(Taken from the US Department of Labor, Bureau of Labor Statistics)
Many Disabled people require assistance with lifting, moving and handling - being turned during the night, being lifted in and out of bed, transferring from a seat to a wheelchair or from a wheelchair to a toilet, being pushed in a wheelchair and so on.
Where you use an individual to assist you with any of these tasks, this is known as manual handling. New regulations were introduced in 1992 (the Manual Handling Operations Regulations) to try and reduce the number of back injuries amongst nurses, care workers, personal assistants and so on caused by such manual handling.
Basically, the regulations say that :
If you have ever had a nurse or a social services care worker someone has probably carried out what is known as a ‘risk assessment’ of your manual handling needs. This will have looked at:
 | the task - what manual handling do you need; |
| you - your impairment, your size and shape, any painful areas and, ideally, your preferences |
| the working area - how easy is it to maneuver in your house, is your bed in a convenient place, are there steps and so on |
| the worker - can they manage the task(s), will they need training |
You should do something similar when you use a personal assistant for manual handling. Think about what tasks you need doing and how you want them to be done.
Then think about what you will need to make it happen :
when you are out and need assistance on and off a toilet and no equipment, or perhaps space, is available
| can your personal assistant always move or transfer you safely. |
| have they been trained in safe handling techniques. |
| will you need to move or re-organize furniture to make moving easier. |
| will you sometimes need two workers. |
| does your personal assistant need to wear clothing which allows them to have a full and unrestricted range of movement. |
| is there equipment which could provide assistance - sliding sheets, transfer board, turning disc, hoist or sling, monkey pole and so on. |
| does the task always have to be done. |
Personal assistants should not generally lift or move someone totally unaided. Whenever possible, they are required by Health and Safety law to use equipment in order to avoid the need for manual lifting.
However, this does not mean that equipment has to be used all of the time. There may be times when you are out and need assistance on and off a toilet and no equipment, or perhaps space, is available.
| Be sensible. |
| Don’t take unnecessary risks. |
| Don’t ask too much of your personal assistant. |
| If necessary, allow them a rest period before moving on to another task. |
| Encourage them to tell you if they think they can’t manage something or that it could be better done differently. |
If you want further advice on lifting, moving and handling, ask your GP to arrange a visit from a health visitor or District nurse.
Introduction
Preventing back injuries is a major challenge to employers. According to the Bureau of Labor Statistics (BLS), more than one million workers suffer back injuries each year, with back injuries accounting for one out of every five workplace injuries and illnesses. One fourth of all compensation indemnity claims are a result of back injuries. This problem produces pain and discomfort to employees, and can have a dramatic change in their productivity and lifestyles.
A BLS survey shows that four out of five of these injuries were to the lower back, and that three out of four occurred while lifting. This survey shows the importance of reducing back injuries caused by lifting. Although no approach has completely eliminated such injuries, a substantial portion could be prevented by incorporating an effective control program, along with an ergonomic analysis and design of work tasks.
OSHA is considering ways to help prevent lifting injuries. The agency requested public comments on October 2, 1986, to help in its research on manual lifting. They are looking at two major categories: engineering controls and administrative controls.
Engineering controls are used to redesign the workstation to minimize lifting hazards. Administrative controls include carefully selecting and training workers so that they can perform their jobs safely.
Suggested administrative controls include:
| Strength testing of existing workers, which one study showed can prevent up to one-third of all work-related injuries by discouraging the assignment of workers to jobs that exceed their strength capacities. |
| Physical conditioning or stretching programs to reduce the risk of muscle strain. |
| Training employees to utilize lifting techniques that place minimum stress on the lower back. |
How to Lift Safely
Before lifting, take a moment to think about what you're about to do. Examine the object for sharp corners, slippery spots or other potential hazards. Know your limit and don't try to exceed it. Ask for help if needed, or if possible, divide the load to make it lighter. Know where you are going to set the item down and make sure it and your path are free of obstructions. Then follow these steps.
| 1. Stand close to the load with your feet spread apart about shoulder width, with one foot slightly in front of the other for balance. |
| 2. Squat down bending at the knees (not your waist). Tuck your chin while keeping your back as vertical as possible. |
| 3. Get a firm grasp of the object before beginning the lift. |
| 4. Begin slowly lifting with your LEGS by straightening them. Never twist your body during this step. |
| 5. Once the lift is complete, keep the object as close to the body as possible. As the load's center of gravity moves away from the body, there is a dramatic increase in stress to the lumbar region of the back. |
If you must turn while carrying the load, turn using your feet-not your torso.
To place the object below the level of your waist, follow the same procedures in reverse order. Remember, keep your back as vertical as possible and bend at the knees.
| 1 PREVENT BACK INJURY |
| 2 GENERAL LIFTING PRINCIPLES |
| i. Get a firm footing. Keep your feet apart for a stable base. Point feet in the direction of travel. |
vi. Lift steadily don't jerk the load.
vii. Keep your back straight and avoid twisting or bending to the side.
viii. Keep the load close. The closer it is to your spine the less force it exerts on your back.
NOTE: Correct lifting is important, and it should be pointed out this does not only apply to lifting patients, but the
heavy stores that are used within a department, e.g. films and processing solutions.
| 3 GENERAL MOVING AND/OR LIFTING PATIENT |
The patient should be encouraged to help him/herself are far as possible; it may be less painful and allow them some independence. To obtain the patient's co-operation, he/she should understand clearly what is expected of him/her, and be instructed accordingly e.g. warn the patient when you are about to lift.
i. Ensure the patient's privacy is maintained
ii. If a patient arrives on a trolley or wheelchair, ascertain how ambulant they are by asking the doctor or nurse, in this instance, do not depend on the patient's comments as they may be confused or too helpful etc. It is best that when in doubt, then lift the patients so as to avoid accidents.
iii. Remove jewellery from your hands and wrists as this may cause skin damage to the patient.
iv. Support/splint areas as needed e.g. fractured limbs, cervical spine etc
v. Ensure the patient's arms and legs are in a suitable position
vi. Ensure there is nothing restrictive to the patient's movement e.g.. bedclothes
vii. Ensure that tubes are free moving e.g. urinary catheters, IV drips, NG tubes, drains etc
viii. Do not rush the patient. If you do you will find that the patient won't be helping and you will have to support the whole weight.
ix. Whenever possible have an assistant, preferably of the same frame and height as yourself. Use a count down to effectively work as a team. When holding onto an assistant, grab his/her wrist in preference to the hand, so if one looses his/her grip then that support is still retained by the other.
x. Lift, don't drag the patient otherwise you may cause skin tearing.
xi. If one person is aiding the patient then be on the patient's weaker side so that they may assist you with their better side."Sometimes the subconscious mind manifests a wisdom several steps or even years ahead of the conscious mind, and has its own way of leading us toward our destiny." Nathaniel Branden
MGM
© ALS Independence 2003-08
