms. The second person should squat in front of the patient and cradle the patient’s thighs in one hand and calves in the other hand. On command, the patient is lifted to clear the wheelchair and is moved as a unit to the desired place.