Wheelchair
4 things you teach someone with a new wheelchair and order
1. Brakes
2. Armrests
3. Footrests
4. Propulsion
THEY ALWAYS NEED TO RETURN DEMONSTRATECurbs
1. Go down with the patient facing away from the curb, big wheels gently go down the curb using the leg to help to slowly lower. Then tip to balance point and rolled back towards and gently place down.
2. To go up get the front wheels on the curb and then place the leg on the curb if you can and lift up the curb with big wheels
Hemiplagic
One-sided weakness, UE is worse, Vision may change, Brain damage
Within visual field, Gaurd them on their weak side, use strong legs and arm to propel
Single Knee Block
Clean vs Sterile
Clean limits transmission of micro which prevents the spread of pathogens
Sterile is a technique for wound care and maintain objects free from mircos
Average Temp for newborns
Average temp for 6-adults
Average temp for elderly
97-100
98.6
96.8
How to enter/exit elevators
1. Patient should be off to the side of the elevator
2. Patient should enter elevator backwards
3. If patients cannont go in backwards have someone angle thing out of the elevator so front wheels do not get stuck
4. Or balance point
Stairs
1. Going up wheelchair faces away, tip the chair to the balance point. The higher person gives cues and the lower person controls the wheels as the top person adjusts. The wheelchair will be rolled up to the next step not lifted.
2. Going down the wheelchair faces the chair, the chair will be tipped back and the wheels are to be rolled down each step.
Paraplegic
Both legs have no feeling, Depending on level of lesions
Within Visual Field, Stay in front, and may have a seatbelt, heel loops, and leg lifter.
Must hook an opposite arm around handle to protect them from falling forward when adjusting anything on chair
Double Knee Block
Contact Precauntion
Usually in a private room, gown, gloves, mask, shoes covers
Average for new borns pulse
Pulse 18+
125 range 70-190
male 75, female 80
know that by each year the pulse decreases
Ramp 5% or Mild
Most outdoor ramps
1. Push up forward
2. go down forward
Times where balance point is used
1. Rough terrain
2. Obstructions
3. Stairs
4. Curbs
Arthritic
May not be able to propel, All joints are affected, UE may be more involved, limited shoulder hypertext.
Guard in front, may use legs to propel, lower seat
Double Knee block Patient
Droplet Precaution
Private room, gown, mask, gloves, possibly goggles
Average Resp/min new-borns
16+30-80
12-20
Ramp 8.3 or Moderate
1. Go up forward, use hip and side on to push if the weight is too much
2. Go down forward but tip to balance point
Friction for propeling
1. Friction rims
2. Vertical Projections
3. Rubber on rims
4. High friction gloves
Quadriplegic
Brain damage, spinal cord injury, all 4 Extremities
Guard in front and very close, May have power W/C
Very high risk for falls
Airborne Precaution
Negative air pressure, gown, gloves, mask, Goggles, or even an air controlling helmet
Average BP newborns
Adults
78/42
120/80
Ramp 10% or Extreme
1. Go up forward or use hip and side on to go up
2. Go down backward with assistance on the low side
(use hip and go down slow)
Folding and Unfolding Chairs
1. Dont drag wheels, pull to you
2. Fold up footrests
3. Straps
4. Push seat down fully
Steps for a sterile wound change
1. Gather supplies 2. Wash Hands 3. Gown, mask, then clean gloves 4. Talk to the patient, ask about wounds, let them know what is going to happen, and take the old dressing off 5. toss old gloves properly and wash your hands 6. Open sterile towel, tongue depressor, gauze, and open med. cream and saline ( pour some out) also your other products 7. Place a sterile glove on, the hand can only touch the inside of the glove, not the outside 8. Apply medication and take some gauze and place it on a sterile field, then dump saline into the container of gauze pads 9. Other sterile gloves on and place the non-sticky cover on the wound, place wet gauze pads on the wound and place dry gauze pads on the wound 10. Use gauze and wrap 1 inch above and below the wound and then clean up 11. Wash hands when done