The SPH Medical EPD improves patient safety
CategoriesPatient Handling

Epidural Trends and the Epidural Chair

Current Epidural Trends in Hospitals and the Epidural Chair

Now more than ever in Labor and Delivery departments and in General Surgery areas the trend is to utilize the Epidural Chair to improve patient comfort and safety.  Equally important is the opportunity to improve safety for nursing and Anesthesia staff.  It is well known that the experience of childbirth is extremely painful for the mother. Modern medicine has advanced to provide mothers with epidural anesthesia for pain during labor. Epidural pain relief can make the child birthing experience less traumatic and exhausting for the mom. Epidural anesthesia depends on the technical abilities of the anesthetist. This requires assessing the risks that are present for the patient, positioning the patient for safe administration, and gathering the necessary staff to help with positioning. An often overlooked factor in patient outcomes in regard to pain relief is the ergonomics that nurses must respect during patient positioning to prevent themselves from developing musculoskeletal injury from repetitive patient positioning over their career. We will discuss these points in this article.

Proper positioning of the patient for safe and effective epidural pain relief can be understood with respect to the anatomy of the spinal column. The spinal cord is protected by the vertebral column. When a patient flexes their core, the posterior vertebral column spinal processes spread apart, allowing direct access to the dural sac that covers the spinal cord for anesthesia administration. Often, the nursing staff must help the patient remain in a still-flexed position to allow for safe administration. Depending on the patient’s body habitus, it can be difficult for nursing staff to hold the patient without compromising their own ergonomics. Patient positioning during administration of spinal anesthesia is very important.  EPD, commonly known as an epidural chair, has been implemented to help place patients flexed, allowing for effective anesthesia delivery.  The epidural positioning chair also doesn’t require nursing staff to put their bodies in stressful contortions, minimizing musculoskeletal injuries in the workplace.

Epidural pain relief is often significant to some expecting moms as they fear the pain during labor. Although it is a commonly performed procedure, epidural anesthesia does not come without its risk. Because the medication is being delivered near the dural sac and spinal cord, there is a risk of medication being administered within the dural sac. Risks seen during epidural anesthesia include a severe drop in blood pressure. Other side effects include difficulty urinating, nerve damage, nausea, vomiting, and infection.

Prevent Injury to the Spinal Cord

Injury to the spinal cord can also occur, with paralysis being a possible outcome. It is essential to understand these risks to help minimize negative outcomes. The Epidural chair helps decrease this risk by allowing the patient to be put in a fixed position that won’t disturb the anesthetist. Safety and reliability are of utmost importance in healthcare, and the EPD can provide proper positioning with adjustments in respect to the patient’s body habitus. Although there are many factors that go into the safe delivery of anesthesia, the utilization of an epidural chair can help mitigate the risk with respect to the proper positioning of the patient.

EPD can be used outside of the labor and delivery floor. With respect to spinal blocks and spinal taps, the chair is used because both procedures require the exact positioning. Spinal taps come with similar risks and can be mitigated similarly with the use of the chair. Often time patients who may need a spinal tap for therapeutic or diagnostic purposes must have a risk assessment which includes the ability to position the patient properly. In the pediatric population, a chair is not as helpful as children often require some form of sedation to help with patient positioning because of their age. In the adult population where body habitus is varied, an EPD chair that can be adjusted to reproduce the same position can help improve patient outcomes.

The Epidural Anesthesia

Epidural anesthesia can also be used to supplement general anesthesia for surgery and to help with pain alleviation during post-operative recovery. Surgeries that occur in the lower extremities can often be excruciating in the post-operative recovery period. Supplemental pain relief can help the patient feel more comfortable, and reduced pain perception can help a patient recover faster by complying with post-operative therapy. The utilization of an Epidural Positioning Device can help mitigate a safe and quick administration of a spinal block even in spite of staff not being able to be present for patient positioning. This kind of anesthesia helps reduce the usage of opioids for patients who refuse or patients with a history of opioid abuse.

Overall The utilization of an epidural positioning chair can help deliver safe and reliable anesthesia while reducing the risks of the procedure, the requirement of staffing, and the risk of musculoskeletal injuries. This chair can be utilized in similar procedures such as the spinal tap or even thoracentesis, which shows promising application outside of just epidural anesthesia. This trend to improve patient and staff safety using the EPD is increasing. Word is spreading in clinical circles that the simplicity and ease of use of the EPD drives compliance and therefore reduces risk, a very positive trend indeed.

