hey everyone it's sarah thredson are sorry and calm and today we're going to talk about crutches and as always when you get done watching this review you can access the free quiz that will test you on this assistive device so let's get started for exams in nursing school you want to make sure that you are familiar with assistive devices such as crutches canes and walkers and in our next videos we will be talking about canes and walkers so with crutches what you specifically want to know for exams is how they should properly fit the different types of gates you can do with crutches how a patient should go up and down the stairs with crutches and how they should get up or set down in a chair so first let's talk about proper fit what are some things that you need to see in your patient that tells you that those crutches fit them properly well before a patient even starts using crutches the crutches will have to be adjusted based on the patient's height and they can be adjusted at the bottom and at the top and usually on most crutches there's a height range where you will slide the part of the crutch to meet whatever your patient's hype is also there's a hand grip on the crutch that can be adjusted as well so some things you want to remember is that you want to be looking at the gap between the crutch rest pad and axilla the armpit there should be a gap there it should be about two to three fingers width which ends up being about one to one and a half inches and the reason you want this gap is because while the patient is using using the crutch they need to be putting all their weight on the hand grips rather than on this crutch rest pad via maxilla area because in this area you have nerves and if they're putting all their weight on that number one it's really gonna be uncomfortable and hurt but it's also gonna damage those nerves in that area also you want to be looking at the hand grips and where they're lining up on the body the hand grips should be even with the top of the hip line so whenever the patient actually uses the handgrips their elbow will be slightly bent at about 30 degrees now let's talk about the different types of gates while using crutches and you want to make sure that you really truly understand these different types of gates that I'm going to go over because exams love to give you a description of a gate that a patient may be doing while using crutches and you'll have to identify it so before a patient even starts ambulating with crutches at first you want to make sure that they are wearing a gait belt for safety also before they start doing one of these type of gates they're going to start in the tripod position and it looks something like this and it forms like a triangle Hintz looks like a tripod and this is where the crutches are about 6 inches out diagonally from the feet so first let's start out with the point gates we have three of them we have the 2-point gate the 3-point gate and the four point eight now how you can keep these straight is that you need to ask yourself how many points are on the ground hence how many crutches are on the ground and how many feet are on the ground whenever you're looking at the scenario because each crutch counts as a point and each foot counts as a point so the two point we're gonna have two points on the ground at a time whether it's a crutch or a foot so what does it look like well this is where the patient will move the crutch on the injured side so we're gonna say it's the right side so they move the right crutch and they move the left foot together then they will move the left crutch on that non injured side and the right foot together so you have two points next is the four-point game and it's a little bit similar to the two-point gait but each point is moving separately because remember in two-point they were moving together the Rye and the left moving together and then the left and the right moving together but here with four point they're separate so the patient will move the right crutch witches will say the injured side then they'll move the left foot then they'll move the left crutch and then they'll move the right foot and the last point gay is the 3.8 and this is where they move both crutches and the injured leg together at the same time and then they will move the non injured leg and then lastly we have the two swing gates and it's either a swing to gate or a swing through gate and let the names help you so the swing to gate is where the patient will move both crutches forward then they will hint swing or move both legs forward and place them at the placement of where the crutches are located now the swing through is very similar to this they will move both crutches forward then they will move both legs forward can't swing both legs forward but they will swing it pass the crutch placement now let's talk about stairs how does a patient navigate up and down the stairs while using crutches well you want to keep these two straight and what I'm meaning is which leg is going to go first up the step versus which leg is going to go down the step first and to remember that remember good up and bad down so whenever a patient is going up the stairs their good leg is going to go first up on the step followed by the crutches and the bad leg which will proceed and go up the step now whenever they're going down the steps they're going to move the crutches down onto the stab that will help provide stability followed by the bad leg because a bad leg is going to go down and then they're going to move the good leg down on to the step and lastly we're going to wrap up the lecture and talk about how a patient sits down and gets up while using crutches to sit in the chair the patient's going to back up to the chair and fill the chair with the non injured leg and when the patient fills the chair with a non injured leg they're gonna stop and move both crutches over to the injured side for support then the patient's going to grip the hand grips and slightly bend the non injured leg and feel behind them and then set in the chair while keeping the injured leg extended to get up from the chair the patient is going to take the crutches and put them on the injured side for support he's going to keep the injured leg extended and push up on the non injured side and using the hand grips of the crutches then he's going to put the crutches in position thank you so much for watching don't forget to take the free quiz and to subscribe to our channel for more videos