Paciente no colaborador
Se deben llevar a cabo los siguientes pasos al voltear al paciente:Es posible que necesite repetir los pasos 4 y 5 hasta que el paciente esté en la posición correcta. Cuando el paciente esté en la posición correcta
Cruz Roja Americana. Ayudar a posicionar y trasladar al paciente. En: Cruz Roja Americana. American Red Cross Nurse Assistant Training Textbook. 3rd ed. American National Red Cross; 2013:cap.12.Qaseem A, Mir TP, Starkey M, Denberg TD; Clinical Guidelines Committee of the American College of Physicians. Evaluación del riesgo y prevención de las úlceras por presión: una guía de práctica clínica del Colegio Americano de Médicos. Ann Intern Med. 2015;162(5):359-369. PMID: 25732278 www.ncbi.nlm.nih.gov/pubmed/25732278.Smith SF, Duell DJ, Martin BC, González L, Aebersold M. Mecánica corporal y posicionamiento. En: Smith SF, Duell DJ, Martin BC, González L, Aebersold M, eds. Clinical Nursing Skills: Basic to Advanced Skills. 9th ed. Nueva York, NY: Pearson; 2017:cap 12.
Versión en inglés revisada por: Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children’s Hospital, Seattle, WA. También revisada por David Zieve, MD, MHA, Director Médico, Brenda Conaway, Directora Editorial, y el equipo editorial de A.D.A.M. Traducción y localización realizada por: DrTango, Inc.
Moving the patient to one side of the bed
A patient’s body may slide slowly in bed when he or she remains there for a long time. The patient may ask to be moved higher to be comfortable or may need to be moved up so the doctor can do an exam.Avoiding Injury
You must move or pull someone up in bed in the correct way to avoid injuring the patient’s shoulders and skin. Using the correct method will also help protect your back.At least 2 people are needed to safely lift a patient into bed. Friction from rubbing can scrape or break the person’s skin. Common areas at risk for friction are the shoulders, back, buttocks, elbows and heels. Never lift patients by grabbing them under the arms and pulling them up. This can injure their shoulders.Prepare to move the patient.
A sliding sheet is the best way to avoid friction. If you don’t have one, you can make a pull sheet from a bed sheet that is folded in half. Follow these steps to prepare the patient: Pull up
How to lift a person who cannot move
To move the dependent who is face up towards the edge of the bed it is very important to learn the correct technique, because this procedure is often the first step for other mobilizations.
Make sure that the bed cannot move. That is, if it has wheels, make sure that the brake is on. Next, the bed should be raised as high as possible (if its height is adjustable), until the caregiver is comfortable to perform the mobilization.
What are the changes in the patient’s position
The currently accepted “standard of care” is to rotate patients every two hours ; however, there is much more to consider in order to find the right solution for the patient. The frequency of rotations should be determined for each individual patient based on factors such as:
Note the “hammock effect” that occurs when a sagging seat causes the patient’s thighs to fold inward, exposing the hips to pressure from the sides of the chair. Likewise, poorly fitted chairs can cause patients to slouch, which will lead to increased pressure on the buttocks, thighs and spine. Placing a cushion on a sagging seat will not solve the problem. It is necessary to replace the sagging seat with a firmer seat that is covered with a suitable pressure-reducing cushion.
 National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. Emily Haesler (Ed.). Cambridge Media: Osborne Park, Western Australia; 2014.