Chapter Eleven | Manual Lateral Transfers SEATEd And PivoT
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608 pages | 768 illustrations Spiral binding | 2022 $116.95 (US) ISBN-13: 978-1-7196-4286-6 APPLyIng, grIPPIng, And reMovIng A gAIT BeLT How to Apply a gait Belt The process for applying a gait belt is described next and shown in Figure 11-1. 1. Let the patient know that you will be using the belt and why; for example, “I’m going to place this safety belt around you so that I have something to hold to in case you need some help.” 2. Put the belt around the person’s waist with the buckle in the front and slightly to one side for patient comfort during trunk flexion (see Fig. 11-1A). (Gait belts with quick-release buckles should be positioned with the buckle in the back to avoid inadver- tent release with trunk flexion.) Instructors eBook Image Bank & Test Bank PowerPoints Instructor’s Guide Standardized Patient Cases Clinical Decision-making cases Students Video Clips of Techniques Clinical Decision-Making Case Studies with significant rounding of the back, the belt may not sit effectively at the waist. For these patients, the belt may need to be placed higher but below the breasts in women. In some cases, placing the belt above the chest and under the arms is the only effective option. In each case, the goal is to create a snug fit so that, if the patient begins to slide downward or fall, the belt is prevented from sliding upward on the patient. Extra care must be taken with patients who have medical conditions that could interfere with safe gait belt placement. Recent back or abdominal surgical incisions, ostomies (surgically created openings in the body for elimination of body wastes), abdominal feeding tubes, or other lines or tubes in the torso area
PATIENT CARE SKILLS Mobility in Context Principles of Patient Care Skills, 3rd Edition Charity Johansson, PT, PhD, GCS | Crystal Ramsey, PT, DPT | Susan A. Chinworth, PT, PhD Maximize patient care skills From positioning and vital signs to transfers and ambulation with assistive devices, this state-of-the-art, multimedia resource teaches students to help their patients progress toward greater mobility and independence. They’ll learn how to navigate confidently in both common and complex clinical situations and to develop the clinical problem-solving and critical-thinking skills they need to succeed. UPDATED & REVISED! Incorporating current research and practice EXPANDED! More emphasis on diversity, neurological content, and distinguishing between recovery and compensation NEW! Intervention boxes Icons highlighting important concepts and care skills “Watch Out!” “Keeping Current,” and “Clinical Tips” boxes that cover important safety reminders, recent research, and pointers for effectiveness and efficiency in the clinic “Try This,” “Clinical Reality Check,” “Thinking It Through,” and “Pathophysiology” boxes that enhance learning A wealth of clinical examples that mirror today’s patient populations Over 750 photographs and illustrations to bring concepts to life See the techniques in action Fifty-five full-color narrated video clips online at FADavis.com show clinicians and patients performing key techniques described in the text. could be compromised by a gait belt. Every situation must be examined individually, but as a general rule, the belt is placed above the vulnerable site. If the belt is placed beneath the site, it will often slide up, causing disruption or injury. Adjustment of the gait belt is usually needed when the patient stands up as the body’s soft tissue at the waist drops. Correct use of a gait belt can provide valuable pro- tection against unnecessary injuries to the patient and the clinician. A gait belt, however, is not a substitute for good body mechanics or patient handling skills during mobility activities. It is also never to be used as a patient restraint. between the belt and the patient’s clothing when the belt is in place.) Chapter Eleven | Manual Lateral Transfers SEATEd And PivoT
WATCh OUT! A loose belt is a liability. If a patient wearing a loose belt begins to fall, the belt will slide up until it catches, usually under the arms. The sliding belt in itself can injure the patient, and until the sliding belt is stopped, the patient will continue to fall, making a safe recovery increasingly difficult. 5. Lift the far metal loop, causing the teeth of the buckle to grip the belt while you bring the tip of the belt across the front of the buckle and slip it through the metal loop to secure it (see Fig. 11-1C). 6. Readjust the belt as needed to maintain a snug fit. 7. Tuck any excess length of belt into the belt (see Fig 11-1D). CliNiCAl TiP: It is important to select a correct size belt for your patient. If you do not have a belt large enough for your patient, it is possible to join two belts. Feed the tip of one belt into the metal buckle of the second belt and fasten, leaving at least 4 to 5 inches of overlap. Make sure the buckle is securely fastened before applying the belt. How to grip a gait Belt The gait belt should always be held with a supinated, or underhand, grip (see Fig. 11-1D). This grip allows the maximum restraining force (supplied primarily by the elbow flexors) if a patient requires support during gait or a transfer. The gait belt will slip more easily out of a pronated grip. Never wrap a loose belt