References:

Comparing Three Different Modified Sitting Positions for Ease of Spinal Needle Insertion in Patients Undergoing Spinal Anesthesia by Sussan Soltani Mohammadi, Mohammadreza Piri, and Alireza Khajehnasiri 2017

CategoriesPatient Handling

Air Transfer Mat Solves Lateral Transfer and Positioning Risk in Hospitals

Solving Lateral Transfer and Positioning Risk in Hospitals

Nurses, certified nursing assistants, and other healthcare workers constantly move, transfer, and reposition patients and residents during their workdays. Needless to say, the repetitive lifting and moving of people to and from beds, chairs and bathtubs can wreak havoc on caregivers’ health. Today, mechanical lift aids, an air transfer mat and other technologies help reduce the risk of injuries to caregivers and patients alike. However, many facilities continue to transfer and position patients manually, assuming that draw sheets and other methods are safe enough. In reality, lateral transfers cause countless repositioning injuries and other nursing injuries every year.

Increased Risk of Injury from Manual Patient Handling Tasks

Patients and healthcare workers alike are often injured during manual patient handling tasks, including when transferring patients laterally from point to point. According to OSHA, healthcare workers are seven times as likely to develop musculoskeletal disorders than workers in other industries. Per the Bureau of Labor Statistics, healthcare workers face among the highest rates of musculoskeletal injury from overexertion. Across all industries, 33 of every 10,000 workers face such risks; in the healthcare industry, 68 of every 10,000 workers do. Additionally, patients are at increased risk of injury from such transfers and other activities. Every year, approximately 440,000 hospital patients die from hospital errors, injuries, accidents and infections, and Medicare patients have a one in four chance of being injured, harmed or killed after being admitted to the hospital.

Risks to Patients

Total care patients – those who are completely immobile and unable to move– must be moved, transferred and repositioned continually by caregivers. Throughout the day, they may be moved from toilet to chair, chair to bed, bathtub to chair and to and from other areas of a facility. Additionally, such patients must be moved from side to side in bed, lifted back up after slipping down in bed and even moved around while their beds are being made.

Every time a healthcare worker manually transfers a patient, they face an increased risk of being injured. Caregivers must often maneuver them from awkward angles and positions, increasing the risk of mishaps. The process is often uncomfortable for patients at the very least, making them dread any time they must be moved and making life more stressful in general.

Risks to Healthcare Workers

Healthcare workers bear the brunt of the risk of injury when laterally transferring patients without the aid of advanced technologies. Because of the obesity epidemic, patients are larger than ever, further increasing the risk of injury. Manual patient handling tasks contribute to countless injuries and chronic conditions among healthcare workers every year, including sprains, strains and slipped disks. Over time, injuries to the low back and shoulders often develop in those who must repetitively move and transfer patients.

According to research performed by Dr. William Marras of Ohio State’s Spine Research Institute, vertebral discs are avascular and depend upon the vertebrae above and below for nourishment and to remain healthy. Due to overexertion, small microfractures in the vertebral discs develop over time and prevent the disc from receiving the required nourishment. Continued overexertion then may result in a severe or career ending back injury. A seemingly “safe” manual patient handling task like a lateral transfer may just be the proverbial straw that broke the camels back.

Hospitals and other facilities face increased costs because of overexertion and injury among nurses and other healthcare professionals, including disability reimbursements and medical expenses. Injuries from manual patient handling cause higher turnover rates and increased absenteeism among healthcare workers. One study revealed that up to 20% of nurses who leave the industry do so because of the risks they face.

Protect Caregivers and Patients with an Air Transfer Mat

Mechanical solutions for lifting, transferring and repositioning patients are more advanced and readily available than ever. By investing in air-powered lateral transfer devices like and air transfer mat, facilities can dramatically decrease the risk of injuries among healthcare workers and patients. Such devices rely on ergonomics to ensure that they suit workers’ capabilities, reducing strain on their bodies. Mechanical lifts with slings, lifts that assist with standing, mechanical transfer aids and other devices go a long way toward protecting residents and caregivers.

When transferring patients laterally, nurses and other caregivers often pull them from bed to gurney with a draw sheet, or they might pull the patient on a sheet, sliding them across a plastic board. Either way, there’s still too much friction, and injuries can easily occur. Today, air-powered lateral transferring devices are the gold standard for reducing the risk of injuries and other problems. These devices use a thin layer of air beneath an inflated mattress to “float” patients from point to point, making the process easier, safer and more efficient for all.

SPH Medical supplies today’s top air-powered patient transfer solutions, allowing facilities like hospitals to reduce the risk of injuries to patients and healthcare workers. Products like AirPal and HoverMatt significantly reduce the risk of nursing injury and repositioning injury; in turn, employee downtime, absenteeism, disability expenses and other issues decrease, allowing facilities to maintain productivity while keeping costs in check. Today, the CDC recommends one patient lift device per eight immobile patients, and air-powered transfer devices are among the most useful and flexible options. Find one that suits the needs of your facility by shopping SPH Medical today.

