BODY

MECHANICS
BODY
MECHANICS
BODY MECHANICS
• The study of proper body movement to prevent and
correct posture problems, reduce stress and enhance
physical capabilities
• Study of human movement
• The way we use our bodies to complete various tasks
during activities of daily living*
• a.k.a kinesiology and biomechanics
• Aristotle – Father of Kinesiology (greek words kinein
which means to move and logos)
• the utilization of correct muscles to complete a task
safely and efficiently, without undue strain on any
muscle or joint
 • Middle Aged*
A • Men and Women = Risk
• Employed
T
• Women are at greater risk after
menopause
R • 80% will experience back pain at
I some point in their lifetime
S • Social and Physiologic factors
K increase the risk
 • Excess Weight
R
I • Smoking
S • Poor work postures and lifting
K practices
F • Previous occurrences of back
A trouble
C • Physical fitness not a predictor of
T
risk but physically fit people do
O
R recover more quickly
S
 PRINCIPLES OF GOOD BODY
MECHANICS
• Your back is critically important to your ability to walk, sit,
stand and run
• Proper care enables you to perform your job well and live
your life with a healthier back
• A significant # of injuries occur every day in the delivery
of health care services to patients in hospitals, rehab
centers and patients’ homes
• Most of these injuries are the result of improper body
mechanics and could have been prevented
• Most back injuries are the result of the accumulative effects
of our lifestyles; rarely result of a single physical injury
 TECHNIQUES TO PROMOTE
GOOD BODY MECHANICS
• Maintain a stable center of gravity
• Maintain a wide base of support*
• Maintain line of gravity**
• Maintain proper body alignment
• Lifting
• Reaching
• Pivoting
• Avoid stooping
ASSISTING PATIENT
TO MOVE UP IN BED
(1 NURSE)
• Explain the procedure
• Wash Hands
• Face the head of the bed with feet apart (one
foot is nearest the bed behind the other foot)
• Place pillow at the head part of the bed
• Instruct client to flex knees bringing the feet as
close to the buttocks as possible
• Instruct client to flex the neck tilting the chin
towards the chest
• Instruct client to place arms across the chest
• Nurse: flex knees and hips, place arm that is closer to
the head of the bed under the client’s shoulder and the
other arm under the thigh
• Instruct client to move up in bed at the count of 3 and
to push the heels and elevate the trunk
• While doing the previous step, rock and shift weight
from the back leg to the front leg
• Assist client in a comfortable position
ASSISTING PATIENT
TO MOVE UP IN BED
(2 NURSES)
• Explain the procedure
• Wash Hands
• Raise the bed to your working level; adjust bed to flat
position; with 2 nurses on opposite sides of the bed,
lower the side rails
• Remove the pillow and place it at the head of the bed
• Place draw sheet on bed under the patient’s midsection
• If able to assist, have the patient flex the knees and
place feet flat on bed
• Fold the patient’s arms across the chest and instruct
the patient to flex the neck with the chin on the chest
• Stand opposite the patient’s center with the feet spread
and turn toward the head of the bed; position one foot
slightly forward
• Fold or bunch drawsheet close to the patient before
grasping it securely and preparing to move the patient
• Shift your weight back and forth from back leg to
front leg, and at the count of 3, move the patient
upward on bed
• Assist to a comfortable position, raise side rails and
adjust bed position
ASSISTING CLIENT TO
A SITTING POSITION
ON THE SIDE
OF THE BED
• Raise the bed to the highest level or the highest level
that patient is able to tolerate
• Place patient in the side lying position facing you
• Stand opposite the patient’s hip; position lifter’s body
diagonally facing the patient and the far corner of bed
• Raise the head of the bed to the highest level
• Place feet apart with foot closer to the headpart in
front of the other foot
• Place arm nearer the head of the bed under the
patient’s shoulder supporting the head and the neck;
place the other arm over the patient’s thigh
• Move the patient’s lower leg and feet over the side of
the bed
• Pivot toward your rear legs allowing the patient’s
upper legs to dangle; shift weight to your rear legs and
elevate the patient
• Remain in front of the patient until the patient regains
balance
• Lower the level of the bed until the patient’s feet touch
the floor
ASSISTING CLIENT TO
TRANSFER FROM
BED TO CHAIR OR
WHEELCHAIR
• Explain the procedure
• Wash Hands
• Assess patient’s ability to assist with transfer; move
equipment as necessary to make room for the chair
• Close door or curtain
• Place bed in low position; assist patient to put on robe
and slippers
• Position the chair at the bedside either facing the head
or foot part of the bed; lock wheels of the bed and
wheelchair
• Assist the patient to a standing position; face the patient
and brace your feet and knees against the patient
• Place your hands around the patient’s waist while the
patient holds on to you. Continue to brace the patient’s
knees with legs and flex knees and hips when seating
the patient between the shoulders and waist
• Use legs to help raise the patient to a standing position
• Pivot the patient into position in front of the chair with
legs positioned against the chair
• Continue to brace the patient’s knees with legs
and flex knees and hips when seating the
patient
• Assist patient for proper alignment when
sitting; use pillows when necessary
 THREE
PERSON
CARRY
• The three nurses stand side by side of the patient’s
bed
• Each lifter assumes responsibility of one of these
areas: 1) head and shoulder; 2) thighs and buttocks;
3) legs and ankles
