Technologies and Assistive Devices to promote patient mobility. Click on a House Level to view the equipment  to assist with that level

The goal of using equipment is to promote activity and protect the caregiver, as well as the patient. The ANA has published Interprofessional National Standards on Safe Patient Handling and Mobility. When patient size, weight, dependency level, fear, or anxiety are barriers to mobility, assistive technology provides a solution to overcome the barriers. Remember that the use of equipment should be to SUPPLEMENT the patient’s mobility, and to help them with ONLY the portion of the task they are unable to do. Patients should be encouraged to actively participate as much as is medically appropriate at every level. The patient should tolerate activity at each level prior to moving to the next level. Tolerance is defined by Vital signs remaining stable (< 10% deviation from baseline) or staying within the safety parameters in the safety screening tool. Remember the phrase “Move it or Lose it!”. We need to push the systems just enough to stimulate adaptive changes but not over-stress them. Building mobility into everyday care tasks makes best use of the philosophy that “Every little helps” and “Small efforts yield great results”.

Stage 1

Promoting in bed mobility and starting to get up to sitting and more upright postures.

Patient

Lasts from medical and hemo-dynamic stability, until the patient is able to move about the bed while maintaining medical stability. This is where the patient is JUST medically stable, and we are beginning to increase the demands on the heart, lungs, oxygen delivery system, nervous system, musculo-sketletal system etc. By challenging the systems just enough to stimulate them to work without taxing them so much that they further deteriorate, we begin the road to recovery.
Assistive EquipmentFriction reducing devices (FRDs) help to overcome the friction of the sheets, and allow the patient to increase participation in repositioning, turning, and moving about in bed.These can also be used under a dependent sling and lift system, to enable patient to move around in the sling.Ceiling lifts or floor based dependent lifts, with repositioning slings help assist with turning, boosting and repositioning or dependent slings to get patient passively up to a chair. Progress the activity by decreasing the “Lift” assist and having the patient increase participation as medical stability allows.Bed features including head of bed, rotational features, tilt beds, tilt tables, to progress upright posture and positioning.This helps with fluid shifting for baroreceptor training and tilt beds that have weight bearing capacity promote calcium and mineral retention in the lower extremities.Beds that go into chair mode or cardiac chairs can assist with passive sitting for upright orientation. Remember, the patient should help as much as medically appropriate.Neuro-muscular Electrical Stimulation (NMES) is also helpful when patients are unable to actively contract their own muscles. Limb slings can help with passive and active range of motion of arms or legs.

Equipment Vendors

Vitalgo

ArjoHuntleigh

Hill-Rom

Stryker

Vancare

Tollos

Handicare

Guldmann

Jamar Patrans

Motomed

Hocoma

WyEast Medical

Restorative Therapies

If you are a vendor that has equipment that could help, and you would like to share your early mobility solutions, please contact us:  Info@earlymobility.com

Click here for picture gallery

Safety Precautions

Respiratory: FiO2 < 60% PEEP <10cmH20 SPO2> 88% Click here for full list of all safety precautions Cardiac: No New arrhytmias, Uncontrolled Ectopy, No New inotropic meds No New MI last 24 hours MAP >65 < 110 Resting HR >50 < 140 Neurological: Able to respond to 3/4 verbal commands PH > 7.25

Stage 2

Working towards active sitting at edge of bed, and continuing with progressive upright positioning as tolerated.

Patient

Tolerating increased activity, vital signs stable most of the time, medical condition improving. Able to help with mobility in bed. Tolerating changes in position well, and able to sit up with assistance.

Assistive Equipment

Friction reducing devices can continue to assist with bed mobility and helping overcome friction of the sheets when sitting up. They can also be used to increase patient exercise in bed. Ceiling lifts or floor based lifts with dependent slings with increased patient participation, or hygiene slings that can be used to allow patient participation to sit up. Use slings and lifts to work on sitting balance at the edge of the bed and encourage increased patient participation with movement. Tilting beds or tilt tables (Static or dynamic), to progress to higher levels of tilt, and progressive upright mobility and positioning, and promote progressive weight bearing. Consider tools that are immediately available at bedside for frequent interventions such as ceiling lifts, or specialty beds to promote upright position periodically throughout the whole day. Continue with Neuromuscular stimulation for muscle contraction if needed. In bed bicycling stimulate increased muscle strength and joint nutrition. Can continue to use chair mode of many beds, remembering to push patients to participate as much as they can in the task. Begin to use sit to stand devices to help with sitting posture and promote longer or more frequent times of upright posture
Equipment Vendors