CategoriesPatient Handling

Patient Positioning and Nursing Injuries

How Patient Positioning and Lateral Transfers Increase Risk of Injury to our Nurses

Patient positioning in a hospital, surgery center, or medical clinic occurs twenty four hours a day and every day. Patients are constantly sliding down in bed and therefore need to be boosted back up, turned, bathed, and transferred. In this article we’re going to review one of the most common and predictable patient positioning tasks, a lateral transfer. Lateral transfers occur in many inpatient hospital units throughout the day. Whether patients are headed into surgery or to the imaging center, numerous departments oversee lateral transfers. In layman’s terms, a lateral transfer consists of transferring a patient from one surface to another. Unfortunately, the unpredictability of this procedure leaves a lot of room for error. As a result, both medical professionals and patients become susceptible to injuries. Specifically, hospital staff are at risk of MSDO’s due to the high frequency of this task and the increasing weight of patients. Lateral transfers have become so dangerous that more constructive alternatives are being developed.

In most cases, nurses perform lateral transfers by using the sheet that’s underneath the patient. If there aren’t enough hands on deck, a plastic board can help offset insufficient manpower. However, this method is far from flawless, and it doesn’t reduce enough friction to prevent a nursing injury or repositioning injury from occurring. Strains and sprains are commonplace but more serious career ending back injuries are occurring. Since a successful lateral transfer hinges entirely on physical effort and effective communication, these practices have been deemed high risk.

In fact, these techniques are so ineffective that medical professionals are over 30 percent more likely to experience musculoskeletal pain.  According to the Bureau of Labor Statistics, Registered Nurses are the number one at risk profession for a back injury with an average of 7 lost work days per injury.  Manual Patient Handling injuries are the primary culprits for this debilitating condition. While occupational injuries aren’t ideal for workers, they can be especially detrimental to hospitals. Not only do injuries leave their personnel indisposed, but these mishaps can also prove costly, requiring hospitals to pay hundreds of thousands of dollars to cover injury costs, and that’s just the direct cost of these injuries.  d

In the hopes of addressing this ongoing issue, the Bureau of Labor Statistics held a study on safe patient handling programs. Their research showed that hospitals with proper lateral transfer procedures were 73 percent less likely to put their nurses or patients at risk. With this compelling evidence, the House made the noble decision to draft the Nurse and Health Care Worker Protection Act in 2015. At its core, this bill seeks to protect nurses from musculoskeletal disorders by requiring hospitals to reinforce their mobility, injury prevention, and patient handling standards.

The Future Of Safe Lateral Transfers

To combat the number of repositioning injuries, companies started introducing air-assisted transfer systems. AirPal is touted as the brains behind this invention and is renowned for being the first to design this revolutionary technology. With the efficacy of air-assisted transfer systems, companies like HoverMatt were eager to make this resource more accessible, leading to increased supply of the disposable or single patient use transfer mattress.

Air Powered Transfer System

In essence, these systems reduce friction while offering unmatched safety for both the patient and the caregiver. As a result, they improve ergonomics, reduce risk of injury to nurses, and improve patient satisfaction and safety during lateral transfers. Thanks to the incredible ability to reduce friction for patients of all sizes, fewer people are needed to oversee lateral transfers. To ensure that patients and staff members remain out of harm’s way, SPH Medical implements air-assisted transfer systems in hospitals all across the country.  SPH Medical is helping to make air assisted lateral transfer systems available to all hospitals at affordable prices.

Reasons To Choose Air-Assisted Transfer Equipment

Air-assisted transfer systems are highly sought-after for their ability to reduce handling injuries, but they offer more benefits than that. In addition to promoting safe practices, this cutting-edge equipment also instills comfort into the patient experience. In other words, patients aren’t as vulnerable to the unease and discomfort that accompanies traditional lateral transfers. With this modern equipment, transitioning a patient from point A to point B is seamless.  This can improve hospital efficiencies and throughput further reducing costs.

According to patients, air-assisted transfer systems give the illusion and feeling that they’re floating from one surface to the next. What’s more, this streamlined process makes patients feel like less of an inconvenience. When caregivers have to exert tremendous energy to move a patient, it can trigger self-consciousness especially for the Bariatric patient.  The dignity and care of Bariatric patients is an important consideration for hospitals across the country.  In her book The Challenges of Caring for the Obese Patient, Sue Gallagher states, “Even the most compassionate caregiver may be reluctant to provide adequate care [to a patient with obesity] because of the threat of caregiver injury.”  Fortunately, air-assisted equipment reduces self-doubt of caregivers and patients alike, bringing patients great peace of mind while allowing medical professionals to provide exceptional care.

