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Basic concept template for evaluating client's use of crutches

Basic concept template for evaluating client's use of crutches

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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


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