Vitalgo

ArjoHuntleigh

Hill-Rom

Stryker

Vancare

Tollos

Handicare

Guldmann

Jamar Patrans

Motomed

Hocoma

Wy’East Medical

Restorative Therapies

If you are a vendor that has equipment that could help, and you would like to share your early mobility solutions, please contact us: Info@earlymobility.com

Click here for picture gallery
Conditions to move to stage 3 Maintain vital signs and tolerate phase II activities and sit without using arms. Be able to kick up each leg and hold for 5 seconds

Safety Precautions

Respiratory: FiO2 < 60% PEEP <10cmH20 SPO2> 88% Click here for full list of all safety precautions Cardiac: No New arrhythmias, Uncontrolled Ectopy, No New inotropic meds, No New MI last 24 hours MAP >65 < 110 Resting HR >50 < 140 Neurological: Able to respond to 3/4 verbal commands PH > 7.25

Stage 3

Stand from sitting and transfer to chair

Patient

Medical problems beginning to resolve. Condition stable, getting stronger in sitting position and tolerating more standing. Ready to take steps to chair and begin ambulation activities. Work towards independent transfers, pre-gait activities for increased tolerance, Increase out of bed activities, begin gait training
Assistive Equipment Friction Reducing Devices (FRDs) can be used by the patient to exercise now, and help with skin integrity as the patient moves and turns in bed independently. Ceiling lifts or dependent lifts can still be used to push more time / complexity with sitting activities, and with ambulation slings, can be used to begin standing, sit to stand activities and upright posture. Tilt tables (Static and dynamic) and Vertical tilt beds can be used to achieve full standing and weight bearing, as well as pre-gait activities and march in place if patient is not ready to move away from the bed. Sit to stand devices (powered and non-powered) can also be used to progress sit to stand and transfer ability if the patient is very weak. Neuromuscular stimulation, in bed cycling, and interval weight bearing and positioning in tilt beds can be continued throughout the day in addition to the “focused mobility intervention or therapy intervention”

Equipment Vendors

Vitalgo

ArjoHuntleigh

Hill-Rom

Stryker

Vancare

Tollos

Handicare

Guldmann

Jamar Patrans

Motomed

Hocoma

Wy’East Medical

Restorative Therapies

If you are a vendor that has equipment that could help, and you would like to share your early mobility solutions, please contact us: Info@earlymobility.com

Click here for  picture gallery
Conditions to move to stage 4 Shift weight in standing, Good balance taking single steps. March 5 steps in place

Safety Precautions

Respiratory: FiO2 < 60% PEEP <10cmH20 SPO2> 88% Click here for full list of all safety precautions Cardiac: No New arrhytmias, Uncontrolled Ectopy, No New inotropic meds, No New MI last 24 hours MAP >65 < 110 Resting HR >50 < 140 Neurological: Able to respond to 3/4 verbal commands PH > 7.25

Stage 4

Ambulation

Patient

Medical condition resolving or resolved. Able to actively participate in therapy. Minor to Moderate assistance to get out of bed, tolerating longer periods out of bed and able to tolerate walking activities. Aim to discharge to ward, subacute unit or home
Assistive Equipment Friction reducing devices (FRDs) can be used to actively exercise patients in bed. Ceiling lifts with ambulation slings can be used to walk in room. Dependent lifts with ambulation slings can be used to walk in hallways especially if patient is at risk for falling. Powered and non-powered sit to stand devices can help with ongoing strengthening and transfer training. Extended walkers with seats can also be used for ambulation. Mobile ventilators and bagging devices allow vented patients to ambulate away from the bed and fixed devices Portable ECMO and Dialysis units allow patients requiring these interventions to safely ambulate away from the bed Vertical tilt beds can help to increase strength and endurance throughout the day for progressive ambulation, or can be used for marching in place when staffing resources limit ability to walk away from the bed safely

Equipment Vendors

Vitalgo

ArjoHuntleigh

Hill-Rom

Stryker

Vancare

Tollos

Handicare

Guldmann

Jamar Patrans

Livengood Medical

Wy’East Medical

Restorative Therapies

If you are a vendor that has equipment that could help, and you would like to share your early mobility solutions, please contact us: Info@earlymobility.com

Click here for picture gallery

Safety Precautions

Respiratory: FiO2 < 60% PEEP <10cmH20 SPO2> 88% Click here for full list of all safety precautions Cardiac: No New arrhytmias, Uncontrolled Ectopy, No New inotropic meds, No New MI last 24 hours MAP >65 < 110 Resting HR >50 < 140 Neurological: Able to respond to 3/4 verbal commands PH > 7.25