The use of one’s body to produce

motion that is safe, energy

conserving, and anatomically and
physiologically efficient and that
leads to the maintenance of a
person’s body balance and control
Rules of body mechanics are based on
gravity
Gravity – force the pulls object toward the
center of the earth.
When an object is balanced, it is firm and
stable. If it is off balance, tendency are it
will fall because it will be pulled by the
gravity
1. Base of Support – portion of the body in
contact with the floor
2. Center of Gravity – point within the body
where there is balance
3. Line of Gravity – imaginary vertical line
passing through the center of gravity
Conserve energy
Reduce stress and strain to muscles, joints,
ligaments, and soft tissue
Promote effective, efficient respiratory and
cardiopulmonary function
Promote and maintain proper body control and
balance
Promote effective, efficient, and SAFE movements
Increase force/stress
Repetitive Motion/twisting
Forward bending
Poor or improper lifting techniques
Poor posture
Poor Job design
Deconditioned/Poor physical fitness
One of the main reasons that injuries
occur
Means that the spine’s normal curves are
exaggerated or decreased creating
stresses and strains in the tissues.
The result is pain and dysfunction and
can lead to serious injury.
Forward bending can over-stretch the low
back muscles to the point where they can lose
strength to protect the spine from injury.
The ligaments are also weakened
Can increase stress on the discs
Range of the bend and time spent in the
position can determine amount of damage
Repetitive twisting can do damage to
the spine.
It over stretches ligaments and
muscles causing weakness.
Can damage discs especially
combined with bending.
Injury can occur when:
 Moving a load too heavy
 Moving a load too often
 Moving a load too far
 Twisting with a load
 Work too far to reach
 Cold temperature, vibration
 Improper chair/equipment
Poor positions
Poor movement
Improper lifting habits
Make the job more difficult
Repetitive twisting and bending
Decreased oxygen delivery to
muscles can cause muscles to
wear down and lead to
weakness
Stand with feet apart one foot slightly ahead of
the other
Wide stance helps balance during lifting
Squat down keeping back straight, keep chin
tucked, and lift smoothly
Keep object close to you
Bend your knees and hips using legs to lift
Do not twist or bend sideways
If changing direction, do not twist, pivot with your
feet
Pull rather than Push (depending on
situation)
If there are wheels/carts (use push)
Pulling reduces friction
Take your time because hurrying
causes muscles to act
inappropriately and increases
chance of injury
Change stressful positions often
If you are sitting for too long- stand
If you are standing for too long- stop and
squat
Carrying an object-hold the load close to
the body
Remember S.H.A.C.K

S-tand on feet 4-8 inches apart

H-ead erect and chin in (to make the spinal column in proper
alignment)
A-bdomen up and buttocks in (to prevent abdominal strain)
C-hest out and stomach in (to give full capacity of lungs for
respiration)
K-nee slightly bent (act as shock absorber)
 Supine or dorsal recumbent
 Lateral recumbent
 Prone or ventral recumbent
 Fowler (semi / high)
 trendelenburg
 Sims
 Lithotomy
 Patient is lying flat on the back
 Patient is on the right or left side with both knees flexed
 Patient lies down.
 Small pillow should place on the head to prevent cervical spine flexion
 “sitting position”
 Patient head is raised or higher than the patient feet
 For respiratory distress
 Semi fowler – patient head is raised around 15 to 30 degrees angle
 High fowler – patient head is raised at 40 – 90 degrees angles
 Patient feet is higher than the patient head
 Patient with hypotension
 Also for venous return
 Patient lies either on his/her left or right side with forward arm flexed and posterior
arm is extended at the back of the body.
 Top knee flex sharply while the bottom knee is slightly bent
 Usually for examination in lower bowel such as insertion of ba.Enema
 a common position for surgical procedures and medical examinations involving the
pelvis and lower abdomen
 common position for childbirth
 positioning of an individual's feet above or at the same level as the hips (often in
stirrups), with the perineum positioned at the edge of an examination table.
Radiographer may be called upon
to transfer or assist in transferring
a patient from a hospital room to
diagnostic imaging department
1.Establish the correct patient identity.
2.Introduce yourself
3.Know any restrictions/precautions
4.Explain the procedure

* NEVER MOVE A PATIENT WITHOUT ENOUGH ASSISTANCE TO

PREVENT INJURY TO YOUR PATIENT AND TO YOURSELF ASWELL*
1.Deviation from correct body alignment.
2.Range of motion and weight bearing ability
3.Strength and endurance
4.Respiratory, cardiovascular, and musculoskeletal
problems.
5.Ability to maintain balance
6.Alertness and responsiveness
1.Give only the assistance that the patient needs.
2.Transfer to shortest distance as possible.
3.Lock all wheels on beds, gurneys, and wheelchairs
4.Move patient toward his/her stronger side while assisting on weaker
side
5.Ask the patient to wear shoes or any object that are not “slippery”
6.Inform the patient of the plan for moving and encourage him/her to
help.
7.Give short and simple commands
ALWAYS SUPPORT
PATIENT`S HEAD,
SPINE, AND
EXTREMITIES
1.By Gurney
2.By Sheet Transfer
3.By Sliding Board Transfer
4.By Wheelchair
5.By logrolling
 a flat, padded table or
stretcher with legs
and wheels, for
transporting patients
or bodies
 Sometimes known as
stretcher
 Patented by J.
Theodore Gurney
Requires at least 3 – 4 persons
1.Place the sheet on the table
2.Ask the patient to turn facing on you
3.Take the half of the sheet and roll it against the patient
back.
4.After the patient is rolled to the opposite side, the
rolled half of the sheet is straightened out.
 It requires three to four people if the patient is adult