• Each assumes a wide base of support with a foot
closer to the bed in front, knees slightly flexed
• The lifter’s arms are placed under the patient’s head
and shoulders, thighs and buttocks, and legs and
ankles with their fingers securely around the other side
of the patient’s body
• Bring the patient to the edge of the bed
• The lifters roll the patient towards their chest
• On the count of 3, the patient is lifted and held against
the lifters’ chests
• On the next count of 3, the lifters step back and pivot
towards the stretcher moving forward if needed
• The lifters gently lower the patient onto the edge of
the stretcher and then to the center of the stretcher by
flexing their knees and hips until their elbows are level
with the edge of the stretcher
• The lifters assess the patient’s body alignment and
raise side rails
• 1st 3: move patient to the side of the bed
• 2nd 3: move patient against lifters' chest
• 3rd 3: lifters altogether stand
• 4th 3: lifters pivot going to the stretcher
BODY
POSITIONING (30-67)
 Body Positioning
• - is placing the client in a specific position to
facilitate diagnostic tests, or perform a
procedure or surgical position.
 Assessment
Assessment
1. Assess client’s body alignment and
comfort level in current position.
2. Review chart for conditions the
influence the ability to move or to be
positioned ( fractures, paralysis, spinal
injury).
3. Assess tubes IV lines, incision or
equipment that may alter the positioning
procedure.
 Assessment con’t
4. Assess client’s level of consciousness
and ability to understand and follow
direction.
5. Assess with ability to assist positioning.
6. Assess clients weight and strength.
Determine if additional assistance is
needed.
 Objectives:
1. Maintain body alignment.
2. Maintain skin integrity.
3. Provide comfort.
4. Maintain optimal position for ventilation
and lung expansion.
Equipment
Device for Proper Positioning
 Preparation
• Raise the level of the bed to nurse's
comfortable working height.
• Remove all pillows and devices used in
the previous position.
• Explain the procedure to the patient.
• Position in bed or examining table.
 Supine Position
• Place client on back
with head of bed flat.
• Place small rolled
towel under the
lumbar area of back.
• Place pillows under
shoulders , neck or
head.
 Supine Position
• Place trochanter rolls or sandbags parallel to the
lateral surface of the client’s thighs
• Place small pillows under under ankle to elevate
the heels
• Support feet in dorsiflexion with firm pillow,
footboard or high top sneakers
• Place pillows under pronated forearms keeping
upper arms parallel to the client’s upper body
 Supine Position
• Place hand rolls in client’s hands . Consider
physical therapy referral for use of hand
splints.
• Assess client in comfort level.
 Prone Position
• Roll client over arm positioned close to body,
with elbow straight and hand under hip. Position
on abdomen in center of bed.
• Turn client’s head onto one side and support head
with small pillow.
• Place a small pillow under client’s abdomen
below the level of the diaphragm
• Support arms in flexed position level at
shoulders
• Support lower legs with pillows to elevate toes
• Assess client comfort level
 Lateral or Side Lying Position
• Lower head of bed completely or as low as client
can tolerate.
• Position client toward side of bed.
• Roll client onto side toward the nurse the flexing
client’s knees and placing one hand on clients
hip and one hand on clients shoulder.
 Lateral or Side Lying Position
• Place pillow under clients head and neck.
• Bring shoulder blade forward.
• Position both arms in slightly flexed position. Upper arm
is supported by pillow level with shoulder, other arm, by
mattress.
• Place tuck- back pillow behind client’s back. (Make by
folding pillow lengthwise. Smooth area is slightly tucked
under the client’s back).
 Lateral or Side Lying
Position
• Place pillow under semi-flexed upper leg level
at hip from groin of foot.
• Place sandbag parallel to the plantar surface
dependent foot. Place high top sneakers on
clients feet.
• Assess client for comfort.
 Sim’s (semiprone)
Position
• Lower head of bed completely.
• Have client turn to left side (unless right side is
designated) and lie with body turned slightly
toward face lying position.
• Position left arm back of client . The right arm is
free and my be placed under the small pillow
which is under head.
 (semiprone)
• Assist client to flex right knee and thigh deeply
toward abdomen. Left knee slightly flexed.
• Place a small pillow under client’s head.
 Dorsal Recumbent Position
• Client to lie flat on his/her back.
• Assist client to flex knees ; position feet
wide apart ( with soles of feet on table or
bed) knees are separated.
• Place pillow under head and upper shoulder
 Dorsal Recumbent Position
• Allow client to place arms where comfortable;
hands maybe held on chest or above head
 Fowler's Position
• Elevate head of bed at 45-60 degrees.
• Rest head mattress or on small pillows or small
pillow.
• Use pillow to support arms and hand of client
does not have voluntary control of hands and
arms.
 Fowler's Position
• Place a small pillow or roll under thigh.
• Place small pillow or roll under ankles.
 Fowler's Position
• Position pillow at lower back.
• Place a small pillow or roll under thigh.
• Place small pillow or roll under ankles.
• Note:
• Place the client in a supine position
with the head of the bed elevated to an
angle of 30 degrees.
 Semi- Fowler's Position
Note:
Semi-Fowler’s Position
Place client in a supine position with the head of
the bed elevated to an angle of 30 degrees
High-Fowler’s Position
Place client in a supine position with the head of
bed elevated to an angle of 90 degrees
 Lithotomy Position

