TRANSPORTATION AND WALKING OF

PATIENTS
1. INTRODUCTION.

Patient transportation refers to the activities that move the patient from one place to another. You can be
transported in bed, stretcher, wheelchair or only with the help of a healthcare professional.

Patient ambulation refers to the act of walking and should be started as soon as possible to avoid problems caused
by immobility. This start is indicated by the doctor and will be progressive. Sometimes, the patient needs to use
walkers, crutches, canes, or the help of healthcare personnel to walk.

2. MAIN RULES FOR THE TRANSPORTATION AND WALKING OF

PATIENTS.

1. Know the patient's situation.

2. Handwashing.

3. Correctly identify the patient and inform them of what is going to be done, asking for their collaboration (if
possible).

4. Prepare all the necessary materials.

5. Provide the patient with privacy.

6. Transport the patient to the bed, wheelchair or stretcher as explained in the previous chapter.

7. Do not abandon the patient in the hallways or leave them standing in drafty areas.

8. If you go over a ramp while traveling, take greater precautions, such as standing in front of the patient and
with your back to the slope.

9. Assess the patient's progression after ambulation.

10. Communicate to the patient what was observed during transport or ambulation.

3. TRANSFER OF THE PATIENT ON A STRETCHER.

1. Inform the patient of the reason for the transfer and its execution.
2. Cover him well.

3. Place the orderly at the head and push the stretcher.

4. Call the elevator and when it stops, press the "STOP" button and then introduce the patient, first the head
of the stretcher.

5. The guard, inside the elevator, will be placed at the head of the stretcher.

6. When leaving the elevator, press the "STOP" button and push the stretcher where it is the first to exit.

They are the feet of the stretcher.

7. To go up a ramp, the orderly will stand at the foot of the stretcher, facing the patient.
 8. To go down a ramp, the orderly will stand at the foot of the stretcher, with his back to the patient.

4. TRANSFER OF THE PATIENT IN A WHEELCHAIR.

1. Inform the patient of the reason for the transfer and its execution.
2. Cover him well.

3. The wheelchair is pushed from behind.

4. If you enter the elevator, pull the chair backwards, towards the elevator.

5. When leaving, the chair is turned around and also left on its back.

6. If there is a ramp, lower the chair backwards, frequently looking back to make sure of the direction.

5. GAIT FACILITATING DEVICES.

Depending on the patient's degree of disability, there are several types of aid. This disability can be:

□ Temporary: like having a leg in a cast.

□ Definitive: like the absence of a leg.

These devices are devices that give the patient balance and support for comfortable ambulation after suffering an
injury to the lower extremity or are an essential element of aid for ambulation.

? PREPARATION OF THE SICK FOR ITS USE.

The use of these devices requires minimal physical conditions of the patient.

Normally, when a person needs one of these devices, they have previously been immobilized for some time and the
lower extremity is impaired for proper ambulation as its muscles are weakened.

The most important muscles to use and strengthen are: the triceps, trapezius and latissimus dorsi.

And this is achieved with the following exercises:

□ Place your hands on the bed and elevate your body.

□ Place your hands on the trapezoid and raise your body.

□ Isometric and isotonic exercises.

TYPES OF DEVICES.

Walker

It is also called a walker or a balcony walker.

This instrument consists of four support points with rubber studs to prevent slipping and provide great stability and
is very useful for people with balance disorders, pain or weakness.

Its disadvantages are that:

□ It does not maintain correct body alignment since the body flexes forward.
□ They allow very slow ambulation.

Its way of use is:

□ Grab the walker by the top on each side.

□ Move it forward, flexing the body.

Walking stick

Provides balance and support for walking, they are used in unilateral injuries, loss of balance or inflammatory
problems that cause pain when supporting. It also allows proper body alignment and prevents joint overload.

To use it, it will be placed on the patient's healthy side about 15 cm away. from the base of the foot.

To walk, the cane and the affected limb are advanced at the same time and then the limb

fury.

To climb stairs, the unaffected limb rests on the step and then the other and the cane.
To lower them, this process is reversed.

Tripod

It is a type of cane with more supports to offer more stability. It is used the same as the cane.
Its disadvantage is that having more base, there is a greater risk of tripping.

crutches

Its use requires skill and practice and therefore, patience during learning is very important.

There are two types of crutches:

Those that rest on the forearm (elbow crutches).

Those that are supported in the axillary area (Canadian crutches).

The crutches have rubber pads to prevent them from slipping; In addition, the footwear that must be used will have
non-slip soles and low heels.

ADAPTATION OF THE CRUTCHES.

Before using the crutches they must be adjusted to the patient's height.

□ In the lateral decubitus position, the distance from the armpit crease to the heel is measured and 5 cm
is added.
□ In a standing position, it is measured from the armpit fold to 15 cm. of the heel.

? TYPES OF GAIT.

There are four types of gait and the use of one or the other depends on the patient's problem.

1- MARCH ON FOUR POINTS.

Indicated for people with leg weakness and who have difficulty supporting their weight.

The phases followed are those of normal walking and the sequence can be: right crutch -> left foot -> left crutch ->
right foot.

2- MARCH ON THREE POINTS.

It is used by people who must walk without supporting the affected limb.

To do this, the two crutches are advanced at the same time and also the injured limb, supporting the weight with the
hands supported on the crutches, then the healthy limb is advanced.

3- MARCH ON TWO POINTS.

It is suitable for patients who can bear weight on both lower extremities.

First the left foot and the right crutch are advanced at the same time and then the right foot and the left crutch.

4- BALANCED GAIT.

It is useful in patients who cannot move their lower extremities (e.g. paralysis) but can bear weight on their upper
extremities.

It can be done in two ways:

Swinging the body to the crutches : the two crutches are advanced and then the body is
balanced to them.
Swinging the body further from the support point of the crutches : both crutches are brought
forward and then the body is swung and placed in front of them.