Lecture on Crutches

Speaker: Sarah Thredson

Overview

Importance of understanding assistive devices (crutches, canes, walkers) for nursing exams.
Focus of lecture: Crutches
- Proper fitting
- Different gait types
- Stair navigation
- Sitting and standing with crutches

Crutch adjustment based on patient height.
- Adjustments possible at the top and bottom.
- Hand grip adjustability.
Key Points for Proper Fit:
- Crutch Rest Pad and Axilla (Armpit):
  - Ensure a 2-3 finger width gap (1-1.5 inches) to prevent nerve damage.
  - Weight should be on hand grips, not on axilla.
- Hand Grips:
  - Should align with the top of the hip line.
  - Elbows slightly bent at ~30 degrees when using hand grips.

Pre-Ambulation Safety:
- Use of a gait belt.
- Start in a tripod position (crutches ~6 inches from feet).
Point Gaits:
- Two-Point Gait:
  - Two points on ground at a time.
  - Move right crutch and left foot together, then left crutch and right foot together.
- Four-Point Gait:
  - Each point moves separately.
  - Sequence: Move right crutch, left foot, left crutch, right foot.
- Three-Point Gait:
  - Move both crutches and injured leg together, then move non-injured leg.
Swing Gaits:
- Swing-To Gait:
  - Move both crutches forward, swing legs to the crutch placement.
- Swing-Through Gait:
  - Move both crutches forward, swing legs past the crutch placement.

Remember: Good Up, Bad Down
- Going Up:
  - Good leg goes first, followed by crutches and bad leg.
- Going Down:
  - Move crutches down first, followed by bad leg, then good leg.

Sitting Down:
- Back to the chair, feel with non-injured leg, move crutches to injured side, sit with non-injured leg bent.
Getting Up:
- Move crutches to injured side, extend injured leg, push up with non-injured leg and crutch hand grips.