For three (3) people

 One person will support the patient`s head
 Other 2 persons will be at each side

For four (4) people

 2 persons per side
Aka smooth mover or smoothie
A glossy, plasticized board approximately 5 feet 10
inches in length and about 2 feet and 6 inches
wide.
This helps in moving patients from one surface to
another
1.Get a sliding board and spray antistatic spray (only if applicable).
2.Move the gurney up against the radiographic table and secure
wheels.
3.Move the patient to the edge of the gurney
4.Assist the patient to turn onto his/her side away from the
radiographic table
5.Place the sliding board under the sheet upon which patient was
lying
6.Then create the bridge between the gurney and the table by using
the sliding board
7. Allow the patient to roll back onto the board (assist if
needed)
8. With one person at the side of radiographic table and
other at the side of the gurney, slide the patient over the
board and onto the radiographic table.
9. Assist the patient to roll toward the distal side of
radiographic table.
10. The person standing on the side of the gurney should
remove the sliding board from under the patient.
1.Make sure the table is not high enough and the wheelchair is close
enough.
2.If patient can move, instruct him/her to push up with the upper arm
when told so.
3.Help the patient to do the sitting position at the edge of the table.
4.Let the patient get off the table, if assistance is needed, you stand at
the patient`s side then take the patients arm to help.
1.Make sure the wheelchair is parallel to the longitudinal axis of the table and
secure the wheels
2.Turn patient on lateral position (facing you).
3.Ask the patient or help the patient in flexing his/her knees.
4.Help the patient place his/her arms across his/her chest (this will help in
reducing friction)
5.You place your arm under patient shoulder and your other arms on patient`s
knees.
6.Carry the patient toward the wheelchair
1.Have the bed at the lowest level.
2.Park the wheelchair with the person’s strongest side next to the bed.
3.Lock the wheelchair brakes and remove feet from foot rests then swing it off.
4.Explain the sequence of lifting and pivoting into the wheelchair
5.Using the bear hug technique, ask the person to place his/her arms on your shoulders
as you place your arms around his/her trunk.
6.Using your leg muscles, stand up and bring the person upward in a slow steady rising
motion.
7.Seat the person on the bed
8.Assist in bring the person’s legs up onto the bed.
*you can also use gait belt for additional security
A PATIENT WHO HAS A SPINAL INJURY OR SPINAL SURGERY MUST BE KEPT IN
GOOD BODY ALIGNMENT WHEN TURNING.
USING A LIFT SHEET THE PERSON IS TURNED IN ONE MOTION.
IT TAKES 2 OR 3 PERSONS TO SAFELY LOGROLL A PATIENT.
 Skin breakdown can occur in a
brief period of time at around 1-2
hours that may result in decubitus
ulcer
“decubitus” come from the Latin word decumbere,
“to lie down”
also known as bedsores and pressure sores
caused by impaired blood supply and tissue
malnutrition due to prolonged pressure over skin
Pressure Areas: scapula, trochanters, heels, knees,
and sacrum
1. Immobility
2. Pressure Area
3. Shearing force
 Focuses on four aspect: (1) pressure reduction and prevention, (2) wound
management, (3) surgical intervention, and (4) nutrition.

1. Place pillow and/or soft blanket on pressure areas.

2. Turn the patient every 2 hours (on soft surfaces) or every 30 minutes (on hard
surfaces).
3. Keep patient moisturize and clean
4. Use lubricant or any product that can help in decreasing the friction whenever
the patient is needed to move
5. Eat well because malnourished patient increases chances of acquiring ulcer
6. Keep incline no higher than 30 degree prevent sliding and friction on lower and
buttocks
 can be made of plaster of paris, fiberglass, plastic, or cast-tape
material (materials use will be dependent on type of injury)
 Used for broken bones and sometimes after surgery
 Casts are started off with a layer of cotton (between the cast and the skin)
 Then cast (fiberglass or plaster) is placed on top
 And finally you are given a sling which helps to support your cast.