 

References:

Gallagher S. The Challenges of Caring for the Obese Patient. Edgemont, PA: Matrix Medical Communications; 2005

Air Powered Transfer System
CategoriesPatient Handling

Lateral Transfer and Positioning Risk in Hospitals

The Dangers Of Lateral Transfers

Simply put, a lateral transfer involves moving patients from surface to surface, including a bed or hospital cart. These transfers pose increased risks to both patients and caregivers. Lateral transfers are performed throughout the day in various departments, ranging from ICU to imaging. Due to the high frequency of lateral transfers and patient positioning the probability of a patient or nurse sustaining an injury increases exponentially if the appropriate Safe Patient Handling techniques are not employed.  Patients that require comprehensive care often can’t move from point A to point B on their own, requiring the nursing staff to oversee their movements. When moving from one surface to another, matters become even more complicated.

In most cases, nurses use the sheet underneath the patient to transfer them. If there are limited staff members available, a plastic board is typically used as an alternative. While this device helps, it doesn’t reduce enough friction to combat the total force required. In essence, when handling a later transfer, nurses must rely on their strength and collaborative efforts to conduct a successful and safe transfer.

By leaving these affairs up to chance, caregivers and patients become more susceptible to a nursing injury or repositioning injury. With hospital injury rates on the rise, it’s imperative for staff members to have safer, easier, and more effective solutions at their disposal. Research shows that medical professionals are over 30 percent more likely to experience musculoskeletal pain due to handling injuries. While these injuries are painful, they can also be costly, setting hospitals back hundreds of thousands of dollars depending on the scope of the claim.

According to a study by the Bureau of Labor Statistics, hospitals that implement safe patient handling programs are 73 percent less likely to expose their staff to handling injuries. These favorable statistics prompted the arrival of the Nurse and Health Care Worker Protection Act. This bill was introduced in 2015, and it states that the Department of Labor must establish new standards on mobility, patient handling, and injury prevention to safeguard medical professionals from musculoskeletal disorders.

The Introduction Of Air-Assisted Lateral Transfer Systems

In response to the Nurse and Health Care Worker Protection Act, companies like HoverMatt have developed air-assisted transfer systems. AirPal was one of the first to develop this cutting-edge technology, and this invention has paved the way for secure repositioning procedures. These transfer systems are designed to reduce friction by providing additional support under a mattress.

They also serve to boost patients up in bed and eliminate the manpower required to move patients. Touted as the gold standard, air-assisted lateral transfer systems breathe ease and security into repositioning patients. To improve patient safety and lessen caregiver injuries, we at SPH Medical implement these systems into hospitals.

The Benefits Of Air-Assisted Transfer Equipment

In addition to promoting optimal safety, air-assisted transfer systems also enhance patient comfort. This equipment is gentle and seeks to improve a patient’s hospital stay or in-home care. Moreover, patients aren’t subjected to the discomfort that comes with lifting them. Thanks to these revolutionary systems, patients aren’t raised but rather smoothly pulled from one surface to another. In fact, many describe it as floating from one position to the next.

This modern technology is also advantageous to patients because it causes less of a disruption. Traditional lateral transfers demand many helping hands, which can make patients feel like a burden. Fortunately, air-assisted transfer systems are easier to handle, meaning fewer medical professionals are required. Not only does this streamline operations, but it also brings patients great peace of mind. Improve the patient experience, protect caregivers, and lessen workplace injuries when you opt for air-assisted lateral transfer systems.

CategoriesPatient Handling

Lateral Transfers: Know The Risks

The Risks of Repositioning a Patient

Caregivers and medical professionals perform countless lateral transfers per day. This procedure is best described as repositioning a patient from one surface to another. With the uncertainty of lateral transfers, both nurses and patients become vulnerable to handling injuries. Whether a patient’s in the ICU or being taken to surgery, several departments are responsible for conducting lateral transfers. With that said, the potential for a nursing injury or repositioning injury to occur increases significantly. Patients that require total care are even more susceptible to these injuries.

Typically, nurses move patients from one position to the next using the sheet underneath them. However, if there’s limited staffing, a plastic board is used to facilitate the process. Though this alternative can ease the physical effort required, it’s not a foolproof plan. In fact, it doesn’t reduce enough friction to compensate for the lack of human resources, resulting in precarious and often dangerous affairs. Simply put, when nurses reposition a patient, the success of a lateral transfer is contingent upon their combined strength and communication.

Unfortunately, these ineffective solutions predispose medical professionals to musculoskeletal disorders. Studies show that healthcare workers are 31 percent more likely to endure musculoskeletal pain caused by handling injuries. In addition to being debilitating, these injuries can also cost hospitals a pretty penny. Depending on the extent of the claim, hospitals may have to cover hundreds of thousands of dollars in injury costs.

To shed light on how unreliable these practices are, the Bureau of Labor Statistics conducted a study on safe patient handling programs. Their findings concluded that hospitals that implement secure lateral transfer procedures are 73 percent less likely to experience nursing or repositioning injuries. Using this information, the House introduced the Nurse and Health Care Worker Protection Act in 2015. In essence, this bill states that the Department of Labor is required to protect medical professionals from musculoskeletal disorders by improving mobility, patient handling, and injury prevention standards.

