Accident and emergency radiography - yimg.com

spreadeaglerainMechanics

Oct 24, 2013 (3 years and 9 months ago)

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Course Title :
ACCIDENT&EMERGENCY RADIOGRAPHY



Course code: RAD
-
422)


Level
:

8



lecture
hours/week :

2h


Lecture Timing :
Wednesday (10
-
12)




1.
Describe the trolley design and its basic components

2.
List the basic safety factors that must be considered when moving a
patient.

3.
List and identify principles of body mechanics.

4.
Identify the components of lifting techniques.

5.
Determine the amount of assistance involved with the transfer

6.
Discus correct manner of transferring patient:


A
-

from wheelchair to x
-
ray table


B
-

from x
-
ray table to wheelchair


C
-

from stretcher to table


D
-

from table to stretcher


8. Explain the safety precautions when examining patients with Foley


catheter, IV bottle, and
chest drainage system.



By the end of this Lecture the student will be able to:

Learning Objectives

Primary care of emergency patient

Transference to and handling
techniques


Lecture .1


Definition




Accident
;

is especially harmful event ,caused unintentionally or which
happen unexpectedly and causes injury or trauma to the body.



Emergency
; is situation in which the condition of a patient or sudden
change in medical status requires immediate action




Emergency in radiology department




-
Emergency actions on the part of the radiologic

technologist as a whole have the objectives of

preserving life , avoiding further harm to the patient ,

and obtaining appropriate medical assistance as


quickly as possible.


-
The radiologic technologist must be able to recognize

emergency situations ,to maintain a calm and confident

presence ,and to take appropriate action.



















General Principles



Although most patients are sent to the radiology department only after
they have been stabilized ,some patients are not stable ,and the status of
other may change while they are in the department


The technologist should keep in mind the following actions when
working with patients in emergency situations:


1
-

Ensure an open airway .


2
-
Control bleeding.


3
-
Observe closely for any indication of shock to prevent or treat.


4
-

Attend to wounds or fractures .


5
-

provide emotional support .


6
-
Continualy re evaluate and follow up the patient .

General Principles

General Principles


A
variable height adjustment


A drip stand holder


A mean of tilt the trolley top


An
oxygen bottle holder


Brakes on the wheels


A radiolucent rubber covered foam
mattress capable of being detached to
slide across onto an x
-
ray table



An adjustable backrest which can be
inclined at various angles



A side rests which can be raised and
lowered as necessary.


The trolley used for transport patient must have certain characteristics to
make it suitable for severe injured patients , this include:
-


Principle for safe patient transfer


2
. Let the patient do as much of the transfer as possible
.



1
.Check chart for precaution before transfer to minimize patient pain


3. Use wide base of support for your stability.



4. Hold the patient with a transfer belt around the waist .


5
. Avoid trunk twisting during transfer .


6
. Watch the patient for signs emergency , and take precaution to


minimize its effects .

Principle for safe patient transfer


1
. Check chart for precaution before transfer


to minimize patient pain
.

Principle for safe patient transfer


2
. Let the patient do as much of the transfer


as
possible

to minimize trauma to the patient and
avoid stress on the technologist.


The safest way of lifting and moving things is
use these principles of body mechanics:


Center of gravity (pelvic area) S2.



Base of support (the feet).



Body alignment

(patient center


Of gravity Close to your own


center of gravity).


Using Proper Body Mechanics

Principle for safe patient transfer

3
. Use wide base of support for your stability.


Principle for safe patient transfer

4
. Hold the patient with a transfer belt
around


the
waist to minimize stress on the patient shoulder.
.

Principle for safe patient transfer

5
. Avoid trunk twisting during transfer

Principle for safe patient transfer

6
.

Watch the patient for signs of any emergency


and take precaution to minimize its effects.


Avoid unnecessary bending.


Avoid unnecessary lifting.


When lifting, face the object you are
moving.


When changing direction of
movement, turn your whole body.


Use your strongest muscles to
accomplish work.


Use your thighs and hips by bending
knees when lifting.


Use both arms to lift.

Principles of Body Mechanics


Using the body’s major moveable parts (head, trunk, arms, and legs) is
an efficient manner to maintain balance, conserve energy, and avoid
strain and injury while performing work.

Body mechanics

Advantages Of Proper Body Mechanics


Prevent injury


Reduce energy
consumption


Components
Of Good Body Mechanics


Posture


The alignment of head, trunk, arms, and legs


The proper alignment of the body


Coordination of body movement

A
-

Wheelchair transfer



Tow persons lift
technique



Standby
assist transfer



Hydraulic lift techniques


Assisted standing pivot transfer

Mechanic of lifting

Standby assist transfer

For patient have ability to transfer from a
wheelchair to table on their own .


1
-

Position the wheelchair at a
45
degree angle


to table

2
-

Move the wheelchair footrest out of the way .

3
-

Be sure that the wheelchair is locked .


Then instruct the patient to:

4
-

Sit on the edge of the wheelchair seat .

5
-

Push down on the arms of the chair to assist


in rising

6
-

Stand up slowly .

7
-

Reach out and hold onto the table with the


hand close to the table .

8
-

Hold onto the table with both hand and sit


down .

Two Persons Lift

For patient cannot bear weight on their lower
extremities.



Hydraulic lift techniques
:

For patients are too heavy to lift manually


Assisted standing pivot transfer

For patient who cannot transfer independently







B
-

Cart transfer (stretcher


1
-

cart to table with moving device


Position the cart close to long side of the
table and then secured (locks and sand
bags)



patient rolled away from table


The moving device(thin sheets of plastic
,
polyster
..) is placed halfway under the
patient


Patient returned to supine position


The sheet device is then used to slowly
move the patient onto the table





2
-

cart to table with out moving
device



( three people need in transfer)



Roll up the draw sheet(
2
) on both
side of the patient


One use to support the patient
head and upper body and other
support the leg (table side)


The third person support the
patient pelvic from the cart side


The patient hands crossed over the
chest to avoid injury





3
-
Hydraulic

lift techniques



For patients who are too heavy to lift manually




It is recommended that the IV bottle be kept
18
to
20
in above the level of
the vein.

Note:



If the bottle is too high, the pressure of the IV fluid can cause it to pass
through
the vein
into surrounding tissues, causing a painful and potentially
harmful condition.



If
the IV bottle is too low, blood may return through the needle into the
tubing,

form a clot, and obstruct the flow of IV fluid.



For a patient with a Foley catheter, during the radiological examination
place the drainage bag and tubing below the level of the bladder to maintain
the gravity flow of urine.

Note:



Placement of the tubing or bag above or level with the bladder


will allow backflow of urine into the bladder. This reflux of


urine can increase the chance of urinary tract infection (UTI).

Caring of Patients with
Foley catheter

Caring of Patients with IV bottles



Chest tubes are used to remove air, blood, or fluid from the pleural


cavity.




When examining a patient with a chest drainage system it should


always be kept below the level of the patient's chest.




The technologist must take care that the tubes of the chest drainage


unit do not kink and do not get caught on radiographic equipment.




The unit must remain below the level of the chest in order to work


properly
.




Caring
of Patients with
chest drains system

References


Frank M. Pierson: Principles & Techniques


of Patient Care, Saunders;4 edition 2007


Adler &Carlton :Introduction to Radiograph
And patient Care



http
://www.healthcarelearning.leeds.ac.uk/pages/le
arnzone/
1
_emertrans/emertrans.htm

Useful websites


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