cast

arm Cotton pudding

 Patient with cast should be assessed for signs of
impaired circulation or nerve compression every 15
minutes
 Pain
 Coldness
 numbness
 Skin color
 swelling
 Swelling due to your injury may cause pressure in your splint or cast for the
first 48 to 72 hours. This may cause your injured arm or leg to feel snug or
tight in the splint or cast.
 Elevate. It is very important to elevate your injured arm or leg for the first 24
to 72 hours. Prop your injured arm or leg up above your heart by putting it on
pillows or some other support. You will have to recline if the splint or cast is
on your leg. Elevation allows clear fluid and blood to drain "downhill" to your
heart.
 Exercise. Move your uninjured, but swollen fingers or toes gently and often.
Moving them often will prevent stiffness.
 Ice. Apply ice to the splint or cast. Place the ice in a dry plastic bag or ice
pack and loosely wrap it around the splint or cast at the level of the injury.
ARM CASTS Short Arm Casts
- below the elbow
to the wrist
Long Arm Casts
- upper arm to part
of hand
Arm Cylinders
- from upper arm
to wrist
ARM CASTS USES
Short Arm Cast
- wrist fractures
 Long Arm Casts
- elbow and lower
arm fracture
Arm Cylinder
Cast
- elbow fracture
and dislocations
  Short leg cast,
below the knee
LEG CASTS to foot
 Leg cylinder
cast, upper thigh
to ankle
LEG CASTS USES
Short leg
cast, lower
leg fractures
and severe
ankle sprains
Leg cylinder
cast, knee
fractures and
dislocations
OTHER CASTS  Unilateral hip spica
cast
- from chest to foot on
one leg
 One + one half hip
spica cast
- from chest to foot on
one leg plus chest to
knee on other leg
 Bilateral hip spica
cast
- from chest to feet on
both legs
OTHER CASTS USES
 Unilateral hip spica
cast
- thigh fractures
 One and one half hip
spica cast
- Thigh fracture
 Bilateral hip spica
cast
- for pelvis, hip, and
thigh fractures
CAST REMOVAL
Casts are removed
with a cast saw
Vibrates but does not
spin
Padding protects
from blade
Heats up
1. Slide an opened and flattened
hand under the cast.
2. Avoid grasping cast with
fingers.
3. Cast must be supported at the
joints when it is moved.
 for life threatening conditions caused by excess of fluid and/or air
in the intrapleural space
Location: (depends on what is being drained)
• Free air in the pleural space rises = tube is placed above the 2nd
intercostal space.
• Fluids gravitate to the most dependent point = tubes places at the
4th to 5th intercostal space.

Chest tube placement: superior tube - air

inferior tube - fluid
 Air accumulation in pleural space
 Fluid accumulations in the pleural space
 Fluid accumulations in the mediastinal space

Example:
 Pneumothorax: Presence of air in the pleural space
 Hemothorax: Presence of blood in the pleural space
 Hemopneumothorax: Presence of air and blood in the
pleural space
 Evacuate air and/or fluid from the chest cavity
 Evacuate fluid from around the heart (mediastinal) after
cardiac surgery to prevent cardiac tamponade
 Restore normal intrathoracic pressure (negative pressure)
 This is accomplished by the use of an underwater seal.
The distal end of the drainage tube is submerged in 2cm
of water.
 Chest tube insertions are a medical activity (PPE is a must)

Equipment:
 Atrium Oasis-Ensure underwater seal
 2 Kelly clamps
 Sterile distilled water
 Cable ties/water-proof tape
 Wall suction set up
 Chest tube insertion tray
 Local Anesthetic
One way valve so air can drain
out of chest cavity but not back in
Monitor fluctuations and volume
Fluctuates with breathing
water level should be at 2 cm
mark
 First Chamber

The Water Seal chamber

Fresh chest tube inserted, patient
could suck air directly into chest.
The distal end must be controlled.
The water seal chamber acts as
A one way valve. Air can get out
and as long as the tube is long
enough, water can not be sucked in.
Bubbles moving through
This chamber means the patient
has an air leak.
 Second Chamber

Single chambers are fine if all you want to drain in air.

When there is fluid it’s time for a second chamber.

2 1
 Third Chamber

Here’s an idea! What if the fluid is thick or just needs extra help to drain?
What if we could add suction? Time for a 3rd chamber.

