Spine loading during the application and removal of lifting slings: the effects of patient weight, bed height and work method
研究了12名护士在不同患者体重、床高和工作方法下应用和移除吊带时的腰椎负荷,发现L5/S1剪切力超过阈值,建议将床升至护士指关节高度以降低风险。
The biomechanical loading on the lumbar spine was assessed as 12 female nurses applied and removed slings under two patients of differing weights (54 and 100 kg), using two work methods, and while working at three bed heights (56, 71, 93 cm). Three-dimensional spine loads at the L2/L3, L3/L4, L4/L5 and L5/S1 disc levels were measured using a validated EMG-assisted biomechanical model. Anterior/posterior (A/P) shear loading at the L5/S1 level consistently exceeded the tolerance threshold limit for disc failure. The peak compression values exceeded the 3400 N tolerance threshold for several participants when placing the sling under the 100-kg patient. In general, working from both sides of the bed generated slightly higher A/P shear loading than the one-sided method. Raising the bed significantly decreased compression and A/P shear forces. Therefore, raising the bed to at least the nurse's knuckle height is recommended when applying and removing patient slings. Practitioners Summary: We investigated the spine loading associated with placing and removing slings used for the mechanised lifting of patients. Peak compression and anterior shear forces exceeded recognised thresholds when placing slings underneath heavier patients. Raising the bed to at least knuckle level helps mitigate these spinal loads.