Patient Transfer & Body Mechanics for the ARRT Exam

Overview

Physical Assistance, Transfer and Patient Support covers the hands-on side of Patient Care: moving patients without hurting them or yourself, holding them still, protecting their skin, and behaving well around dying patients. Spinal abuse from lifting is the leading cause of injury to health care personnel, and one rule runs through the whole chapter: assess, then move.

Body mechanics is three definitions. The center of gravity sits at the center of the pelvis, the base of support is the area the feet enclose at 4 to 8 inches apart, and the line of gravity drops straight down through the center of gravity and should fall through the middle of the base. Before any transfer you confirm identity from the wristband, ask about weight-bearing limits, and ask what medication was given in the past 2 to 3 hours. Wheels lock and wheelchair footrests come up before anyone moves.

The named devices sort by what the patient can still do. A gait belt needs some weight bearing, a transfer board needs a seated patient who can help, a sliding board or HoverMatt moves a patient lying flat, and a Hoyer lift handles the fully dependent case. The air-assisted HoverMatt floats the patient on a layer of air that cuts friction and shear, and Ehrlich and Coakes requires at least two trained people for air-assisted transfer devices.

Restraints need an order from a physician or other authorized practitioner plus facility policy, knots that will not tighten with movement, a device that is easy to remove quickly, and release for range of motion every 2 hours. On the hard table, pressure that is not relieved within a few minutes can start an ulcer, so long studies get a radiolucent pad and a position change every 30 minutes rather than the ward's 2 hours. The chapter closes with the Kubler-Ross grief stages, DABDA: denial, anger, bargaining, depression, acceptance, learned in order even though patients do not move through them in order.