1 water seal 2 1 3
chamber
2 drainage chamber
3 suction chamber
 Water seal is a window
into the pleural space
 If air is leaving the chest,
bubbling will be seen
here
 Bubbling in water seal
chamber may be present
with pneumothorax
 Prior to removing chest tube to determine if patient
can do without chest tube(s)
 Assessing for air leak (clamp only briefly)
 Changing the chest drainage unit (clamp only
briefly)
 Performing physician-ordered procedure.
 Some instances when sudden large volumes of fluid
are evacuated
 Gastric intubation via the nasal passage (NGT)
 Intestine intubation via the nasal passage (NET)
 a common procedure that provides access to the stomach for
diagnostic and therapeutic purposes
 Can use NGT for feeding and giving medicine purposes
 Can also use NGT to apply suction on stomach contents
 Anesthesia is patient choice
Diagnostic indications for NG intubation include the
following:
 Evaluation of upper gastrointestinal (GI) bleeding
 Aspiration of gastric fluid content
 Identification of the esophagus and stomach on a
chest radiograph
 Administration of radiographic contrast to the GI
tract
Therapeutic indications for NG intubation include the following:
 Aspiration of gastric content from recent ingestion of toxic
material
 Administration of medication
 Feeding
 NG tube can be kept following corrosive ingestion for the
development of a tract in the esophagus that subsequently can
be used for balloon dilatation
 NAMES # OF DESCRIPTION USES
LUMENS
Levin (common) 1 Plastic tube that is passed through Gastric Decompression
the nose into the stomach
Sump (common) 2 Radiopaque tube with a plug Drain fluid from the
pigtail that lets air flow into the stomach
stomach
Nutriflex 1 Mercury-weighted tip; coated Feedings
with a gastric secretion-activated
lubricant
Moss 3 Has a balloon to anchor into Aspiration of fluid;
stomach while 2nd and 3rd lumen duodenal feeding
are used for aspiration and
feeding
Sengstaken - Blakemore 3 Thick catheter with 2 balloons Control of bleeding from
used to exert pressure against esophageal varices
walls of esophagus
 NAMES # OF LUMENS DESCRIPTION USES
Cantor 1 Long tube with a small mercury- Relieves obstructions in
filled bag at the end; contains the small intestine
drainage holes for aspiration
Harris 1 Mercury-weighted tube passed Gastric and intestinal
through the nose and carried decompression
through the digestive tract by
gravity
Miller - Abbott 2 Long small-caliber catheter; one decompression
is a perforated metal tip and the
other has a collapsible balloon;
radiopaque tube
 A surgical creation of an
opening into the stomach
 Through this opening, a
tube is placed from the
inside of stomach to the
external abdominal wall
for the purpose of feeding
a patient who cannot
tolerate oral food intake
 The tube is closed off
after feeding with a clamp
or a plug-in adapter
 Tracheostomy is an opening into the trachea created surgically to relive respiratory
distress caused by an obstruction on upper airway
 After the surgical incision is made and the opening exists, a tracheostomy tube is
inserted into the opening
When tubes are inserted
through the mouth into the
trachea as a means of
establishing or opening an
airway for patients
Correct placement of tube
is approximately 5 to 7 cm
above the tracheal
bifurcation (carina)
 Comes from the greek word “mikros” which means small
and “organismos” means organism
 Cannot be seen by our naked eyes (can only be seen by
using microscope)
 Microbiology – is the study of microorganism
 Pathogens / pathogenic disease – are microbes that can
cause disease to human
1. Bacteria
2. Fungi
3. viruses
4. Parasites

*additional: prions – microorganisms found in the

brain cells and may mutate that causes disease
 Unicellular organism that has both DNA
and RNA
 Some bacteria are aerobes while others
are anaerobes
 Most common
 Has an ability to multiply
 Can be found on air, water, and soil
 Shapes: rod shape (bacilli), spherical
(cocci), and spiral (spirilla), pleomorphic
(irregular shape)
 Unicellular or multicellular
 Cells that requires aerobic environment to live and reproduce
 Can be in a form of yeast (one celled) or molds/mycelia
(multicelled)
 Dimorphic fungus is another form of fungi that can be a yeast or
mold depending on the temperature
 They are plant like but no chloroplast
 They get food from plant and animal wastes
 Candida albicans (thrush) – commonly seen disease cause by yeast
They are unicellular
Can be found on salt or fresh water
They are organism that lives on another
organism (it can cause harmful effect and
sometimes beneficial)
Can be classified as helminths and protozoa
 More complex one-celled microorganism
 They can move from place to another place by
pseudopod, flagella, or cilia
 Pseudopod movement – amoeboid action in which
part of the cell is pressed forward then the rest of the
body will follow
 Flagella – whip-like protozoa which move cell by
their swift movements
 Cilia – smaller and more delicate hair-like
projections on the exterior of the cell way which
moves microorganisms in a synchronize way
Described as parasitic worm
Can be classified as Platyhelminthes
(flatworms) or aschelminthes (roundworm)
Usually lives on human intestines
Some helminths also migrate to other part of the
body
Has either DNA or RNA
Borderline between living (inside host then it will
multiply) and non living (outside host and
inactive)
It burst the host cell then It will attack other cell
thus causing sickness
Smallest
 Making of bread
 Making of medicine such as vaccination (fungi are use to
make medicine)
 Increasing soil fertility (Fungi and bacteria cause dead
organisms to decay and turn it to natural fertilizer)
 Bacteria is use to make cheese and pan de coco
 Cleaning the environment
 Commercial production of alcohol and wine
Can cause illness
Can cause food poisoning
Can causes tooth decay
Food turns bad because of bacteria and
fungi
1. An infectious agents and a reservoir of available
organism
2. An environment in which the pathogenic microbes
can live and multiply
3. A portal of exit from the reservoir
4. A means of transmission
5. A portal of entry into a new host
1. Airborne (suspended in air)
2. Vehicle (indirectly by materials contaminated
usually through food, water, drugs, and blood)
3. Vector bone (insect bites)
4. Contact (direct and indirect) – most frequent;
fomites
5. Droplet – sneezing/coughing (3 ft distance)
Direct physical contact (body surface to body
surface) between infected individual and
susceptible host.
Examples: Influenza virus; Infectious
mononucleosis; chlamydia.
Precautions: Hand hygiene; masks; condoms.
Infectious agent deposited onto an object
or surface (fomite) and survives long
enough to transfer to another person who
subsequently touches the object.
Precautions: Sterilizing instruments;
disinfecting surfaces and objects.
Via coughing or sneezing, or (in health care)
during suctioning.
Droplets can be projected up to about one
meter.
Examples: respiratory viruses.
Precautions: Masks; cover mouth; stand clear.
Transmission via aerosols that contain
organisms in droplet nuclei or in dusts. Can
be spread via ventilation systems.
Examples: TB; measles; chickenpox;
smallpox
Precautions: Masks; negative pressure
rooms in hospitals.
A single contaminated source spreads
the infection (or poison). This can be a
common source or a point source.
consumption
Examples: Foods, drinks
Transmission by insect or animal vectors.
Example: Mosquitoes – malaria vector,
ticks – Lyme disease vector.
Precautions: Protective barriers (window
screens, bed nets); insect sprays; Lotion
 is the invasion of an organism's body tissues by disease-causing agents, their
multiplication, and the reaction of host tissues to these organisms and
the toxins they produce
 Infectious disease - also known as transmissible disease or communicable
disease
- Is illness resulting from an infection
Nosocomial infection – infection acquired inside the hospital
a. iatrogenic infection – result from the particular treatment
b. community acquired – when person with infection enters inside the
hospital
1. Incubation
2. Prodromal
3. Full disease / illness phase / actual
disease
4. Convalescence
Pathogens enter the body and
begins to produce non-specific
sign and symptoms
Disease process begins
Specific sign and symptoms
starts to appear
Actual disease
Most communicable period
Disease are in fully extent
AKA recovery period
Sign and symptoms starts to
diminish and eventually
disappear
 Medical Asepsis Surgical Asepsis
Definition Clean Technique Sterile Technique
Emphasis Freedom from most Freedom from all
pathogenic pathogenic organisms
organisms
Purpose Reduce Prevent introduction of any
transmission of organism into an open
pathogenic wound or sterile body
organisms from one cavity
patient-to -another
 Disinfection and sterilization are both decontamination processes

