Low Back EpidemiologyLow Back Epidemiology

1) 5th most frequent reason for medical consultation.

2) The cost of low back pain is approaching 100 billion dollars/year.

3) 7.5 million people per year will have significant low back pain

4) Low back pain can be avoided.

Causes of Low Back PainCauses of Low Back Pain

Aging– Disc and bony changes such as DJD, Stenosis,

osteoporosis– Neuro-muscular changes

Causes of Low Back PainCauses of Low Back Pain

Acute trauma

– Spinal fractures

– Disc herniations

– Soft tissue injuries

Causes of Low Back PainCauses of Low Back Pain

Occupational Stresses

– Incorrect lifting technique

– Asymmetrical posture

– Prolonged sitting

Causes of Low Back PainCauses of Low Back Pain

General health risks factors– Obesity– Cigarette smoking– General deconditioning– Diabetes– Cardiovascular disease

Posture – Good and BadPosture – Good and Bad

• Poor Posture• Forward Bent (Slump Posture)

• Sway Back (Increased Lordosis)

Back – Principles Of CareBack – Principles Of Care

Remain close to the object.Use the largest/strongest muscles.Widen your BOS.Use short lever arms.Avoid twisting when lifting.Maintain COG close to objects COG.When possible: push, pull, or slide.

Lifting – Lordosis ModelLifting – Lordosis Model

Deep SquatGolfer’s LiftPushing, Pulling, and Carrying

Deep SquatsDeep Squats

1) Object close to body 2) Stabilize lumbar spine 3) Lift with legs

Golfer’s LiftGolfer’s Lift

1) To lift small objects

2) Requires balance

3) Maintain stable spine

CarryingCarrying

1) Waist level

2) Hold object close to body

3) Ask for assistance if needed.

Transfer ActivitiesTransfer Activities

Utilizing Draw SheetSupine to sitStand PivotOne person lift

Utilizing Draw SheetUtilizing Draw Sheet

Position bed Lower side rails Grasps sheet at hips and shoulder Count 1, 2, 3 move

Supine to Sit TransferSupine to Sit Transfer

Slide pt to edge of bed Instruct pt Position hands Have pt to assist if possible

Supine to Sit TransfersSupine to Sit Transfers Count 1,2,3 “move”

Lift up on pt’s back

Slide legs off table

Make sure pt is secure

Stand Pivot TransferStand Pivot Transfer

Manage environment Position chair parallel to bed Secure gait belt No skid footwear Instruct pt on what you are doing

Stand Pivot TransferStand Pivot Transfer

Have pt assist if possible

Remember low back mechanics

Fall PreventionFall Prevention

Pt is assessed on admission for risk of fall

Admitting RN assesses each pt

All health care team members participate in fall prevention monitoring

Fall Prevention InterventionFall Prevention Intervention

Bed in low position and locked

Call button within reach

Bed rails raised

Pts with risk of fallsPts with risk of falls

Yellow dot on the chart

Yellow dot on patient’s wrist band

Yellow diamonds beside the door

Falls may be caused by:Falls may be caused by:

Health status

Response to medication

External factors in environment

Definition of a FallDefinition of a Fall

Fall is defined as a patient on the ground secondary to an unplanned occurrence.

All Staff Monitors Pt’s For All Staff Monitors Pt’s For FallsFalls

Reporting to unit nurseAssisting fall risk Pt seen OOBObserve pt in room and look for

– Leg over rails– Sliding down in chair

Fitness CenterFitness Center

Fitness CenterFitness Center