Back Care Basics

1
Back Care Basics

• Introductions
• Housekeeping items
• Washrooms
• Refreshment breaks
• Overview of lab style
• Discuss
• Demonstrate
• Do

2
LEARNING OBJECTIVES

• Explains the principles of good body mechanics
• Demonstrates back care knowledge and injury
  prevention techniques
• Describes guidelines for footwear, clothing and
  safety
• Demonstrates assisted walking using transfer
  belt, safely.

• Demonstrates pivot transfers
• Identifies core strengthening exercises using
  center of gravity principles
• Demonstrates position principles when assisting
  students
• Discusses ways to prevent injuries

3
BACK CARE BASICS

• Musculoskeletal injuries (MSI) account for
  approximately 30 of all lost time injuries to
  workers in British Columbia. (http//www2.worksafe
  bc.com/Topics/Ergonomics/MSIPreventionProcess.asp
  )

4
WORKSAFE BC FACTS

• Patient handling is the top cause of injury among
  healthcare workers.
• Care workers who manually transfer or reposition
  patients are at significant risk of
  musculoskeletal injuries

• Causes of back injury
• Improper lifting
• Poor posture
• Overexertion
• Slips and falls
• Excessive weight
• Lack of exercise

5
INJURY PREVENTION

• Education
• Identify risk factors
• Lifting, reaching, overexertion, pushing,
  pulling, kneeling, repetitive movements,
  unexpected movements of students, leaning
• Understand steps to prevention of injury
• Ask for help
• Use your professionals (Occupational
  Therapists-OT, Physiotherapists-PT, NSS
  Coordinators-Nurses)
• Work Safe BC (http//www2.worksafebc.com/Topics/E
  rgonomics/Resources-General.asp )
• Free PDF files that include
• Understanding the Risks of Musculoskeletal Injury
  (MSI) An Educational Guide for Workers, on
  Sprains, Strains, and Other MSIs BK78
• Back Talk An Owner's Manual for Backs BK4

6
BASIC PRINCIPLES

• Prepare the setting and equipment before starting
  any lift or move.
• Encourage student to assist as much as possible!
• Use good posture
• Feet apart (wide base of support) or walking
  stance.
• Keep back straight, bend with your knees.
• Keep your chin tucked in.
• Elbows slightly bent, at your sides, closest to
  your body.
• Your shoes must have adequate support with
  non-slip soles
• No sandals, no open toe shoes, no heels.

7
CLOTHING

• Group Discussion
• Consider the following questions
• Jewelry concerns? Risk to student? Yourself?
• What is appropriate clothing?
• Why is this important in back care?
• What things need to be considered when dressing
  for work?
• Are student age and gender factors?

8
Disc Protrusion VideoWorkSafeBC

• http//www2.worksafebc.com/Publications/Multimedia
  /Videos.asp?ReportID35330

9
Discover your center of gravityPelvic tilt
principle Activity

• Sitting to Stand
• Standing to Sitting
• What happens to your body during this? How do you
  sit?
• Think arms, thighs, shoulders, abdomen, pelvis,
  back, knees
• Now try both without using your arms
• What happened?

• 4. Assist person into sitting position
• Have your partner discuss their comfort level.
  Where were their knees? Buttocks? Shoulders?
• Review the body mechanics of sitting to stand and
  stand to sit.
• Discuss point of no return when sliding forward
  on chair.

10
Injury Prevention

• Hold weight close to your body.
• Use your legs and thigh muscles, as they are
  stronger than arms and trunk.
• Avoid twisting of trunk, use pivot or step
  motion.
• Use momentum, gravity and mechanical devices.
• Use both hands to avoid twisting.
• Palm up grip gives stronger movement.
• ASK for ASSISTANCE if weight is too heavy, dont
  be intimidated!
• Co-ordinate move by saying, 1-2-3 Lift (ensure
  you discuss with partner, BEFORE move/lift).

