USMLE STEP 2 CS- DIFFERENTIAL DIAGNOSIS OF VAGINAL DISCHARGE

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USMLE STEP 2 CS- DIFFERENTIAL DIAGNOSIS OF FOOT PAIN

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Differential Diagnosis of Foot Pain By Dr Esumei

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USMLE STEP 2 CS- DIFFERENTIAL DIAGNOSIS OF CALF PAIN

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USMLE STEP 2 C S- DIFFERENTIAL DIAGNOSIS OF BACK PAIN

Backache Differential Diagnosis by Dr Esumei

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USMLE STEP 2 CS - Amenorrhea

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USMLE STEP 2 CS - Headache Differential Diagnosis- Interactive

TRANSFERS

Ways to Transfer Patients from Bed to Wheel Chair




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COMMENTS

 

1. Let's get real folks. Never, ever, let a patient place their arms around your neck, or do what she did at 3:15 in the video. To much chance of breaking you neck and injuring the patient. I know, I seen this happen to an RPT once. Confined her to a wheelchair for the rest of her life...

 

2. the patient is not supposed to hold onto the therapist's neck on 3:15.  pretty dangerous for the therapist

 

3. That's what I was shocked to see myself. That's an instant fail in my class.

 

4. I would like to see this done on an obese person. Much harder...

 

5. As a student pta, this scares me...her back is rounded the entire time, the patient cannot see where their going because her head is consistently on the wrong side, and she placed the patients arm around her neck when it should have been placed within the gait belt....I stopped the video half way through because it frustrated me...

 

6. This is called "Hurt the therapist transfer."  Tactile cues may also be very important to use. The patient may not be able to hear you when you r in a headlock.

 

7. Good video except the 3:15 mark for dependent transfer. We have been taught in school never to let the patient grab your neck or shoulder in this scenario. Plus, she's completely horizontal and twisting with the patient (which was just covered at 2:50 or so). Wish there was more video on actual bed mobility exercises. Have yet to find one.

 

8. Yeah that looked freaky wrong. Back was rounded and she was getting her neck torqued on. Why not just block the knees and do a normal stand-pivot?

 

9. more videos pls. you Physical Therapists and doctors Helps us PT students to learn more...

 

10. DEPENDENT TRANSFER NOT ANYMORE IMPLEMENTED AS THIS WILL HURT THERAPISTS/PTA/CAREGIVERS.

 

11. We always learned to have the patient look to where they are going. Here they have the patient look away - seems counter-intuitive.

 

POST YOUR OPINION ABOUT THIS CRITICAL SUBJECT FOR THE BENEFIT OF

CARE GIVERS, STUDENTS, PATIENTS AND FAMILY.

Moving a patient from bed to a wheelchair

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From http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000428.htm

Follow these steps to move a patient from bed to a wheelchair. The technique below assumes the patient can stand on at least one leg.

If the patient cannot use at least one leg, you will need to use a lift to transfer the patient.

Preparation

Think through the steps before you act, and get help if you need it. If you are not able to support the patient by yourself, you could injure yourself and the patient

Make sure any loose rugs are out of the way to prevent slipping. You may want to put non-skid socks or shoes on the patient's feet if the patient needs to step onto a slippery surface.

Explain the steps to the patient.
 

    Place wheelchair on the same side as the patient's good leg.
 

    Park the wheelchair next to the bed, close to you.
 

    Put the brakes on and move the footrests out of the way.

Getting a Patient Ready to Transfer

Before transferring into the wheelchair, the patient must be sitting.
 

To get the patient into a seated position, roll the patient onto the same side as the wheelchair.
 

    Allow the patient to sit for a few moments, in case the patient feels dizzy when first sitting up.
 

    Put one of your arms under the patient's shoulders and one behind the knees. Bend your knees.
 

    Swing the patient's feet off the edge of the bed and use the momentum to help the patient into a 

sitting position.
 

