Before a patient starts using crutches for the first time, each
crutch must be adjusted to the patient’s height and need.
Each crutch can be adjusted at the top and bottom. Below are some
key concepts that tell if the crutches fit your patient
properly.
- There should be a 2-3 finger width (1-1.5 inches) gap between
the armpit (axillae) and crutch rest pad when the patient holds the
crutches.
- The elbows should be flexed about 30 degrees when the hands are
placed on the handgrips.
When a patient starts learning how to use crutches, the nurse
should apply a gait belt to the patient for safety. When a patient
is ready to start ambulating with crutches, they will start in the
tripod position. Each tip of the crutch will be about 6 inches to
the side of the feet diagonally.
The key to understanding what moves first (the good or bad leg)
when either going up or down the stairs is to remember:
- Going up the stairs: the patient will move the “good” leg
(hence non-injured leg) up onto the step first and then
will move the “bad” leg (hence injured leg) and crutches up onto
the step.
- Going down the stairs: the patient will move both crutches down
onto the step and then move the “bad” leg (hence injured leg) down
and then move the “good” leg down.
Sitting Down and Getting Up from a Chair
- Sitting Down: the patient will be backed up to the chair until
they feel the chair with the back of their non-injured leg. The
patient will then move both crutches onto the injured side and grip
the handgrips of the crutches for support. The patient will keep
the injured leg extended out and slightly bend the non-injured leg.
Then the patient will feel for the chair’s seat with the
non-injured side and sit down…all while keeping the injured leg
extended out.
- Getting Up: the patient will keep the injured leg extended out
forward and put both crutches on the injured side and grip the
handgrips of the crutches. Then the patient will lean forward and
push up with the arm of the non-injured site on the chair’s seat
and by using the handgrips on the crutches, which is on the injured
side. Once standing, the patient will bring the crutches into the
tripod position.
Keeping all this in mind a nurse has to evaluate the patient on
his crutch using techniques and simultaneously correct him if
necessary