crutch walking and carries- en

7/27/2019 Crutch Walking and Carries- En

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CRUTCH

WALKING


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DEFINITION

Crutches are orthopedic devices created to assist in weight bearing when a

patient has a leg injury or weakness in the lower extremities.

PURPOSE

Used to assist in weight bearing when a patient has sustained an injury to

the leg, knee, ankle, or foot, such as a fracture or severe sprain.

To aid the user in walking while relieving weight from one foot or leg.

Crutches are also used following surgery on the leg, knee, ankle, or foot.

EQUIPMENTS ADJUSTMENTS:

To adjust height:

-position axillary pad ~8cm (3" or 3-5 fingerwidths) below the axilla-the tip of the crutch should be ~5cm (2") anterior and 15cm (6") lateral tothe foot

To position hand grip:-adjust the hand grip to the level of the wrist crease (alternatively, adjust to

height of the greater trochanter of the femur)-elbow angle should be ~20-30 degrees

INDICATIONS

Pain caused of abrasion on AV joints

Inflammation of AV joints

Postoperative or conservative treatment of AV injuries,

After amputation and supplying of AV

Aberration of AV

Imbalance (disorder of balance), weakness or paralysis of AV.

PRECAUTIONS:

Have someone nearby for assistance until accustomed to the crutches. Frequently check that all pads are securely in place and all hardware is

tight.

Check screws at least once per week.

Clean out crutch tips to ensure they are free of dirt and stones.

Remove small, loose rugs from walking paths.


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Beware of ice, snow, wet or waxed floors, and telephone and extension

cords.

Avoid crowds; leave class early.

Never carry anything in your hands; use a backpack.

Watch for pets.

CRUTCH WALKING GAITS

Four-Point Crutch Gait

Indication:Weakness in both legs or poor coordination.

Pattern Sequence:Left crutch, right foot, right crutch, left

foot. Then repeat.

Advantages:Provides excellent stabilty as there arealways three points in contact with theground

Disadvantages:Slow walking speed

Three-Point Cru tch Gait

Indication:Inability to bear weight on oneleg. (fractures, pain, amputations)

Pattern Sequence:First move both crutches and theweaker lower limb forward. Thenbear all your weight down throughthe cruthes, and move thestronger or unaffected lower limb

forward. Repeat. Advantages:

Eliminates all weight bearing onthe affected leg.

Disadvantages: Good balance is required.


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Two-Point Crutch Gait

Indication:Weakness in both legs or poorcoordination.

Pattern Sequence:Left crutch and right foottogether, then the right crutchand left foot together. Repeat.

Advantages:Faster than the four point date.

Disadvantages:Can be difficult to learn the pattern

Swing-Through Crutch Gait

Indications:Inability to fully bear weight on both legs. (fractures, pain, amputations)

Pattern Sequence:Advance both crutches forwardthen, while bearing all weight downthrough both crutches, swing bothlegs forward at the same time past

the crutches

.Advantage:Fastest gait pattern of all six.

Disadvantage:Energy consuming and requires good upper extremity strength.


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LIFTING ANDMOVING


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EMERGENCY RESCUE

Is a rapid movement of patient from unsafe place to a place of safety

INDICATORS FOR EMERGENCY RESCUE

Danger of toxic gases or asphyxia due to lack of oxygen

Danger of fire or explosion

Serious traffic hazards

Risk of drowning

Danger of electrocution

Danger of collapsing walls

TRANSFER is moving a patient from one place to another after giving first aid.

SELECTION OF PATIENTS DEPENDING UPON THE FOLLOWING:

Nature and severity of the injury

Size of the victim

Physical capabilities of the first aider

Number of personnel and equipment available

Nature of evacuation route

Distance to be covered

Sex of the victim

POINTERS TO BE OBSERVED DURING TRANSFER

Victims airway must be maintained open

Hemorrhage is controlled

Victim is safely maintained in the correct position

Regular check of the victims condition is made

Supporting bandages and dressing remain effectively applied

The method of transfer is safe, comfortable and as speedy ascircumstances permit.

The patients body is moves as one unit

The taller first aiders stay at the head side of the victim

First Aiders/ bearers must observed ergonomics in lifting and

moving of patient.


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EQUIPMENTS:

Stretcher (may be improvised)

Wheel chair Straps/ slings

Method of Transfer

A. DRAGS

ANKLE PULL

The ankle pull is the fastest method for moving a victim a short distance over a smooth

surface. This is not a preferred method of patient

movement.