    Move the patient to the edge of the bed and lower the bed so the patient's feet are touching the

ground.

Pivot Turn

If you have a gait belt, place it on the patient to help you get a grip during the transfer. During the

turn, the patient can either hold onto you or reach for the wheelchair.

Stand as close as you can to the patient, reach around the chest, and lock your hands behind the

patient or grab the gait belt.

    Place the patient's outside leg (the one farthest from the wheelchair) between your knees for

support. Bend your knees and keep your back straight.
 

    Count to three and slowly stand up. Use your legs to lift.
 

    At the same time, the patient should place their hands by their sides and help push off the bed.
 

    The patient should help support their weight on their good leg during the transfer.
 

    Pivot towards the wheelchair, moving your feet so your back is aligned with your hips.
 

    Once the patient's legs are touching the seat of the wheelchair, bend your knees to lower the patient

 into the seat. At the same time, ask the patient to reach for the wheelchair armrest.
 

    If the patient starts to fall during the transfer, lower the person to the nearest flat surface, bed, chair

 or floor.

Alternate Names

Pivot turn; Transfer from bed to wheelchair

References

Timby BK. Assisting with basic needs. In: Fundamentals of nursing skills and concepts. 10th ed. Philadelphia, PA: Wolters Kluwer Health: Lippincott Williams & Wilkens. 2013: unit 6.

Updated by: Dennis Ogiela, MD, Orthopedic Surgeon, Danbury Hospital, Danbury, CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.  

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BODY MECHANICS

 

DO IT YOURSELF TRANSFER

HOYER LIFT TRANSFER

 

USMLE STEP 2 CS - Headache Differential Diagnosis-- solution

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Headache Differential Diagnosis by Dr Esumei

This crossword was created by Dr. Anthony Esumei with EclipseCrossword - www.eclipsecrossword.com

1 M 2   P I     S G     E R 3                   S I N U S I T I S A     D I 4     5 M O N C   6                                 E T E N S I O N   H E A D A C H E L       N U U       I M S       N O T     7                                   G R T E M P O R A L   A R T E R I T I S       I   R       T C         I E H 8                                             S U B A R A C H N O I D   H E M O R R H A G E     E A     B D 9                                       T R I G E M I N A L   N E U R A L G I A     I C   H   E

Across 25 Y/O M, C/O stuffy nose for 2 weeks. Notes 5/10 frontal headache, rhinorrhea, greenish yelow nasal discharge, fever, pain in both cheeks, no cough, chest pain or wheezing. 25 y/o F medical student with lots of assignments and impending examination. C/o recurrent bilateral headache, 5/10, and occurs 5 times a week 57 y/o M, C/O R temporal headache, 7/10, worse with chewing food, slight relief with tylenol, fever, blurred vision in R eye 67 y/o M c/o sudden severe headache, 9/10, nausea, vomitting and confusion. No h/o trauma. O/E pt has L hemiplegia and nuchal rigidity 68 y/o M, C/O headche and pain while shaving, 2 months ago, 7/10, electric in nature, lasts for 5 minutes. His physician requested for CBC, ESR and MRI brain

Down 31 yo F c/o unilateral headache,throbbing, 5/10, photophobia, sonophobia, sees flashing light on R visual field, nausea and vomiting, weakness and numbness on R side of body 21 YO obese F c/o bilateral headache, 3/10, constant, gnawing, 3 weeks duration, slightly relieved by tylenol. She is sexually active and on oral contraceptive pills. No ETOH, 18 y/o F C/O bilateral throbbing headche, 7/10, associted with fever of 100 degrees F, and neck pain. Patient appears confused and complains about the light in the room (photophobia). Kernigs and Brudzinski's signs were positive 31 y/o M, c/o L Temporal headache, 4/10, occurs at 4pm daily. Has L eye pain, redness, tearing and L rhinorrhea .

This crossword puzzle was created by Dr. Anthony Esumei with EclipseCrossword. USMLE Step 2 CS

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