Wheelchair Transfers -- Continued

Bed-to-Wheelchair Transfer

1. Lower the bed to wheelchair level, and elevate the head of the bed.

2. Position the wheelchair parallel to the bed with wheels locked and footrests out of the way.

3. With the patient in the supine position, place one arm under the patient's shoulders, one under the knees, and in a single, smooth motion, raise and turn the patient to a sitting position with his or her feet dangling over the side. Patients with back pain may find it easier to sit up from a lateral recumbent position.

4. Take a moment to assist the patient with slippers and a robe, and allow time for the patient to regain a sense of balance, as this may help to alleviate orthostatic hypotension.  At this point, competent patients are able to stand and move to the wheelchair with little assistance, although a steadying hand at the patient's elbow is a good practice.

5. A gait belt, or transfer belt, should be used with weak, unsteady patients, which provides a secure hold. Grasp the gait belt or reach around the patient and place your hands firmly over the scapulae; the patient's hands may rest on your shoulders. On your signal, lift upward to help the patient stand. Use a broad base of support and keep your back straight. Now instruct and assist the patient to pivot a quarter turn so that the edge of the wheelchair is touching the back of the patient's knees, then ease the patient into a sitting position in the chair. Position the footrests and leg rests, and cover the patient's lap and legs with a sheet or bath blanket to provide warmth and comfort and to protect the patient's modesty.

6. Falls most commonly occur when the patient sits in the wheelchair. The patient may miss the edge of the seat or tip the chair by sitting too near the edge. To avoid such an accident, be sure to lock the wheels of the chair and assist the patient until seated securely.

 

Wheelchair-to-X-Ray Table Transfers

1. Place the wheelchair parallel to the table, lock the brakes and move footrests out of the way. 

2. Adjust the height of the table lower to the chair height.

3. Help the patient to stand and pivot with the patient's back to the table.

4. Then ease the patient into a sitting position on the edge of the table.

5. If the table is a stationary table, place a step stool with a tall handle nearby.

6. Have the patient place one hand on the stool handle, put the other arm on your shoulder and step up onto the stool, pivoting with the back to the table.

7. Now ease the patient to a sitting position.

8. After the patient is seated on the table, raise the table if its height is adjustable.

9. Place one arm around the patient's shoulders and one under the knees. With a single, smooth motion, place the patient's legs on the table while lowering the head and shoulders into the supine position. Patients with back pain may want to lie on one side before moving into the supine position.