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Back Care 999. Patient Handling & Back-care. Presented by: P W IOSH Trainer. Learning. Tell me and I will forget Show me and I may remember Involve me and I will understand. Course objectives. By the end of the course, participants will:
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BackCare999 Patient Handling &Back-care Presented by: P W IOSH Trainer
Learning • Tell me and I will forget • Show me and I may remember • Involve me and I will understand
Course objectives • By the end of the course, participants will: • Be able to demonstrate a working knowledge of key people handling. • Have a basic knowledge of human anatomy. • Understand principle-led moving and handling best practice.
Manual handling operations • “any transporting or supporting of a load by hand or bodily force • Includes: • Lifting, putting down, pushing, pulling, carrying or moving thereof • Using mechanical aids, e.g. trolleys
Driving forces • Addressing manual handling issues can lead to benefits: • Legal compliance: criminal law • Social: fewer sick days and less absenteeism • Moral: should not be injured for work • Market: bad H&S = bad publicity • Financial: accidents cost money - civil liability • Personal: avoid pain, loss, ongoing problem
Backs! 2012 campaign • 5 million lost working days p.a. due to back pain • Back pain is the nation's leading cause of disability with 1.1 million people disabled by it. • www.hse.gov.uk/betterbacks/index.htm • Wider context – 2008/9: • 180 fatalities at work • 130,000 other major injuries
Manual handling quiz • What proportion of reported workplace accidents result from manual handling? • 2008/9 reported injuries • Other 13% • Falls 8% • Struck by 15% • Slips trips 26% • Handling 38% • Chart removed to reduce size
Manual handling quiz • Which of the following types of workplace has the highest proportion of accidents resulting from manual handling? • a. Health care • b. Retail • c. Construction • d. Agriculture
Sites of >3 day injury caused by handling Back 47% etc Graphic removed to reduce size
Types of injury from manual handling • Fractures • Damage to muscles, ligaments and tendons • Spinal disc injuries • Trapped nerves • Abrasions and cuts • Burns • Work related upper limb disorders • Hernias • Death
Work related upper limb disorders • WRULD or repetitive strain injuries (RSI) • Tennis elbow • Carpal tunnel syndrome • Frozen shoulder • Caused by: • Repetitive activities • Carrying out an activity for a long period of time without adequate rest intervals • Poor posture / non-neutral joint positions
Cause of injury • Traumatic stress • Cumulative stress • Degenerative change • Psychological causes
Vulnerable groups • Old • Young • Obese • Untrained • Those with existing injury • Tired • Pregnant women
3 most important things • Family • Home • Relationships • Wealth / ability to earn • Leisure / sports • Health
Practice lift • Demonstrate a typical lift • Demonstrate a good lift • What are the changes?
Vertebrae & discs Nucleus Cartilage
Discs Photos removed to reduce size www.spineuniverse.com/displayarticle.php/article1431.html
Centre of gravity Graphic removed to reduce size
Centre of gravity Graphic removed to reduce size
Centre of gravity Graphics removed to reduce size
Principles of efficient handling • Dynamic stable base • Neutral position of body • Short levers – centre of gravity close • Correct secure hand hold • Good commands and communication
Muscles • Relaxed muscles • Body in neutral position • Static muscle fatigue • Use of major muscle groups • Graphic removed to reduce size
Team handling • What are the problems? Photos removed to reduce size
Team handling • Planning of lift • Communication • How to grasp • When to lift • What level to carry • Which route • Set down points on route? • Co-ordination • Disparity of individuals: size, speed, strength • Awkward areas
Team handling • 1 person = 100% • 2 people = 66% of individual capacity • 3 people = 50% of individual capacity • 1 = 60 • 2 = 80 • 3 = 90
Team handling • Consider other options • Avoid • Mechanise • Use manual handling aids • Run through sequence of events verbally • Walk the route • One person take charge of giving instructions • Stick to established teams if possible
Problem loads • Inanimate objects • Unexpected issues • Light • Heavy • Centre of gravity • Intrinsically harmful • Sharp edges • Acids • Unpredictable behaviour • Partly fixed load • Liquids – centre of gravity • Poor sealing of container • People • Unexpected issues • Light, heavy, C of G • Weak side / strong side • Collapsing • Intrinsically harmful • Teeth & nails • Hygiene • Unpredictable behaviour • Change of mind • Struggling • Aggression
F L U E N C Y • A mnemonic • Feet • Load • Unlock • Even • Natural • Control • Your back
Pushing and pulling • Pushing generally preferable: • Operator slip or trip – no load impact • Less risk of pulling load onto feet & ankles • No twisting to see where you are going • Better position for arm joints • Can often use both hands • Cage less likely to tip if fixed wheels leading • But: • Visibility may be hindered • http://www.hse.gov.uk/research/rrpdf/rr009.pdf
Pushing and pulling considerations • Wheels: • Initial direction & obstructions • Size • Fixed or rotating • Load: • Stability / safety • Visibility • Route • Obstructions • Slopes • Hands • Between waist and shoulder height • Neutral position • Avoiding impacts • Legs: “A” frame to overcome inertia • Travel • Slow speed • Avoid starting & stopping
Pushing a wheelchair • Pre-use checks • Wheels • Foot rests • Clothing of client • Brakes • Client understands what is happening • Use • Dynamic stable base • Short levers
Health and Safety at Work etc. Act 1974 • Section 2(1) general duty • "to ensure, so far as is reasonably practicable, the health, safety and welfare at work of all his employees"
Health and Safety at Work etc. Act 1974 • s3: duty to others who may be affected; contractors, visitors, neighbours & public • s7: employees duties: • Take reasonable care of themselves and others • Co-operate with employer • s8: Not intentionally or recklessly interfere with or misuse anything provided for health and safety
Management of H&S at Work Regs 1999 • Every employer shall make a suitable and sufficient assessment of the risks to health and safety of employees & non-employees. • Must implement suitable preventative and protective measures.
Management of H&S at Work Regs 1999 • Regulation 4: hierarchy of control measures: • E – Eliminate • R – Reduce • I – Isolate • C – Control • S – Signage • P - PPE
Provision & Use of Work Equipment Regulations 1998 (PUWER) • Work equipment must be: • Suitable • Adequately maintained • Inspected if necessary at regular intervals by a competent person • Adequate information & training must be provided • Risks adequately controlled, e.g. guarding
Lifting Operations and LiftingEquipment Regulations 1998 (LOLER) • Lifting equipment: • Any equipment used at work for lifting or lowering loads including attachments used for anchoring, fixing or supporting it • Loads can include a person