Transfer methods and precautions between bed and wheelchair

Wheelchair is a key means of transportation for rehabilitated patients. Many measures in daily life must be completed with the help of wheelchair, such as the transfer of bed wheelchair toilet exercise table, etc.

The transfer between wheelchair and bed is not only a complicated transfer, but also the first step for patients to implement mobile activities. This measure requires patients to be affected by unsafe factors such as wheelchair seat, no unstable fracture and postural hypotension; If you want to implement self-reliance transfer, the patient must also have a certain trunk and limb control ability. At the same time, the drop between the wheelchair and the bed should be as small as possible. During the nursing process of wheelchair bed transfer, nurses should follow safe, fast and applicable guidelines to guide and assist patients to complete this measure.

(1) Transfer between wheelchair and bed assisted by two people: this method is generally used for patients with extremely weak physical strength, too thin to move to wheelchair, or with low advanced brain function and loss of physical activity ability. Two nursing staff work together to move the patient from bed to wheelchair or from wheelchair to bed. There are two methods in detail:

① Lateral transfer method. The wheelchair is locked at 20 ° to the bed. The patient took the seat, bent his trunk forward, and inserted his arms under his ribs. A nurse nurse stood after the patient died, his legs clamped one side of the rear wheel of the wheelchair, his hands passed through the patient's armpits, grabbed the patient's interspersed forearms, wrapped his arms around the patient's chest and clamped the lower part of his chest. Another nurse is facing the bed, standing with both feet back and forth, holding the patient's lower limbs with both arms, one hand in the thigh and the other hand in the lower leg. The heavier the patient is, the higher the hand is. During this process, the hands shall be clamped and the arms shall be raised to prevent touching the wheelchair. If the nurse's strength is weak, the buttocks can be raised slightly by gently pulling to both sides.

② Vertical transfer method. The wheelchair shall be vertically locked at the bedside, and the front shall be close to the bedside as far as possible. The patient took the seat, bent his trunk forward, turned his back to the wheelchair, and his body was as close to the bedside as possible. The two nurses left back and forth, stood on both sides of the patient, and put their shoulders against the lower part of the patient's chest; The nurse holds the patient's hip with one hand. If the patient is heavy, he can hold the patient's trouser waist, place one hand under the patient's thigh and hold the other nurse's hand. The patient's upper limbs were placed on the shoulders of two caregivers. According to the agreed signal, the two caregivers lift the patient at the same time and put the patient on the wheelchair.

(2) Transfer between single person assisted wheelchair and bed: the transfer between single person assisted wheelchair and bed is the most common method for patients to transfer independently. This method requires patients to have certain trunk control ability, support their body and complete the transfer with the help of nurses. Commonly used methods are:

① Transfer method of standing position. The wheelchair is obliquely placed at the bedside for 30 °, and the patient moves at the bedside to make his feet touch the ground and his trunk bend forward; The caregiver bends his hip straight back and faces the patient. If the patient's biceps brachii is strong, he can hold the caregiver's neck with his arms. If his upper limbs are strong, he can hang vertically in front of his knees; The nurse's hands hold the patient's hips. If the patient is heavy, you can hold the patient's pants or belt, but pay attention to prevent the formation of the patient's skin damage. The nurse's feet and knees are against the patient's feet and knees, lock the knee hub, and then straighten the back and tilt back. The patient is pulled up to a standing position; At this time, we must pay attention to the nurse's knees, clamp and lock the patient's knee hub, and use my center of gravity rather than waist strength to balance the patient's weight. After the patient stands firm, the nurse gradually turns back to make the patient back to the front of the wheelchair, moves one hand to the patient's shoulder blade to stabilize his chest, and then the nurse gradually bends his hip and puts the patient quietly on the wheelchair. If the patient has lower limb spasm, the transfer of standing position can only be carried out after fully alleviating the spasm. At the same time, nurses must pay attention to self-maintenance and make full use of their focus to control patients' activities. If it is a hemiplegic patient, the nurse only needs one foot to support the patient's knee to avoid his ignorance, and then pull up the patient for transfer.

② Bed vertical transfer method. For some patients who have certain trunk control ability and support the body with both hands or one hand, this method can be used when the gap between the wheelchair and the bed is small. The wheelchair faces the bed and is vertically close to the bedside; Move the patient's body close to the edge of the bed, back to the wheelchair, bend the trunk forward, extend one or both hands backward to grasp the wheelchair armrest; The nurse stands on one side of the wheelchair, holding the patient's shoulder blade with one hand and placing the other hand at the root of the patient's thigh; Then the patient and the caregiver exert force at the same time, and the patient tries to prop up the body and move the hips back and up; The caregiver holds the patient's torso back so that the patient's hips move from the bed to the wheelchair.

The fundamental premise of self-reliance transfer between bed and wheelchair

1. Have good muscle strength of both upper and lower limbs.

2. Have outstanding trunk control ability.

3. Have certain transfer skills, and assist when necessary.

(3) Transfer between self-supporting bed and wheelchair: there must be three fundamental prerequisites for the transfer between self-supporting bed and wheelchair: ① good muscle strength of both upper and lower limbs; ② Have outstanding trunk control ability; ③ To have certain transfer skills, you must also provide assistance when necessary.

Paraplegia and nerve numbness of both lower limbs mainly rely on the strength of both upper limbs to transfer. It requires that the drop between the bed and the wheelchair should not be too large, the muscle strength of both upper limbs of the patient can support weight lifting, and the patient can hold the trunk for transfer. The detailed method is: the wheelchair is locked 30 ° against the bed; In the patient's seat, hang both lower limbs beside the bed, move the body as close as possible to the wheelchair, hold the armrest on the far side of the wheelchair with one hand, and press the bedside or bed surface with the other hand, and bend the trunk forward as far as possible; Then use both hands to move the torso and transfer the hips from the bed to the wheelchair. If the patient's upper limb strength is weak, a skateboard can be placed between the bed and wheelchair. The patient puts his hips on the skateboard, and then pushes and pulls his hands to complete the transfer. Because there may be a risk of falling down when completing the transfer, the patient must be familiar with it again before it can be implemented by himself