بسم الله الرحمن الرحيم

1. بسم الله الرحمن الرحيم Course Title : ACCIDENT&EMERGENCY RADIOGRAPHY Course code: RAD-422) Level : 8 lecture hours/week : 2h Lecture Timing : Wednesday (10-12)

3. Learning Objectives By the end of this Lecture the student will be able to: • Describe the trolley design and its basic components • List the basic safety factors that must be considered when moving a patient. • List and identify principles of body mechanics. • Identify the components of lifting techniques. • Determine the amount of assistance involved with the transfer • 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.

4. Lecture .1 Primary care of emergency patient Transference to and handling techniques

5. 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

6. 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.

7. General Principles General Principles 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 .

8. Basic trolley design The trolley used for transport patient must have certain characteristics to make it suitable for severe injured patients , this include:- • 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.

9. Principle for safe patient transfer • 1.Check chart for precaution before transfer to minimize patient pain • 2. Let the patient do as much of the transfer as possible. • 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 .

10. Principle for safe patient transfer • 1. Check chart for precaution before transfer • to minimize patient pain .

11. Principle for safe patient transfer • 2. Let the patient do as much of the transfer • as possibleto minimize trauma to the patient and avoid stress on the technologist.

12. Principle for safe patient transfer 3. Use wide base of support for your stability. 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

13. Principle for safe patient transfer 4. Hold the patient with a transfer belt around the waist to minimize stress on the patient shoulder. .

14. Principle for safe patient transfer 5. Avoid trunk twisting during transfer

15. Principle for safe patient transfer 6.Watch the patient for signs of any emergency and take precaution to minimize its effects.

16. Principles of Body Mechanics • 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.

17. 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. 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

18. Mechanic of lifting A- Wheelchair transfer • Standby assist transfer • Tow persons lift technique • Hydraulic lift techniques • Assisted standing pivot transfer

19. 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 .

20. Two Persons Lift For patient cannot bear weight on their lower extremities.

21. Hydraulic lift techniques: For patients are too heavy to lift manually

22. Assisted standing pivot transfer For patient who cannot transfer independently

23. 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

24. 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

25. 3-Hydraulic lift techniques For patients who are too heavy to lift manually

26. Caring of Patients with Foley catheter • 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 IV bottles • 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.

27. Caring of Patients with chest drains system • 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.

28. References • Frank M. Pierson: Principles & Techniques • of Patient Care, Saunders;4 edition 2007 • Adler &Carlton :Introduction to Radiograph And patient Care Useful websites http://www.healthcarelearning.leeds.ac.uk/pages/learnzone/1_emertrans/emertrans.htm

29. The End ThankYou