Caring for the seriously ill, must be able to give the patient a comfortable position in bed with extra pillows (pillows under your back 2 at the position of “reclining” at the back 3 pillows with “half-sitting up in bed” position of the patient). Patient’s legs should be slightly bent at the knees. To do this, enclose a folded blanketlo. The foot of the patient should be in the palm, under the lockminute patient enclose a small pillow.
When you move the patient in bed The necessitymo remember the biasing force, which is atcause of the formation of pressure ulcers. To do this, redisplacements of the patient should be moved. The patient is involved in the movement in the bed (it is desirable to move together).
Moving the patient in bed:
- turn the patient on his back;
- remove the pillow and blanket;
- put a pillow cushion that will prevent the patient’s head hit the headboard;
- offer the patient to cover their elbows wrists;
- one person to stand in the upper part of the bodyschA patient, take the hand that is closer to the patient’s bedside, brought under the upper neck
part of the patient’s shoulder;
- promote hand further to the opposite shoulder;
- with the other hand grasp the hand of the nearest and Tribescho patient (hug);
- second mate, standing at the bottom part of the bodyschA patient brings his hands under the waist and hip of the patient;
- offer the patient to bend your knees, keeping feet on the bed;
- bend the patient’s neck, chin pressed to the chest (and thus decreases the resistance and increases patient mobility);
- ask the patient at the expense of “three” push heels on the bed and to promote the assistants, lift your torso and move outcasts
- one of the assistants, located in izgoloVias, raises his head and chest of the patient, the other puts a pillow;
- help the patient to take a comfortable position in bed;
- cover with a blanket;
- make sure that the patient comfortable;
- Wash the hands.
To prevent the formation of pressure ulcers is necessary every 2 hours change the position patsienthat: from the “supine” to translate in atProposition “lying on its side.” To do this:
- bend the left leg at the knee of the patient Soestve (if you want to turn the patient on his right side), palming off the left foot to the right popliteal
- put one hand on the patient’s thigh, the other on his shoulder;
- rotate the patient onto his side, the (thus “lever” effect on hip facilitates Poworachivanie);
- pillow beneath the head and body of the patient (thereby reducing the lateral bending of the neck and the neck muscles voltage);
- to give both the patient’s arms slightly flexed position, with the hand, located on top, leIt lies on the level of the shoulder and head; arm located
from below, lying on the pillow next to his head;
- placed under the patient’s back folded onDushku, slightly podsunuv it under the back straight edge (so you can “hold” the patient onthe decomposition “on the side”);
- put a pillow (from the groin area to the hundrednN) under slightly bent “upper” leg of the patient (thus carried prophylaxis pro
Ledge in the knee and ankle, and prevents hyperextension of the feet);
- provide abutment at 90 ° to the bottom of the foot (thus providing a fold back of the foot and prevents its “sagging”).
From the position of the patient “lying on its side” (fig. 39) can easily translate it to “prone” (Fig. 40). To do this:
- remove the pillow from under the patient’s head;
- straighten the patient’s arm at the elbow;
- pressed his hand to the body along the entire length;
- placing the patient’s thigh under the brush, “Perevipouring “of the patient through his hand on his stomach;
- move the patient’s body in the middle of the bed;
- rotate the patient’s head to the side and be placed under its lower cushion (thus decreasing flexion or hyperextension of the cervical vertebrae);
- enclose a small pillow under the abdomen just below the level of the aperture (thus reducingetsya hyperextension of the lumbar vertebrae and the tension in the back, in addition, the women reduced the pressure on the chest);
- bend the patient’s arm in the elbow;
- hands up so that the brush LAYOUTgalis next to his head;
- placed under the lower leg and ankle joints pillow to prevent sagging andgate outside of the foot.
From the “prone” set the paSims patient’s position – an intermediate position between the “prone” and “lying on its side”:
- remove the pillow from under the patient’s abdomen;
- bend “upper” leg at the knee joint;
- pillow bent under “upper” leg so that the lower shin leg was lying on the lower thigh level (thus preventing rotation of the hips inward prevented nererazgibanie limbs and carried profilakteak bedsores in the knee joint);
- pillow under “upper”, sognutuyuv elbow, arm angle of 90 °;
- straighten the elbow “lower” and put her hand on the bed without bending (thus withstored biomechanics of the patient’s body);
- provide a stop for the network 90 ° (thus ensuring correct folding rearof the stop and are prevented from sagging).
After placing the patient in the position of the Sims, nerevesti it to “supine”, it is necessary:
- remove the pillow from under the hand and knee SoestIslands of the patient;
- straighten the arm and put your sides;
- put the “upper” foot on the “bottom”;
- straighten and put his hand to his hip “bottom” of the patient’s hand;
- lift the torso away from you and put the patient in the position “on the side”;
- help straighten the “bottom” hand out from under the patient’s torso;
- move the patient on his back;
- help the patient to lie down comfortably on the bed, one man placed under the patient’s neck and shouldersleft forearm and hand, his other hand claspinga patient; another helper stands at the bottom of the patient’s body and put his hands under the small of the back and the hip of the patient;
- offer the patient to bend your knees, keeping feet on the bed, bend the neck, pinningchin to your chest;
- offer the patient at the expense of “three” pushXia heels on the bed and give possible assistancenicks torso lift and move to the head of the bed;
- fix and enclose additional perfumeki;
- improve the sheet;
- hide patient.
After putting the patient at any of these polozheny, make sure he feels comfortable.