11
Core Strengthening

• Pelvic Floor
• Muscles
• Kegel exercises strengthen the pelvic floor
• Abdominal Wall
• Strengthen the oblique's (side abdominal muscles)
• Upper and lower abdominal exercise
• Quadriceps/Back
• Wall squats with good back posture
• Leg lifts and arm raises

• Warm-up exercises
• Not warming up before stretching leaves your back
  susceptible to injuries. Warm muscles are more
  flexible than cold muscles and are less likely to
  tear.
• Balancing Exercises
• also help to strengthen the core muscles (back.
  abs, hips and buttocks), which are used in
  balancing.
• http//www.bigbackpain.com/back_exercises.htmlbac
  kstrengtheningexercises

12
ONE PERSON PIVOT TRANSFER

• Used When
• Student is able to bear weight.
• Rehabilitation therapist (OT, PT) has determined
  student is safe to transfer.
• EA can safely manage pivot, after considering
  height and weight of self and height and weight
  of student.
• Student is able to participate in transfer.
• NOTE This is a pivot, not a LIFT of the
  student, if the student requires lifting then
  alternative mechanical device is required

13
ONE PERSON PIVOT TRANSFER

• Discuss principle of pivot transfer
• DEMONSTRATE
• BREAK INTO GROUPS OF TWO
• PRACTICE

14
ONE PERSON PIVOT TRANSFER

• EA ensures safety of area
• EA explains transfer to student
• EA ensures brakes are on (if wheelchair or mobile
  chair)
• Position chair parallel to toilet (or alternate
  chair)
• Remove footrests (if applicable)
• Position transfer belt securely
• Position students arms around EAs waist (not
  your neck area)
• Ensure students feet are on floor

• Face student with hips and knees slightly bent
• Unlock safety belt (if used)
• Block students knees and feet if required
• Lean student forward from the hips
• Grasp transfer belt with both hands at students
  waist
• Count 1-2-3 STAND.
• Pivot student towards destination, slowly
• Lean students shoulders slightly forward while
  lowering hips to the chair or toilet.

15
ASSISTED WALKING

• Used When
• Student can take steps.
• Student requires assistance for safety.
• Rehabilitation therapist (PT, OT) has assessed
  and approved the safety of assisted walking.

16
ASSISTED WALKING

• DEMONSTRATE
• BREAK INTO GROUPS OF TWO
• PRACTICE ASSISTED WALKING
• PRACTICE SLIDE TO GROUND (FALL)

17
ASSISTED WALKING

• Ensure area is free of obstacles
• Ensure enough space for two people
• Apply transfer belt securely to student
• Ensure students feet are firmly on floor
• Ensure student is aware of movements and is ready
• Grasp transfer belt at waist

1. Count 1-2-3 STAND
2. Assist student to standing position
3. Maintain firm grasp on transfer belt at back and
   side position
4. Slowly walk with student, EA is slightly behind
   supporting self in walking stance (one foot
   forward) to ensure good center of gravity

18
ASSISTED WALKING

• Points to remember during assisted walking
• Ensure a good center of balance for EA at all
  times.
• DO NOT ATTEMPT TO CATCH A FALLING STUDENT!
• If you can
• Place your body behind the student, place your
  arms around their torso, pull them closer to your
  center.
• Widen your base of support by placing one foot
  behind the other.
• Allow the student to slide down your body toward
  the floor.
• As they slide down, gently lower them to the
  floor.

19
Review of Principles

• ABCs
• Alignment Good posture
• Proper alignment is necessary to ensure no excess
  strain on joints and muscles.
• Balance
• Holding your center of gravity, close to your
  base of support.
• Moving your feet further apart, increases your
  base.
• Coordinated body movement
• using your weight to help with movement. (often
  the momentum, rocking that gets you going!)

20
QUESTIONS?

• REMEMBER
• It is up to you to identify the risk factors and
  request help to prevent risk to YOU and YOUR
  student
• Dont be afraid to ask for help!