• Ask the patient to lie on his/her back as in dorsal

recumbent position
• Help client separate knees and flex thighs deeply
towards the abdomen.
• The lower part of legs and feet are brought upward,
feet are lifted off the table and placed in stirrups.
 Lithotomy Position

• Have client move buttocks down to the edge of

table.
• Place pillow under hear.
• Allow client to place arms where comfortable.
 Knee Chest
Position
• Ask client to face down on table or bed. Then with client
keeping knees and lower legs in same location, help client
to raise body and hands ( or elbows) and knee. When
thighs are perpendicular (straight up and down) with table
orbed , have the client lower shoulders to the table or bed
• Adjust position to keep client’s back straight
 Knee Chest
Position
• Face is turned to one side , or arms maybe flexed and used
to”cushion” the head with face downward.
( Another way is to flex elbows deeply and rest arms on
either side of shoulders. Let client choose). Place small
pillow under head.
 Knee Chest
•
Position
Place a small pillow under chest, if this is more
comfortable for the client.
• Stay close to the client the entire time the
client is on the table of bed.
 Trendelenburg
Position
• Check the availability of bed
straps to be used to prevent the
patient from slipping off the bed.
• Remove the pillow from the head
part and place it at the edge of the
bed.
• Place the patient flat on his/her
back. The head of the bed is
lowered at 30 degree angle below
horizontal level.
 Reverse Trendenlenburg
Position
• Completely the opposite of
the Trendelenberg position.
• This position is assumed
by clients with increase
intracranial pressure and
the client cannot sit down
with the 45 degrees angle
of the bed.
 C-Curve
Position
• Let the patient assume a fetal position .
• No pillows provided on the bed.
• This position is indicated for client for
induction of spinal anaesthesia and for
lumbar or spinal tap.
 General Consideration
1. Make sure that the mattress is firm
2. Water bed is filled correctly.
3. Bed board should be placed beneath
sagging mattress.
4. Ensure that bed is clean and dry.
5. Avoid placing 1 body part particularly one
with bony prominences, directly on top of
another part.
 Evaluation
1. Client comfort is increased
2. Breathing is adequate and unlabored
3. Footdrop is prevented
4. Joint movement is maintained
5. Skin remains intact without evidence of
breakdown
6. Body alignment is maintained
THANK
YOU!
SCULTETUS
ABDOMINAL
BINDER

Cecile G. Gumban
• Explain the procedure
• Prepare the needed equipment (specify what type of binder
is needed)*
• Wash hands and wear gloves**
• Loosen the top sheet at the foot part
• Position patient in supine position with head slightly
elevated and knees slightly flexed
• Instruct and help the patient roll away from the nurse
toward the raised side while supporting abdominal incision
and dressing firmly with the hands. Place the fan-folded
binder under the patient's lower back, in the same manner
as applying a sheet for an occupied bed***
• Note the patient's case
*for obstetrical/OB Surgical Patients: start overlapping the
tails from the top moving toward the bottom
*for Surgical Patients: start overlapping the tails from
bottom moving toward the top*
• Secure the top or bottom pair of tails with a horizontally
placed pin for each end
• Remove gloves
• Arrange the beddings
• Make patient comfortable
• Wash hands
• Documentation
THANK YOU!
19 DAYS BEFORE