How Lateral Transfers Repositioning Risks Are Being Solved

With the growing prevalence of handling-related injuries, air-assisted transfer systems were developed. At the forefront of these developments was AirPal. This company is touted as the first to introduce air-assisted transfer systems, and their invention inspired others to follow suit. HoverMatt, for instance, offers air transfer systems that breathe security and physical ease into repositioning patients.

In addition to reducing friction, these systems also provide much-needed support. With these added elements, less manpower is required to oversee a safe lateral transfer. It also makes it easier for nurses to boost patients up in bed. To promote patient and staff safety, we at SPH Medical implement these cutting-edge systems into hospitals.

Why Choose Assisted Lateral Transfers Equipment?

With its vast benefits, more caregivers and hospitals are opting for this modern equipment. Most notably, air-assisted transfer systems eliminate handling risks, but they also provide a more comfortable experience for the patient. In other words, with air-assisted transfer equipment, patients don’t have to endure any discomfort. Traditional lateral transfers are often accompanied by unease and difficulty. With this savvy technology, a smooth transition is promised from one surface to the next.

With assistance from air transfer systems, patients say they feel as if they’re floating. Above all else, air-assisted transfer systems streamline repositioning matters, making the patient feel like less of a burden. When multiple hands are required to carry out this task, it can make the patient uncomfortable and self-conscious. Fortunately, air-assisted equipment brings patients great peace of mind, allowing them to receive optimal in-home or hospital care.

CategoriesPatient Handling

Epidural Safety for Patients and Staff

What is Epidural Safety?

Epidural Analgesia’s are used to reduce or completely eliminate pain. It is when the doctor inserts opioids or local anesthesia in their patient’s epidural space, which blocks the nerve roots. Staff and patients can be protected from injury when exercising epidural safety during this procedure.

Local anesthesia can include opioids such as morphine, hydromorphone, and fentanyl or drugs of a different class such as mepivacaine, lidocaine, bupivacaine, and ropivacaine. Mepivacaine and lidocaine can last up to 2.5 hours. Bupivacaine and ropivacaine are the options of choice for continuous epidural effusion because they last 4 to 7 hours. The walking epidural is a mix of narcotics, epinephrine, and local anesthesia that the doctor inserts into the patient’s epidural space.

Epidural Analgesia’s are often used during child birth to assist the woman in managing her pain. They are also utilized during surgery to numb the patient. Epidurals are often effective in blocking pain from the waist down. Their dosage is calculated by an anesthesiologist based on the type of epidural and how much of the patient needs to be numbed. They can eliminate pain for people in short term or long term situations.

Common Applications

Epidurals come in different types, depending on what they are being used for. Childbirth uses the standard epidural and the combined spinal epidural, which is also called the walking epidural. The walking epidural involves the administration needle coming in contact with the fluid around the spinal cord, whereas the needle does not meet the fluid around the spinal cord in the standard epidural.

The Benefits for Patients and Nurses

The benefits of having an epidural are plentiful. The walking epidural is beneficial because it allows for the mother to still have an awareness of the lower half of her body when giving birth. This allows the patient and nurse to coordinate the rhythm of her pushes. A walking epidural may or may not allow the mother to do cat and cow stretches. The standard epidural is beneficial because it completely eliminates feeling, which can avoid patients going into shock during invasive surgery, trauma, or child birth.

Epidural Safety and the Risks of Epidurals

The risks for patients when getting either type of epidural are low blood pressure, being mandated to stay in bed, and having to rely on a catheter. The catheter can cause problems such as the rare case of hematoma, epidural abscess, postdural puncture syndrome, and infection at the site of insertion.

Standard epidurals leave the patient with no feeling in the lower extremities, which can prevent the ability to shift in bed and the ability to move the baby into a more favorable position when birthing. Standard epidurals also involve the risk of local anesthetic toxicity, which can present with irritability, seizures, circumoral paresthesia, dysgeusia, cardiac dysrhythmias, tremors, and tinnitus.

The drugs used for epidurals can also have side effects on the patient. The opioids commonly used can cause nausea, vomiting, respiratory depression, decreased levels of consciousness, and the excessive itchiness all over the body.

Nurses and medical personnel are at risk for getting injuries when administering epidurals as well. Positioning the patient correctly and supporting them while administering the epidural can be a potentially dangerous task. This has typically been a manual process of holding and supporting the patient. Manual patient handling is the cause of many back injuries for nurses across the country as well as strains and sprains. Musculoskeletal Disorders The Epidural Positioning Device is a key tool to keep the patient and doctor safe. It assists patients with maintaining the optimal position for their epidural to be administered. This is because it supports cervical, thoracic, and lumbar flexion. This positioning is essential because a patient can be paralyzed if they were to slip out of position while the needle was injected. The chair prevents doctors and staff from straining as well. It also allows patients more personal space, as opposed to traditional methods of epidural safety administration.

