Riverview IU 6 Presents Back Safety and Lifting

Riverview IU 6 Presents… Back Safety and Lifting Strategies in the School Setting. IU 6 PT/OT Deptartment Fall 2011

Staff Introductions… n n n n n Jill Shull, DPT –PT Mariam Bankovich, PT Jennifer Hindman, DPT Kathy Walton, MS OTR/L Lisa Ryver, OTR/L Julie Hovis, MS OTR/L Ke. Leigh Rice, COTA/L Lacretia D. Lachnicht, OTR/L Toni Riskus, COTA/L

In-Service Objectives n n n Discuss work-related injuries and symptoms Educate participants on normal spine alignment, posture, and back safety Educate participants on rules for lifting.

Work-Related Injuries

2009 Pennsylvania Department of Labor and Industry Injury Statistics Total recordable nonfatal injuries and illness for private illnesses was 3, 277, 700. n Cases involving missed days of work was 965, 000. n Sprain and strain injuries cases totaled 379, 340. n Cases involving injuries to the back was 195, 150. n Cases involving falls was 212, 760. n

Common Work-Related Musculoskeletal Injuries Musculoskeletal injuries involve the nerves, tendons, muscles and supporting structures (i. e. intervertebral discs) n Carpal Tunnel Syndrome n Tenosynovitis, n Neck Tension Syndrome n Low Back Pain

Common Symptoms Of Work. Related Musculoskeletal Disorders Pain Numbness Tingling Muscle weakness Difficulty moving/walking Difficulty performing ADLs. Reduced worker productivity Lost time from work Temporary or permanent disability Inability to perform job tasks Increase in workers compensation costs

SAVE YOUR BACK!!!

Anatomy of the Spine… n 7 Cervical Vertebrae n 12 Thoracic Vertebrae n 5 Lumbar Vertebrae n 5 Fused Vertebrae n Disks- between vertebrae acting as shock absorbers n Curves of spine should be maintained for correct posture, body mechanics and safe lifting

Radiograph of Normal Cervical Spine

Radiograph of Cervical Spine with Pathology

Radiograph of Normal Thoracic Spine

Radiograph of Normal Lumbar Spine

Back Safety Tips

Identifying Poor Posture and Risks n n Prolonged sitting is the enemy (>20 min without position change is harmful) Avoid slouched posture or rounded back and forward head Frequent or repetitive stretching at end Range of Motion Heavy loads offer greater risks n n Repetitive, forceful, or prolonged exertions, or frequent heavy lifting, pushing, pulling or carrying of heavy objects Prolonged awkward postures Avoid bending at the waist or neck Avoid repetitive twisting

Sitting Tips § § § NO SLOUCHING!!! Sit upright with shoulders and hip in alignment Hips, knees, and ankles at a 90 degree ankle Feet flat on the floor Arm rest with 90 degrees at elbows

Computer Position n n Keyboard- 25 -26 inches above floor = elbow height. Monitor height- 23 -33 inches above floor = top of print level with level of eyes. Monitor- tilt to decrease glare and do not place near window. Frequently used items should be within 14 inches from front of desk.

Decrease Strain On Body n The following may be needed in order to ensure proper body alignment. Foot rest n Wrist rest n Swivel chair n Document holder n Proper Lighting (overhead and task oriented) n

Prevent Upper Body Fatigue Keep upper arms straight up and down in line with your body. n Maintain elbows at 90 degrees. n Keep wrist in neutral- wrist should be straight when fingers are on home row of keyboard. n Utilize wrist rests or arm rests. n

Standing Tips

Standing Tips Stand upright to ensure that a vertical line goes from the ear, to shoulder, hip and ankle (this position puts less stress on neck and back muscles) n Have work surface at elbow height n Take breaks in between tasks and change positions!!!!!! n Put frequently used items with in reach n Use a raised foot for one leg at a time n

Standing Workstation Utilize a rubberized cushion or anti-fatigue mat. n Utilize a foot rest or stool to assist in changing position. n Do not twist!. . . take an extra step. n

Lifting Tips…… n n n Lift using your legs and keep your back in a vertical position Keep objects close to your body Do not bend at the back or neck Wide Base of Support Move your feet…do not twist.

GET HELP WHEN YOUR NEED IT! n Always have a second person to assist you with any lift over 50 lbs

Push, Don’t Pull Objects…

Adaptive Equipment in the School Setting

Equipment n n n Power and Manual Wheelchairs Hi/Lo Tables Walking Aides (Walker, Crutches, Cane) Mechanical Lifts Adaptive Chairs n n Slant Boards for Writing, etc. Adaptive Writing Utensils Adaptive Scissors Adaptive Feeding Equipment

Wheelchair Safety Always lock wheelchair brakes before placing a student in or removing him/her from a wheelchair. n Place students in a wheelchair with his/her bottom as far back in the seat as possible to encourage upright posture. n fasten hip or seat belts n

Wheelchair Safety (Cont. ) Check feet to make sure they are in the foot rests before fastening straps. n Always discuss the destination if you are escorting or pushing a student using a wheelchair. Do this regardless of the students level of assistance. n Always lock the brakes if you are coming to a stop, even if it’s for a few seconds. n

Wheelchair Safety (Cont. ) When outdoors turn the chair around and go backwards down short inclines and over curbs. n Watch for cracks in sidewalks so front wheels do not fall into and cause the chair to tip. n

Hoyer Lift

Indications for Using a Hoyer Lift n n Must be trained in proper use of equipment- all lifts are different If a student is dependent, assistance of 2 people is necessary to perform the transfer using a Hoyer lift Indicated for students who are unable to walk or bear weight through their legs without support Used to move students on/off of mats, chairs, wheelchairs and toilets YOU SHOULD BE TRAINED BY A PT OR OT IN THE SCHOOL SETTING BEFORE ATTEMPTING ANY TYPE OF TRANSFER

Transfer Tips for Moving Students n n n Contact the PT/OT staff assigned to your district for child specific training Prepare the area for transfers-be as close as possible Educate the student on what is about to occur n n n Never grab a student by the arm to assist them Be sure the wheelchair is prepared (i. e. brakes locked, leg rests out of the way, and seat belt unbuckled) ALWAYS USE A GAIT BELT WHEN LIFTING

Safety Tips n n n n Always have a clear path Make sure you can see Assess the size of the load Do not hold your breath Allow time between lifting activities Push not pull Face your work Take a movement break

If A Student Falls… n Do Not Move The Student! n n First assess for injury and level of pain. If a fall occurred notify the nurse for an assessment and documentation. Maintain the position of fall but make them comfortable and safe until the nurse completes the assessment. Complete IU 6 incident report form and notify your supervisor.

Prevention Proper posture and alignment n Good body mechanics n Good physical health and exercise n Rest n

Preventative Exercises

QUESTIONS? ? ?

Quiz Time!!! n n n Name a work injury_____________ Which is not a risk factor for a back injury? n Poor posture Poor body mechanics n Stressful living Decline in physical fitness n Work Habits Type of shoes worn Rest is a prevention for injury? T or F Keep the curve in your’ lower back? T or F Weight close to body weighs more? T or F

THANK YOU & Have a great year!