بسم الله الرحمن الرحيم

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 components2. 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 transfer6. 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.

Basic trolley designThe 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

ReferencesFrank M. Pierson: Principles & Techniques of Patient Care, Saunders;4 edition 2007Adler &Carlton :Introduction to Radiograph And patient Care

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

Useful websites

The End

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