CategoriesPatient Handling

Epidurals and Spinal Blocks

Most Common Use of Epidurals

There are many times when a patient wants to be or needs to be awake during surgery. The classic case is the Caesarean section when a mother cannot have her child vaginally. She wants to see and hold her baby the moment it’s born. This procedure is possible with the use of an epidural block. By injecting numbing medication into the epidural space just above the spinal cord, the woman can have surgery and not feel pain. And she can hold her baby. The most common use of epidurals is to relieve pain during labor when combined with CBD.

In order to understand what happens in an epidural or a spinal block, you have to know a little about the anatomy of the spinal cord and the coverings of the cord, called meninges.

Anatomy

The spinal cord itself is a long rope in which the fibers are neurons. The cord gets smaller as it gets farther away from the brain. This is because the neurons leave the cord and go out to innervate various body parts.

The meninges are fibrous coverings over the cord to protect it and keep the cerebrospinal fluid inside. The CSF circulates from the brain down along the cord.

There are three layers that cover the cord. The pia mater is the one next to the cord. It is covered by the arachnoid mater, which, in turn, is enclosed by the dura mater.

The pia mater adheres to the cord tightly. It runs up into the brain, following the gyrae and sulci and carries the blood vessels that supply the cord.

Above the pia mater is an open space called the subarachnoid space. This is where the CSF is found. The arachnoid mater is the roof of the subarachnoid space. The arachnoid mater has no innervation and no blood vessels. The subdural space contains fat and the venous sinuses.

The dura mater is two layers. One forms the floor of the subdural space. The other is the lining of the bone of the spinal column, forming the roof. Between the two linings is the epidurals space.

Epidural Block and Spinal Block

Epidural Block
Unlike the subarachnoid and the subdural spaces, the epidural space extends all the way from the brain to the end of the spinal cord. Under sterile conditions, local anesthesia is injected into the skin and a needle is inserted through the skin of the back into the epidural space. A sterile catheter is placed within the space, angled down towards the patient’s feet. The needle is removed. The catheter stays in place as long as it is needed so that the patient can receive further doses of medication, if required. Epidural pain relief is highly effective.

Spinal Block
The spinal block is simpler. Under sterile conditions and local anesthesia, a needle is inserted into the subarachnoid space, where the CSF is. Medication is injected into the space and the needle is withdrawn. This is a one-time injection only.

Proper positioning of the patient is essential in either of these procedures. The needle has to be placed in a tiny space no more than 0.4 mm deep. That’s 0.015 inches. Finding that tiny space and not being off to the side at all requires the hands of an expert. Anesthesiologists generally do these procedures.

They often use an epidural positioning device or an EPD. This epidural chair holds the patient very still and in the perfect position for the procedure. An EPD helps immensely when the patient is having severe pain during labor.

Labor pain can be intense and labors can be long and hard. Many women desire the epidurals. But not everyone can be guaranteed to hold still during the catheter insertion. Injury to the meninges or even the spinal cord itself can occur if the patient moves suddenly during the procedure. Nurses have been injured as well, trying to hold women still when the labor pains hit. Using the epidural chair keeps the nurses safe and minimizes the risks to the patient.

Many Labor and Delivery units are using the EPD to help improve safety for new moms and their babies and equally as important to insure the safety of our nurses.

The EPD is used for Thoracentesis
CategoriesPatient Handling

Epidural Chair for Epidural Safety

Epidural Analgesia for Pain Relief During Labor and Delivery

Epidural injections or epidural anesthesia is defined as regional anesthesia that blocks pain in a specific area of the body. To perform an epidural injection, the anesthesiologist utilizes a hollow needle to place an epidural catheter, which is a small and flexible plastic tube, into the space between the spinal column and outer membrane of the spinal cord (epidural space). This is in the middle or lower back. The area that the catheter will be placed will first receive a local anesthetic. As a result of the epidural injection, the nerve messages are blocked, which in turn causes numbness and also epidural pain relief in the lower half of the body. In terms of applications, epidural anesthesia is usually used for legs and lower belly surgeries, for helping control pain after chest and belly related major surgeries, as well as for relieving pain during labor and delivery. This is a complicated procedure so epidural safety is extremely important.

With respect to labor and delivery, a lot of women decide on having the epidural injection in order to cope with the severe pain during the whole birthing process. In this case, an epidural pump is utilized where pain relief drugs are continuously administered through the epidural tube mentioned earlier. The pain during labor is relieved as long as the drugs are being constantly pumped into the body. When the pumping is stopped, the entire feeling will come back within a few hours.

