Hi. I'm Meris, and in this video, we are
going to be talking about mobility devices such as canes, walkers, and crutches. I am
going to following along using our Fundamentals of Nursing flashcards. These are available on our
website, leveluprn.com. If you already have a set, and you want to follow along with me, I'm
going to be starting on card number 72. Let us get started. Okay. So starting off, you
can see that there is a lot of information here on canes and walkers. So I would very much
encourage you to read this for detail and to go through this in your books because you will
have a lot of patients who use mobility devices. So first up, we are talking about canes. I want
to give you some very important patient teaching. The cane should be held on the strong
side. You may also call the strong side the good side or the unaffected side. So be sure
you read any test question very carefully to make sure you understand which word it's using and
what it means. So we hold canes on the strong side. The other thing is that the cane should be
at the height of the patient's wrist or greater trochanter. The greater trochanter is that
big bump on the femur right below the hip. It usually aligns with where the wrist will fall
when the patient's arm is by their side, okay? Very important to know. And if I am using a
four-pronged cane, I want to make sure that the flatter side is towards my body versus the rounded
side which should go out, because I do not want my patient to trip and fall over those prongs.
Okay. So talking about walkers, walkers also should be at the height of the wrist when
the patient's arms are by their side, so same generally height. And we are going to make sure
that the patient has their elbows flexed when they are using it. We do not want it to be straight
arms. That's going to lead to discomfort and injury. Big thing to know about walkers, though,
is going to be that if my patient uses them, and they are sitting in a chair, I need my patient
to learn to use the arms of the chair to help them get out of the chair, not the walker itself. The
walker is not fixed to the ground, so if I try to pull myself up using it, I may end up pulling the
walker, pulling myself, falling down, being hurt. So I push up off of the chair using the armrest of
the chair. I do not pull myself using the walker. Okay, so moving onto crutches. Very important
patient teaching starting right off the bat is going to be that the pads of the crutches
should not be up against the axilla, the armpit. We have very important nerves and blood vessels
that run right here, so we don't want our patient to be cutting off the circulation there. That's
really going to lead to injury and discomfort. So we want it to be two inches below the axilla,
and we need to teach our patients that when they are using crutches, they should be putting
their weight on their hands, so on the handgrip, not putting their weight on the actual rest
of the axilla. Again, weight on the hands on the handgrip, not in the armpits, okay?
Very important patient teaching there. Now we have a bunch of different crutch gaits,
as you can see. We have just a lot, so I would encourage you to know a little bit about each of
them, understand each of them. The big one that I want to hit here is going to be the swing-through
gait. This is probably what you think of when you think of somebody using crutches. This is the
idea that I'm moving both crutches together at once and then I am swinging up with both legs to
meet the crutches. So this is probably what you're used to seeing, but keep in mind that based on my
patient's deficit, they may have different crutch gaits. For instance, two-point, where they are
moving the opposite leg and the crutch together, three-point, where both crutches are moved with
the injured leg and then the uninjured leg is advanced, and then we also have four-point, which
is moving one crutch and then the opposite leg and then the second crutch and then
the last leg, so kind of walking on all fours almost, but I mean, standing
upright. But think of it as walking on all fours. And then we have the one-crutch gait also,
so be familiar with those so that you understand what the patient teaching of those might be.
Now another thing to know about crutches, very, very important, is how to go up and down
stairs with these. So you'll see here that we've got a lot of best practices. I'm going to hit the
highlights for you and give you a cool chicken. So when I am climbing the stairs, meaning I'm
going up the stairs, I'm going to position my unaffected, my strong leg next to the stair
railing and then hold onto the hand rail on that side. I'm going to position the crutch under
the armpit of the other side, the affected side, and then I'm going to step up with the unaffected,
the good leg, and then bring the affected leg up. So I'm going up, I'm descending the stairs
with my-- I'm sorry, ascending. I'm going up. I'm climbing the stairs with my good leg. Up
with the good, okay? Then descending the stairs, meaning I'm coming down, I'm going down the
stairs, where it's going to be a little bit different. I'm going to position the affected
leg near the stair railing, hold the hand rail, put the crutch under the unaffected side. Now I'm
going to lower the crutch one step. Then I'm going to move the affected leg, the injured leg, the
bad leg down, and then move the unaffected leg. Here's a very simple way to remember it. That's a
lot of words. We go up with the good and down with the bad, right? We want more good; we want less
bad in our lives, so same thing with the stairs. We go up with the good leg, down with the bad leg.
So that's the cool chicken for how to remember that. It's a lot of information for crutches, but
it's really important because once your patient goes home on crutches, they need to know how
to navigate their home and the outside world. So okay. That is it for crutches, for canes
and walkers. Sorry, my brain malfunctioned. I hope that review was helpful. If it was, please
like this video and leave us a comment below. If you have a better way to remember these
crutch gaits, because there's a lot of them, please tell me in the comments. I very,
very, very much want to know because this is tricky stuff. Be sure you subscribe to the
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