PROCESS DEFINITION METHODS APPLICATION

To eliminate most
harmful Phenolic disinfectants, heavy
microorganisms metals, halogens (chlorine), is used mostly to
DISINFECT (not including bleach, alcohols, hydrogen decontaminate
their spores) from peroxide, detergents, heating, surfaces and air
objects; inactivate and pasteurization
viruses
To kill ALL
microbes whether Heat, chemicals, irradiation, is used for food,
STERILIZE harmful or not high pressure, and filtration medicine, and surgical
and their spores instruments
 Air disinfectants - disinfectant is dispersed as either as an aerosol or
vapor at a sufficient concentration in the air
 Alcohols - high-concentration can effectively inactivate viruses. It is
safe and inexpensive to use in household environment.
 Aldehydes – are somewhat effective on spores and fungus also.
 Oxidizing agents – Chlorine and oxygen are strong oxidizers that
causes the microorganism to collapse.
 Phenolics – It is the oldest known disinfectant for e.g. mouthwashes.
 Steam under pressure / autoclaving - most effective and convenient
way to sterilize material that can withstand high temperature
 Heating / Dry Heat – Under heating flaming, incineration, boiling in
water. It has no effect on the spores. Advisable for powders
 Chemical sterilization – for material that can only withstand at low
temperature sterilization ( 54 to 60 C)
 Radiation - for sterilizing medical equipment, such as syringes,
needles, cannulas, and IV sets
 Sterile filtration - Clear liquids that would be damaged by heat,
irradiation or chemical sterilization. Filtration is done through pores
that are smaller in size
 All practices that are intended to confine microorganisms to a specific area by
limiting their number, growth, and chances of transmission.
 Procedures used to protect the client and his environment from acquiring the
disease from the disease causing microorganism.
 REDUCTION
 Makes use of “clean technique”

Considerations:
 Know what is dirty
 Know what is clean
 Remedy contamination immediately
 Perform hand hygiene and put on gloves (PPE)

 When invading sterile areas of the body, maintain the sterility of the
body system
 When placing an item into a sterile area of the body, make sure the
item is sterile
 Body fluids should be considered contaminated

 When performing patient care, work from cleanest to dirtiest patient

area.
Isolation precautions
Hand washing
Use of PPE
Use of disposables and clean surfaces
Control and teaching of visitors/relatives
Developing and educating healthcare providers
 Isolation – measures to prevent the spread of infections or potentially
infectious organisms to people
 Barrier technique (reverse isolation) – measures to protect highly
susceptible clients from infection

Centers for Disease Control and prevention (CDC) :

 Category Specific Isolation (CSI) precaution
 Disease Specific Isolation (DSI) precaution
 Universal Precaution
 Body Substance Isolation (BSI) system
Decrease the risk of transmitting
unidentified pathogens
Hepatitis B, C, and HIV
Does not apply to feces, nasal secretions,
sputum, sweat, tears, urine, vomitus (unless
they contain visible blood)
Included all body parts and secretions and
excretions
Does not include clients with airborne diseases
Follows hand washing, gloving, gowning,
wearing masks, eye wear, hair and shoes
covers
Adheres to needle destruction and disposal
and proper disposal of waste
Susceptibility – the degree to which an individual can be
affected. It can be reduced by:
1.Hygiene
2.Immunizations
3.Nutrition
4.Fluid
5.Rest and sleep
6.Relief from stress
 Practices designed to render and maintain objects and areas
maximally free from microorganisms
 ELIMINATION
 Focuses on “contamination”
 Makes use of “sterile technique”