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E with significant rounding of the back, the belt may not sit effectively at the waist. For these patients, the belt may need to be placed higher but below the breasts in women. In some cases, placing the belt above the chest and under the arms is the only effective option. In each case, the goal is to create a snug fit so that, if the patient begins to slide downward or fall, the belt is prevented from sliding upward on the patient. Extra care must be taken with patients who have medical conditions that could interfere with safe gait belt placement. Recent back or abdominal surgical incisions, ostomies (surgically created openings in the body for elimination of body wastes), abdominal feeding tubes, or other lines or tubes in the torso area APPLyIng, grIPPIng, And reMovIng A gAIT BeLT How to Apply a gait Belt The process for applying a gait belt is described next and shown in Figure 11-1. 1. Let the patient know that you will be using the belt and why; for example, “I’m going to place this safety belt around you so that I have something to hold to in case you need some help.” 2. Put the belt around the person’s waist with the buckle in the front and slightly to one side for patient comfort during trunk flexion (see Fig. 11-1A). (Gait belts with quick-release buckles should be positioned with the buckle in the back to avoid inadver- tent release with trunk flexion.) The belt should always be placed over
289 Correct use of a gait belt can provide valuable pro- tection against unnecessary injuries to the patient and the clinician. A gait belt, however, is not a substitute for good body mechanics or patient handling skills during mobility activities. It is also never to be used as a patient restraint. could be compromised by a gait belt. Every situation must be examined individually, but as a general rule, the belt is placed above the vulnerable site. If the belt is placed beneath the site, it will often slide up, causing disruption or injury. Adjustment of the gait belt is usually needed when the patient stands up as the body’s soft tissue at the waist drops.
Chapter Eleven | Manual Lateral Transfers SEATEd And PivoT
D ■■ The belt should always be placed over the patient’s clothing, never against the patient’s bare skin. If the patient is very thin or frail, you may choose to place a towel between the belt and clothing for added padding.
■■ Place the belt so that the metal teeth of the buckle are on the front and the corre- sponding metal flap is on the side closer to the patient. (The stitched seam of the belt may face inward or outward, depending on the belt manufacturer.) 3. Pass the metal-tipped end of the belt between the teeth of the buckle (see Fig. 11-1B). 4. Pull the belt snug but not uncomfortably tight. (You should be able to slide two fingers
between the belt and the patient’s clothing when the belt is in place.)
23/12/17 12:34 pm the tip of the belt across the front of the buckle and slip it through the metal loop to secure it (see Fig. 11-1C). 6. Readjust the belt as needed to maintain a snug fit. 7. Tuck any excess length of belt into the belt (see Fig 11-1D). Clinical Tips offer pointers for increasing effectiveness and efficiency in the clinic, while Watch Out! boxes highlight important safety reminders. 5. Lift the far metal loop, causing the teeth of the buckle to grip the belt while you bring WATCh OUT! A loose belt is a liability. If a patient wearing a loose belt begins to fall, the belt will slide up until it catches, usually under the arms. The sliding belt in itself can injure the patient, and until the sliding belt is stopped, the patient will continue to fall, making a safe recovery increasingly difficult.
Full-color photographs demonstrate proper techniques for both the patient and the therapist.
FIGURE 11•1 cont’d (D) Tuck any belt excess into the belt. Grasp the belt behind the patient with an underhand grip. (E) Have the patient lean forward slightly before removing the belt to avoid injury to the patient.
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