Epidural Pain Relief and Epidural Safety

In addition to epidural pain relief, the main pros for having an epidural injection during labor and delivery is being able to rest and relax, which helps a lot of women have a positive birthing experience.  Another main advantage for taking an epidural is that it helps women be more alert, which in turn allows them to take an active role during their birthing process. Last, but not least, recent research shows that epidural injections may play a role in reducing postpartum depression in a certain number of females.

With the high frequency of epidural injections occurring in during labor and delivery units across the country, it’s important to consider the manual patient handling involved in positioning patients and the safety risks for patients and nurses alike.  A device that should be considered is the epidural chair or the epidural positioning device (EPD). Patented in 2001, the epidural positioning device reduces risk of injury to nursing staff and improves patient comfort. The EPD features a 180 degrees adjustable face rest, a six position adjustable armrest allowing patients to comfortably rest their arms, an adjustable torso support to promote spinal flexion, and a height adjustable foot rest.  The EPD is not just for labor and delivery. The EPD is currently considered the standard of care by surgical staff to administer spinal blocks prior to total hip and knee surgeries. With the functional design and obvious safety benefits the SPH Medical EPD has become the standard of care wherever spinals and epidurals are performed.

From a clinical perspective, anesthesiologists are using the epidural chair permits to encourage lumbar, thoracic and cervical flexion, positioning patients in both a correct and comfortable manner and importantly a stable, safe and secure position as well. The stable positioning supported by the Epidural Chair reduced the risks of complication while the anesthesiologist places the epidural. Thanks to the EPD, nursing staff are not having to hold patients in a static position, apply counter pressure, or manually handle patients. A number of recent studies have shown that the comfort and satisfaction levels of a large number of female patients that received the epidural analgesia were significantly higher when the epidural positioning device was used.

Reduce Risk of Injury in The Labor and Delivery Unit

Healthcare workers and patients are placed at risk of injury in the labor and delivery unit when staff members are manually handling patients.  Whether it is holding, lifting, boosting or pushing the patient in a proper position, the patient not being able to change his or her position and follow the staff instructions, or even the patient being nervous, unpredictable or maybe nauseous and dizzy, positioning patients can be a very challenging task.

In point of fact, when handling patients during epidural injections, a large number of nurses are at risk of micro tears in their joints and vertebral discs that could eventually lead to injuries. Fortunately, thanks to the epidural positioning device, nurses and healthcare workers not only avoid these safety risks and challenging situations, but are also free to perform other imperative tasks.

CategoriesPatient Handling

Epidural Chair for Thoracentesis

Why use the Epidural Chair for Thoracentesis

Thoracentesis is an invasive procedure used to diagnose and medicate pleural effusions, during the treatment of a condition whereby excess fluid accumulates in the pleural space. Thoracentesis is used to manage symptoms like pain and shortness of breath. It relieves pressure in your lungs and provides epidural pain relief. The procedure also establishes the cause of the excess fluid found in the pleural space. Conditions such as tumors, lung infections, and heart failure are some of the causes of pleural effusions. This article offers you valuable information on the thoracentesis procedure and how the epidural chair can help the process.

Why is proper positioning important?

Patients are often encouraged to sit upright when the medical personnel performs the procedure. Sometimes women in pain during labor are encouraged to rest their hands on a pillow placed on a bedside table. It helps pulmonologists and sonographers access the posterior axillary space. That is a dependable part of the thorax and offers epidural pain relief to them.

Proper positioning is also vital for the safety of sick people. Hospitals should be guided by principles of Ergonomics when looking into their positioning. Ergonomics looks into the creation of tasks suited to worker’s capabilities. When used in handling the sick, it incorporates safety procedures and mechanical equipment used to move and lift them so that health care employees avoid manual exertions. Moreover, patient handling ergonomics maximizes their comfort and safety during movement.

How long is the procedure?

Thoracentesis is performed in a hospital by pulmonologists and sonographers. It usually takes 10 to 15 minutes. However, if an individual has a lot of fluid in their pleural space, it takes more than 15 minutes.

Why are nurses at risk of injury during this procedure, and why does the EPD benefit them?

One of the worst risk factors for nurse injuries during thoracentesis lies in moving and lifting patients. Manual handling of the sick is amongst the leading cause of back injuries, especially in nurses. Most American states require hospitals to adhere to the Safe Patient Handling program. This program evaluates high-risk tasks in inpatient units like pushing, pulling, lifting, and prolonged static holds. It establishes solutions centered on lessening the risk.

A nurse usually assists the patient to get into the proper position by moving around the bedside tray table and using the stool to offer support to their feet. During labor pain, they use a pillow to place the hands to ensure that they are comfortable. Nurses may trip if the bedside table is not locked securely. Therefore, risky positioning can contribute to unnecessary injury to patients and medical staff.