Considerations:
 Know what is sterile and not sterile
 Keep sterile and not sterile items apart
 Remedy contamination immediately
1.Always face the sterile field. (objects out of vision are considered unsterile)
2.Keep sterile equipment above your waist level or above table level (they are
considered margins of safety and promote maximum visibility of sterile field)
3.Do not speak, sneeze, and cough over a sterile field
4.Never reach across sterile field (when a nonsterile object is held above a sterile
object, gravity causes microorganism to fall into the sterile field)
5.Keep the unsterile objects away from the sterile field
6.Keep the sterile field dry (microorganism do not pass easily on dry surface)
7.Edge of sterile field is considered unsterile
8.Never assume that the object is sterile
 Importance:
 Handsare the most common mode of
pathogen transmission
 Reduces the spread of antimicrobial
 Handwashing resistance
 Preventshealthcare-associated
 Antiseptic
infections
Handwashing
 Alcohol-based
Hand Rub
 Surgical Antisepsis
1.Before and after touching the patient
2.Before cleaning and/or aseptic
procedure
3.Possible risk of exposure to bodily
fluids
4.After touching patient surrounds
 How to hand rub

To effectively reduce the

growth of germs on hands,
hand rubbing must be
performed by following all
of the illustrated steps.
This takes only 20–30
seconds!
How to hand-wash

To effectively reduce the

growth of germs on hands,
handwashing must last at
least be performed 40 to
60 seconds and should be
performed by following all
of the illustrated steps.
 The EPA classifies disinfectants as high, intermediate, or
low level, based on the effectiveness and contact time of the
solution and the biocidal activity of an agent against
bacterial spores, mycobacterium tuberculosis, lipid and
non-lipid viruses, and vegetative bacteria.

Level of Bacterial Tubercle Non- Lipid Vegetative

disinfection spores Bacillus lipid Viruses Bacteria
Viruses
High Maybe Yes yes Yes yes
Intermediate No Yes Yes Yes Yes
low No no No ye Yes
 Surgical Handwashing Medical Handwashing
Tip up to 1 inch above the Tip up to wrist
elbow
Hand is higher than the Elbow is higher than the level of
level of elbow hand
For surgical incision and For radiologic procedure such
operative procedure as X-ray or any non-invasive
procedure
 Aka cardinal sign
 are measurements of the body's most basic functions which is
useful for detecting and monitoring medical health condition
 There are four basic vital sign (sometimes five)

1. Body Temperature (5)

2. Pulse Rate (4)

3. Respiration (3)

4. Blood Pressure (2)

5. Pain (1)
 Is the physiologic balance between heat produced
in body tissues and heat lost to the environment
 Must be stable in order for the body`s cellular and
enzymatic activities to function efficiently
 Changes of 2 to 3 degrees to body temperature
has an effect to body`s physiology
 Thermometer – device use to measure body
temperature
 Heat – produced by chemical process from
metabolic activities in human body
a. Medulla oblongata
b. Pons
c. Pituitary gland
d. hypothalamus
 1. ENVIRONMENT (10) 6. EMOTIONS (5)

2. TIME OF THE DAY (9) 7. HORMONE LEVELS (4)

3. PHYSICAL EXERCISE (8) 8. WEIGHT (3)

4. DISEASE (7) 9. INJURY (2)

5. FOOD (6) 10. AGE (1)

 PYREXIA – AKA FEVER
- PATIENT WHOSE BODY TEMPERATURE IS
ELEVATE ABOVE NORMAL LIMIT
 FEVER – INDICATES Disturbance IN THE HEAT-REGULATING
CENTERS OF THE BODY
 HYPOTHERMIA – BODY TEMPERATURE BELOW THE
NORMAL RANGE
 HYPERTHERMIA – BODY TEMPERATURE ABOVE THE
NORMAL RANGE

NOTE: AS BODY TEMPERATURES INCREASES, THE BODY`S

DEMAND FOR OXYGEN INCREASES
1. HEAT BODY TEMPERATURE (10) 6. HOT SKIN (5)

2. INCREASE PULSE RATE (9) 7. CHILLS (4)

3. INCREASE RESPIRATION RATE

8. LOSS OF APETITE (3)
(8)

4. DISCOMFORT (7) 9. BODY WEAKNESS (2)

5. ACHING (6) 10. RED EYE (1)

 AGE CELSIUS FAHRENHEIT
3 MONTHS – 3 YEARS 37.2 – 37.7 C 99 – 99.7 F
5 YEARS – 13 YEARS 36.7 – 37 C 97.8 - 98.6 F
FATAL 41 UP - 34 BELOW 105.8 UP - 93.2 BELOW

NOTE: A VARIATION OF 0.5 TO 1 DEGREE ABOVE OR

BELOW THE NORMAL RANGE IS STILL CONSIDERED AS
NORMAL
 1. Axillary (10)