1. Grasp the victim by both ankles or pant cuffs.

2. Pull with your legs, not your back.

3. Keep your back as straight as possible.

4. Try to keep the pull as straight and in-line aspossible.

5. Keep aware that the head is unsupported and

may bounce over

SHOULDER DRAG

The shoulder pull is preferred to the ankle pull. It supports the head of the victim. The

negative is that it requires the rescuer to bend over at the waist while pulling.

1. Grasp the victim by the clothing under the

shoulders.

2. Keep your arms on both sides of the head.


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3. Support the head.

4. Try to keep the pull as straight and in-line as possible.

BLANKET DRAG

This is the preferred method for dragging a

victim.

1. Place the victim on the blanket by using the

"logroll" or the three-person lift.

2. The victim is placed with the head approx. 2

ft. from one corner of the blanket.

3. Wrap the blanket corners around the victim.

4. Keep your back as straight as possible.

5. Use your legs, not your back.

6. Try to keep the pull as straight and in-line as possible.

A. ONE MAN CARRIES

CARRY IN ARMS

This only works with a child or a very

light person.

1. Place one arm around the

victim's back and the other underneath

his or her knees and lift the person into

your arms.

2. Walk to safety. Have the victim place an arm around your shoulders while

walking, if possible.


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FIREFIGHTER CARRY

1. Crouch down and place one of the

victim's arms across your shoulder. Wrap

your arm around the victim's legs and graspthe other arm of the victim.

2. Lift the person using your legs and carry the person to a safe place.

PACK STRAP

1. Crouch down in front of the victim and

place both of his or her arms over your

shoulders.

2. Cross the person's arms and grasp

the opposite wrist with both of your hands.

You should be holding onto his or her left

wrist with your right hand and vice-versa.

3. Pull the injured person's arms close to

your chest and squat slightly.

4. Push your hips into the victim while

bending forward slightly. Balance theperson's weight with your hips while walking.

FIREMANS CARRY

This technique is for carrying a victim longer distances. It is very difficult

to get the person up to this position from the ground. Getting the victiminto position requires a very strong rescuer or an assistant.

1. The victim is carried over one shoulder.

2. The rescuer's arm, on the side that the victim isbeing carried, is

wrapped across the victim.


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PIGGY BACK

Although this is an effective carry, how far you will bephysically capable of moving the victim will depend on hersize and weight. It is also reduces your ability to carry your

won equipment, particularly if you are hiking with backpacks.

1. Crouch in front of the victim with your back toward herand ask her to put her arms over your shoulders.

2. Grasp the victims thighs, pull them in toward you andslowly stand up, remembering to keep your backstraight.

B. TWO MAN CARRIES

TWO-HANDED SEAT CARRY

1. Crouch down, facing each other on either sideof the injured person.

2. Cross over your arms behind the victim andgrab hold of her waistband or belt.

3. Pass your other hands under the victimsknees and grasp each others wrists.

4. Bring your hands toward the middle of thevictims thighs.

5. Get in close to the injured person and stand up slowly; you are now ready tomove off.

HAND AS A LITER


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The two-handed and, in particular, the four-handed seat carries can only be used withconscious people because they require the person being carried to have some controlover her body and give some assistance to the rescuers.

1. With the person to be carried standing close to you, first hold your left wrist with

your right hand, and ask your carrying partner to do the same.

2. Now, link hands, taking hold of your partners right wrist. This should form asquare.

3. Allow the victim gently sit back onto your hands and get her to place her handsaround your shoulders.

C. THREE MAN CARRIES

HAMMOCK CARRY

Three or more rescuers get on both sides of the victim. The strongest

member is on the side with the fewest rescuers.

1. Reach under the victim and grasp one wrist onthe opposite rescuer.

2. The rescuers on the ends will only be able to grasp one wrist on the

opposite rescuer.

3. The rescuers with only one wrist grasped will use their free hands

to support the victim's head and feet/legs.

4. The rescuers will then squat and lift the victim on the command of

the person nearest the head, remembering to use proper lifting techniques.

BEARERS ALONGSIDE

1. Each person kneels on the knee nearest the victim's feet.

2. On the command of the person at the head, the rescuers lift the

victim up and rest the victim on their knees. If the patient is being

placed on a low stretcher or litter basket: On the command of the


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person at the head, the patient is placed down on the litter/stretcher. If the victim is to be

placed on a high gurney/bed or to be carried: At this point, the rescuers will rotate the

victim so that the victim is facing the rescuers, resting against the rescuers' chests.

3. On the command of the person at the head, all the rescuers will stand.

4. To walk, all rescuers will start out on the same foot, walking in

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