AIM:
To roll a person with complete C4 tetraplegia from supine to side lying.
Rationale:
A person with complete C4 tetraplegia cannot roll from supine to side lying. In order to ensure that the person does not develop pressure areas, the position of the patient needs to be changed regularly (usually every 2 hours).
Note: Prior to performing the roll, the patient will usually need to be moved across the bed in the opposite direction to the roll (not shown in video clip)
Equipment:
- Height-adjustable wide bed
- 3 pillows
- Stool or chair
Key Points:
- Ensure there is sufficient room to roll the patient towards you, so that the patient is not at risk of falling out of bed
- Ensure the bottom arm is moved to the side and the top arm is moved across the body before moving the top leg
- Maintain support of both the top arm and leg during the roll
- Encourage the patient to lift and turn the head in the direction of the roll
- On completion of the roll, ensure the top arm and leg are supported on pillows, with no pressure on bony prominences
Common Errors:
- Therapist provides inadequate support or pulls on the top arm
- Therapist does not adjust bed to a suitable height to ensure safety of both patient and therapist.
- Patient is positioned too close or too far away from the side of the bed
Progression and Variety:
- Not applicable as the patient is passively moved into side lying