2. Tympanic site (7)

3. Oral site (5)

4. Rectal (3)

5. Forehead (2)
Oral site: Rectal site:
 Is taken through mouth under the tongue  Most accurate and reliable
 Average oral temperature: 37 Celsius or  Is taken at the anal opening of the
98.6 Fahrenheit rectum
 Written as: 98.6 Fahrenheit as 98.6 o  Average rectal temperature: 37.5 Celsius
or 99.6 Fahrenheit
 Written as: 99.6 Fahrenheit as 99.6 r
Axillary Site:
 Most common and safest
Tympanic site:
 Is taken in the axilla or armpit
 Uses digital thermometer
 Average axilla temperature: 36.4 – 36.7
Celsius or 97.6 – 98 Fahrenheit  Is taken through ear
 Witten as: 97.6 Fahrenheit as 97.6 ax  Average tympanic temperature: 37.5
Celsius or 99.5 Fahrenheit
 Written as: 97.6 Fahrenheit as 97.6 t
Aka aural thermometer
A small hand-held device that measures
the temperature of the blood vessels in
the tympanic membrane of the ear
Patient may be sitting upright or in a
supine position
1. Place a clean sheath on the probe that is to
be inserted into the external auditory canal
2. hold it firmly in place until the temperature
registers automatically on the meter held in
the non-dominant hand
3. Remove the probe and read the indicator
4. Remove the probes cover
The thermometer is place
under the patient`s tongue
and held in place until the
instrument signals that is
has a registered
temperature
The most common and safest method
Glass temperature at least 5 minutes or
longer
Useful for measuring infant`s
temperature
Time and precision of placement is
necessary to acquire accurate reading
Most reliable measurement of body
temperature
Close to pelvic viscera or “core”
temperature of the body
Take note: avoid this procedure if there is
hemorrhoids
Take note: don`t use oral thermometer for
rectal purpose and vice versa
1. Choose the Correct thermometer
2. Put on clean gloves
3. Assure Patient`s privacy
4. PATIENT is at Sim`s position
5. Lubricate thermometer tip
6. Gently insert the tip of thermometer into the
rectum about 1 to 1.5 inches and hold it in place
for 2 – 3 minutes
7. Remove the thermometer then do hand-washing
 Electronic thermometer
a. Digital heat sensor
b. Infrared wave sensor
c. Basal thermometer

 Liquid-filled glass
thermometer
a. Mercury filled
b. Alcohol filled

 Temperature strips
thermometer
standard electronic
thermometer
Uses electronic heat
sensor to detect body
temperature
Can be use in mouth,
armpit, or rectum
 use infrared rays to measure the
body’s temperature
 most common form is the
tympanic thermometer
 A new and developing
thermometer that measures the
temporal artery in the forehead
also uses infrared waves to
measure temperature
 digital thermometer that is
highly sensitive and tracks
precise, minute,
temperature changes within
the body
 They are most often used
for female fertility purposes
and ovulation tracking
Most common
glass thermometer
Household item
Started to be
phase out in
commercial market
due to the risk
brought by
mercury
 Standard replacement for mercury
filled thermometer
 Not toxic
 the alcohol is infused with a dye
so it can be easily read
 Ethanol
 To reset the thermometer, be sure
to shake it until the alcohol level
resumes to room temperature
before using it again
 measure the body’s
temperature due to liquid
crystals present on the strips
that react to heat
 Place on forehead
 Changes color that is matched
to a provided chart
 others the strip itself will show
a numerical value for body
temperature
 reusable
 AKA heart rate
 is the number of times your heart beats per
minute
 High pulse rate for low blood pressure
 Low pulse rate for high blood pressure
 Stethoscope - a medical instrument for listening to
the action of someone's heart or breathing
 Bradycardia – lower than 60 beats / minute
 Tachycardia – over 100 beats / minute
1. Apical (10) 6. Temporal (5)

2. Radial (9) 7. Dorsalis pedis pulse (4)

3. Carotid (8) 8. Posterior tibial pulse (3)

4. Femoral (7) 9. Brachial (2)

5. Popliteal (6)
 Apical – over the apex of heart (with the aid of stethoscope) ----- most accurate for
infants/children
 Radial – radial artery at the wrist (base of the thumb)
 Carotid – carotid artery at the front of neck (below and slightly lateral to the chin)
 Femoral – femoral artery (at the groin)
 Popliteal – back of the knee
 Temporal – temporal artery ( in front of the ear)
 Dorsalis pedis (pedal) – top of the feet in line with the groove between extensor
tendons of the great and 2nd toe
 Posterior tibial – inner side of ankle
 Brachial – groove between biceps and triceps above the elbow
 Age Pulse rate
Infant 120 beats / minute
4 years old - 10 years old 90 - 100 beats / minute
Adult 60 - 90 beats / minute

Note: in acquiring pulse rate

especially through radial pulse, avoid
using your THUMB finger
 PROCEDURE FOR APICAL PULSE
1.Place the px in semi-fowler position
or supine position
2.Place the bladder of stethoscope at
the 5 intercostal space (5cm from
th

left sternal margin)

3.Count the beats for 1 minute
(regular rhythm)
 Exchange of gases
 Inhalation (inspiration) and exhalation (expiration)