The Epidural Positioning Device benefits nurses in several ways. One of them is positioning the patient in a comfortable position that provides epidural pain relief faster. The nurse can help other health care personnel with other duties as they are not limited to holding the patient.

The device ensures that the sick person sits in the epidural chair steadily. That puts the nurse at ease when performing this procedure. It correctly positions the person who is ill since it is adjustable. Consequently, It helps the nurse to put them in the most optimal position. The epidural chair ensures there is no movement, which is crucial to nurses when conducting the procedure.

How does the Epidural Chair (Epidural Positioning Device) Help position Patients During Thoracentesis

The Epidural Positioning Device helps to solve risk factors attributed to administering the procedure and manual patient handling challenges. It assists in patient positioning to minimize unsafe manual patient handling that is being performed every day during this procedure. The EPD ensures a comfortable and relaxed flexed spine position for the patient while maintaining a stable position. Medical personnel recommend it for more than Thoracentesis including women in pain during labor, pain centers, and operating rooms. It also offers pain relief in the epidural as well as spinal relief.

The stand offers adjustable foot support to assist in patient positioning. It also has an adjustable mount for the epidural device that consists allows it to be attached directly to an operating table. The epidural chair reduces risk of errors, avoids accidents, improves patient comfort, and lowers injury risks to staff. These factors contribute to medical personnel satisfaction and patient outcomes. They are a comfortable and efficient option that guarantees the happiness of the sick and nursing staff.

CategoriesPatient Handling

EPD for Thoracentesis

What is Thoracentesis and what are the risks to patients and staff?

Thoracentesis is a procedure to remove the excess fluid that is found in the space between the lungs known as the pleural cavity. This is also sometimes called a Pleural Tap. The accumulation of fluid in the plural cavity is called pleural effusion. According to hospital staff patients with many different conditions or diagnosis experience this issue. Thoracentesis is performed for both diagnostic reasons, to determine why pleural effusion is occurring, and therapeutic reasons; to relieve the pressure on the lungs making it easier to breath, reduce pain, and shortness of breath. Patients can be seen in doctors offices and hospitals to drain this excess fluid. There are several key clinical staff members that are often involved in this procedure. In the hospital setting, thora’s are often performed in the imaging department.

Why the imaging department?

The imaging department is often the most common location to perform thora’s because the experts in ultrasound technology have the equipment needed to locate the right location in the rib cage to insert the needle for drainage. Sonographers are often tasked with all the patient prep and set up required to get the patient ready for the procedure. The pulmonologist will arrive after the patient is prepared perform the procedure.

Patients are typically sitting comfortably at the edge of a chair or bed and asked to lean forward over a table with a stool supporting their feet.

Once the sonographer has identified the correct location the doctor will clean the location and insert a local anesthetic to numb the area. Then the doctor will insert the needle between the ribs and into the pleural space to drain the fluid. The trained ultrasound staff will monitor the patient as the fluid is drained over 10-20 minutes. In some cases this will take longer.

What are the risks to patients?

There are several risks related to this procedure that are documented by the National Heart, Lung and Blood Institute. Rare complications include liver or spleen injuries. More common risks include a collapsed lung or pneumothorax, pain, bleeding, bruising, or infection.

Protecting patients and hospital staff

Over the last 10 years the healthcare industry has made significant progress nationally reducing risk of injury to nursing and hospital staff.  It has been well documented by the CDC/NIOSH and American Nurses Association after years of research by the Veteran’s Health Administration that clinical staff of all disciplines are at risk of career ending Musculoskeletal Disorders from manually lifting, moving, and positioning patients. Using Safe Patient Handling and mobility devices reduces a caregiver’s risk of injury and improves the safety and quality of patient care.

The EPD for Thoracentesis

A large University Medical Center’s Imaging department first contacted us in 2019 about Thoracentesis and the manual positioning issues they were facing. They described the unstable bedside table with non-locking wheels that they were having their patients lean over and the static holds that their staff were having to perform. The Imaging Director felt that their sonographers were manually positioning patients and being put at risk of injury. One staff member was injured which made finding a solution a top priority. In addition to staff injury concerns, patients were at risk of falling due to the current procedure of using the unsafe bedside table. They needed a better solution. The Epidural Chair or EPD seemed like a perfect fit. The head support, arm rests, and foot plate can all be positioned to support the patient safely and comfortably. They were excited to explore the use the EPD to support patients during this procedure.  After an onsite evaluation the feedback was unanimous. The pulmonologists and sonographers all agreed that the EPD was the ideal solution to reduce risk of injury to staff and to improve patient safety and comfort. Today the EPD for Thoracentesis procedures is becoming the new standard of care for patient and staff safety.

SPH Medical was founded on the principals of improving workplace safety for our frontline caregivers and improving patient outcomes through Safe Patient Handling and mobility across the entire continuum of care, from the ICU to home. Contact SPH Medical to request more information.

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