hey everyone is cereth red sterner sorry and calm and in this video we're going to go over canes crutches and walkers and as always whenever you get done watching this video over assistive devices you can access the free quiz 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 talk 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 that Scylla area because in this area you have nerves and if they're putting all their weight on that number one it's really going to 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 gate 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 going to 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 4-point gate and it's a little bit similar to the two-point gate 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 be 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 whatever 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 Bab 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 okay you want to make sure that you're familiar with how a cane should properly fit a patient how to actually walk with a cane how a patient should go up and down stairs with a cane and how they should get up from a chair or sit down in a chair with the cane therefore let's start with the proper fit how do you know as the nurse of this cane actually fits your patient well before a patient uses a cane for the first time it has to be adjusted most canes can be adjusted at the bottom by sliding the cane into location of where it should go to fit the patient but once the patient is holding the cane or once they have the cane standing beside their body how do you know it actually fits the patient well there's two ways you can tell the first way is that the top of the cane which is felt this area here should be even with the great trochanter the great trochanter is a prominence of the femur so that's all but the cane should rest about right there whenever the patient's standing up and has the cane beside of them or the top of the cane should be even with the wrist crease that is closest to the hand so those are two ways you can tell also whenever the patient is clean the cane the elbows should be flexed at a 15 to 30 degree angle so those are some things that you can look for as the nurse to tell you that this cane properly fits your patient now let's talk about how a patient should walk with the cane before a patient starts using their cane and practicing with it you want to make sure that they are wearing a gait belt for safety in addition you're going to stand on the patient's weak side in case they lose their balance so whenever they start using the cane they want to make sure that they're in the proper position the position that they want to be in they want to make sure that they are positioning the tip of the cane at least four inches from the side of the foot and they want to hold the cane on the strong side of the body so remember that the cane needs to be on the strong side very important concept to remember so how are they going to actually ambulate with this cane well to emulate with a cane what they're going to do is they're going to move the cane with the weak side together forward so they move the cane along with the weak side together and then they will move the strong side forward so how does a patient go up and down the stairs with a cane well the concept is the same like how we learned with crutches remember I told you to remember up equals good down equals bad and what we're referring to is the good leg going up first which would be the strong leg versus whenever we're going down the stairs it would be the bad leg that's gonna go first so the weak side therefore how do we go up the stairs using that concept well what the patient wants to do is they want to hold the cane on that good / strong side then they're going to move the good leg up onto the step and they're gonna put weight onto the cane and then move the cane and the bad leg up onto the step now to go down the stairs the patient again is going to hold the cane on the good side that strong side they're gonna move the cane down onto the step with the bad leg so the bad leg is going down then they're going to move the good leg down onto the step and lastly let's talk about how a patient will sit down and get up using a cane to sit down with a cane the patient is going to back up to the chair until he fills the chair with the back of the legs then the patient will allow the cane to rest on the side of the chair and place both hands on the chairs armrest and place weight on the hands while keeping the weak leg extended out and been the strong leg to sit down to sit up with the cane a patient's going to place the cane on the strong side and lean forward in the chair while keeping the weak leg slightly extended forward then the patient is going to push down on the canes hand grip and the chair armrest and then put weight on the strong leg and stand in position with the cane when you're studying Walker's for your exams there are some things you want to remember you want to remember the proper fit what are those characteristics that the Walker actually fits your patient how to walk with the walker so the gait and how the patient to get up and sat down in a chair so first let's talk about proper fit how do you know that this Walker actually fits your patient well before a patient even uses a walker for the first time it has to be adjusted and on most Walker's they're adjusted down at the bottom you have to adjust each leg there's four of those legs so you've adjusted the Walker now what do you look for these are things you want to remember for your exams well have the patient hold onto the hand grips while they're standing with the Walker and you're going to look at that elbow there should be about a fifteen to thirty degree bend in the elbows also when the patient holds their arms down at their side their wrist crease should line up with those hand grips those two things really tell you that this Walker fits this patient the next thing you want to know about is the gait how does your patient actually walk with the Walker and this is something that you really want to pay attention to for exams so you want to make sure that you're paying attention to what's moving first is that the walkers at the weak side or the strong side and how that order goes so before a patient actually uses a walker for those first couple times you want to make sure that you have applied a gait belt to their waist for safety also you want to stand on the patient's weak side in case they start to stumble or fall you want to be there and you want to tell the patient before they start ambulating with their Walker that they don't want to stare down at their feet while they're doing it even though that just seems like something natural you want to do that can actually mess them up and cause them to fall they want to look straight ahead just like if they were walking normally and the starting position how do they start out walking with their Walker well they want to make sure that the back tips of the Walker match up with the middle of their foot now let's talk about how you actually ambulate with a walker to ambulate with the Walker first the patient's going to get in position and hold onto the handgrips of the Walker first they will lift and move the Walker forward and then make sure all four points of the Walker are touching the ground then they will move the weeks put weight on the hands the other hand grips and then move the strong side again they will lift the Walker move it forward make sure all four points are on the ground then they will move the weak side put weight on the handgrips and then move the strong side to sit down in a chair a patient is going to take their Walker hold on to the hand grips and slowly back up to the chair until they fill the chair with the back of their legs then they're going to slightly extend that weak leg out and take their hands and position them behind them and then their strong leg and feel for the chairs armrest and then set down to get up from the chair what the patient's going to do is of course make sure the Walker is out in front of them they're going to lean forward out of the chair make sure their hands are on the hand rest and slightly extend that weak leg out then they're going to put weight on their hands by pushing up on the armrest of the chair and with their strong leg and putting their hands on the hand grip of the Walker then they are ready to ambulate and again to do that they will lift the Walker make sure all points are on the floor move that weak leg put weight on the handgrips and then move the strong side thank you so much for watching don't forget to take the free quiz and to subscribe to our channel for more videos