Average rate on respiration:

 Infant ------ 30 to 60 breaths / minute
 Adult ------- 15 to 20 breaths / minute

 Respiration fewer than 10 breaths / minute may lead to

cyanosis
 OBSERVING RESPIRATION
1. Keep px in sitting or supine position
2. Don`t tell the px that his respiration is being
observed
3. Observe chest wall for symmetry movement
4. Count the number of times the px`s chest rises
and falls for 1 minute
 Pressure – product of flow times the resistance
 It is the amount of blood flow ejected from the pumping chamber of
the heart against blood resistance
 Sphygmomanometer – device use to measure the blood pressure
 There are two important words in acquiring blood pressure….
Systolic (highest point; contraction) and diastolic (lowest point;
relaxation)
 Measures in mm hg (millimeters of mercury)
 Hypotension – low blood pressure
 Hypertension – high blood pressure
 Ideal 120/80 mm hg
What should my blood pressure be according to my age?
Age Systolic BP Diastolic BP
3-6 116 76
7-10 122 78
11-13 126 82
14-16 136 86
17-19 120 85
20-24 120 79
25-29 121 80
30-34 122 81
35-39 123 82
40-44 125 83
45-49 127 84
50-54 129 85
55-59 131 86
60+ 134 87
Blood Pressure Chart for Children

Age Males (mmHg) Females (mmHg)

1-3 80/34 - 120/75 83/38 - 117/76

4 to 6 88/47 - 128/84 88/50 - 122/83

7 - 10 92/53 - 130/90 93/55 - 129/88

High Blood Pressure Range

If one or both numbers are usually high, you have high blood
pressure (Hypertension)
Systolic pressure Diastolic pressure Stages of High
(mm Hg) (mm Hg) Blood Pressure
210 120 Stage 4

180 110 Stage 3

160 100 Stage 2

140 90 Stage 1
1. Mercury manometer – more accurate ;
less convenient
2. Aneroid manometer – dial ; circular ;
household
3. Digital manometer – electronic ; less
reliable
 PROCEDURE FOR ACQUIRING BLOOD PRESSURE
1. The length of the cuff's bladder should be at least equal to 80% of
the circumference of the upper arm.
2. Wrap the cuff around the upper arm with the cuff's lower edge one
inch above the antecubital fossa.
3. Lightly press the stethoscope's bell over the brachial artery just
below the cuff's edge.
4. Rapidly inflate the cuff to 180mmHg. Release air from the cuff at a
moderate rate (3mm/sec).
5. Listen with the stethoscope and simultaneously observe the
sphygmomanometer. The first knocking sound (Korotkoff) is the
subject's systolic pressure. When the knocking sound disappears,
that is the diastolic pressure.
physical suffering or discomfort caused by
illness or injury
Measured in del
Human body can bear only up to 45 del
While giving birth, the woman can experience
up to 57 del (similar to 20 bones being fx at
the same time)
1. Number scale
2. Faces scale
3. FLACC
Patients rate pain on a scale from 0-10, 0 being no pain and 10 being
the worst pain imaginable
A scale with corresponding faces depicting various levels of
pain is shown to the patient and they select one
 Face , legs, activity, cry, consolability
 is a measurement used to assess pain for children between the ages of 2 months and 7 years or
individuals that are unable to communicate their pain

Criteria Score 0 Score 1 Score 2

Occasional grimace or Frequent to constant
No particular
Face frown, withdrawn, quivering chin,
expression or smile
uninterested clenched jaw
Normal position or Uneasy, restless, Kicking, or legs drawn
Legs
relaxed tense up
Lying quietly, normal Squirming, shifting,
Activity Arched, rigid or jerking
position, moves easily back and forth, tense
Crying steadily,
No cry (awake or Moans or whimpers;
Cry screams or sobs,
asleep) occasional complaint
frequent complaints
Reassured by
occasional touching, Difficult to console or
Consolability Content, relaxed
hugging or being comfort
talked to, distractible
 Glucose level in our body
 Fbs is one of the common and easiest way acquiring blood sugar
 Measures in mg/dl (milligram per deciliter) or mmol/l (millimoles per liter)

Normal and diabetic blood sugar ranges:

 Between 4.0 to 6.0 mmol/L (72 to 108 mg/dL) ----- when fasting
 Up to 7.8 mmol/L (140 mg/dL) ----- 2 hours after eating

For people with diabetes, blood sugar level targets are as follows:
 Before meals: 4 to 7 mmol/L (72 to 126 mg/dl) for people with type 1 or type 2
diabetes
 After meals: under 9 mmol/L (162 mg/dl) for people with type 1 diabetes and
under 8.5mmol/L (around 154 mg/dl) for people with type 2 diabetes
Normal blood pressure 120 / 80
Normal blood sugar levels 80 – 120
Normal heart rate per minute 60 – 80
Normal cholesterol level in mg 200
Ideal body mass index (BMI) 20 – 25
Minutes of exercise needed per 150
week
Proportions of vegetables and 5
fruits daily
Liters of water required per day 2–3
Number of sleeping hours daily 7 -9