Now that we’ve covered the sling basics on how to select, inspect and apply slings, let’s take a closer look at the various sling styles.
As you may recall from the 5 Steps to Choosing the Right Sling for Patient Transfers, slings can be grouped into a few basic categories. There are slings for seated transfers, toileting, positioning, sit-to-stand, and walking.
Today’s blog will focus on the band sling, a small, versatile sling that is often under-utilized or overlooked. It’s designed to assist caregivers with tasks that involve lifting, supporting, and positioning of limbs.
So why is the Band Sling not often used? Is it the lack of awareness that this type of solution exists? Is it the uncertainty of how to use this sling style?
Or is it because we believe limbs are easy to lift and hold? After all, how heavy can a limb be
Well, let’s consider, in 2018, Stats Canada reported that 26.8% percent of adult Canadians were considered obese and 36.3% were overweight, increasing the risk of various medical conditions such as cardiovascular disease, diabetes, osteoarthritis and more. The trend in healthcare has seen the steady rise of heavier patients with complex care needs, couple this with aging caregivers and overall caregiving has become harder.
A quick Google search indicated that the average male weighs about 187 lbs. and the average female weighs roughly 155 lbs. So, how heavy are the limbs our caregivers are lifting?
Well, to roughly estimate the weight of limbs, the VA Safe Patient Handling app Safe Patient Handling | VA Mobile suggests using 16% of the individual’s body weight to calculate the lower extremity and 5% to calculate the upper extremity. Keep in mind that medical devices, casts, splints, or various medical conditions, for example lymphedema will increase the weight of the limb.
Given these guidelines, the lower extremity weight for the average male would be about 30 lbs. and almost 25lbs for the average female.
It seems like a weight anyone can lift, but can you lift a 25 or 30 lbs. limb frequently, while maintaining an awkward position, or bending and reaching over the bed with injury?
The 2007 article titled “When is it safe to manually lift a patient” by Thomas R Waters, recommended 35 lbs. as the maximum weight limit for manual lifting with the caveat that the lift needed to be performed under ideal conditions. In situations where the caregiver needed to lift with extended arms, off the floor, or from a seated or kneeling position the 35 lb. weight limit would need to be decreased. When a task required the caregiver to lift greater than 35 lbs. the recommendation was made to use safe patient handling solutions. For limbs that require lifting and weighed greater than 35 lbs. a band sling could be the solution.
Limb lifting in healthcare oftentimes requires the arms to be extended while providing care or being in awkward positions, which sets both the caregiver and patient up for a potential injury. Given that these situations are not ideal, how much weight can be manually lifted if we cannot or do not want to use a band sling?
A paper from 2009 titled “Recommended Weight Limits for Lifting and Holding Limbs in the Orthopedic Practice Setting” provided insight into this question. The authors of the paper developed an easy-to-use limb lifting tool for orthopedic clinicians in the form of a chart. This visual aid provides body mass ranges, limb weight estimates, maximum limb lift weights and maximum limb hold times. This tool could also prove to be helpful in other settings where caregivers need to lift and hold limbs for various caregiving tasks.
The guideline suggests that a maximum weight for a one-handed limb lift should not exceed 11.1 lbs. and a 2 handed lift should not exceed 22.2lbs. If we consider the average male and female lower limb weights given these guidelines, manually lifting these limbs should not be performed without either additional help or with the use of a safe patient handling solution like a band sling.
The tool also provides recommendations regarding weight limits when holding the limb up for 1, 2 and 3 minutes at a time.
Now given what we know, if we can potentially reduce the risk of caregiver injury from lifting limbs manually and at the same time provide a safe, comfortable, supportive, and dignified limb lift for the patient, the Band Sling is worth a try.
If you are interested in learning more about our Band Sling or to demo it, feel free to connect with us at Handicare.
At Handicare we strive to make everyday life easier.
What tools do you use to activate individuals? Many times, we rush to complete a transfer and don’t think of how they can assist. During this session we will look at the many ways a band/limb sling can be utilized through the continuum of care.
Wednesday, September 14, 2022 @ 2:00pm EST
View Past Webinar
Let’s recap, picking up from the last blog post, you may recall we touched upon the pre-use sling inspection, the safety check performed by the caregiver prior to the sling application for the lift and transfer.
The sling is clean for a dignified lift and transfer
The sling is clean for the individual’s comfort
The sling is clean to reduce the risk of an infection
Launderable slings should only be used by a single patient or resident and washed when soiled. With regards to using slings between patients or residents, caregivers should ensure slings are clean and should also be aware of and follow their organizational infection control policies procedures and protocols related to sling use and care. If using disposable slings, caregivers should be aware that these slings cannot be laundered and need to be removed from circulation when they become soiled, damaged, or no longer required by the individual.
Prior to sling application, the caregiver needs to check the sling to ensure it is the correct sling style, and size for the patient or resident. The caregiver also needs to ensure the individual does not exceed the sling’s safe working load (SWL).
Why? It’s important for caregivers to be aware that there are numerous factors that will impact the integrity of the sling. Given that slings will deteriorate over time and with use, misuse, and/or from the washing and drying process the sling will need to be inspected to ensure it is safe to use.
Taking the time to perform the visual sling check prior to each use is important and can potentially prevent painful and costly injuries.
Slings that do not pass the pre use sling inspection should be removed from circulation as per the organizations policies, procedures, and protocols.
Worn out with holes, rips, tears, loose stitching, or frays
Are discoloured
Damage to Velcro, loops, clips, or buckles
Missing pieces such as straps
Have knotted loops or straps
Questionable in the eyes of the caregiver
Another sling inspection process that you may or may not be familiar with is the Sling Audit, which differs from the pre-use sling inspection. The pre-use sling inspection is performed prior to each sling use at the point of care and the sling audit, is a standardized and documented sling inspection process, the frequency of which may be defined by your organization.
Handicare recommends that sling audits be conducted once every year.
This formalized process which captures information such as sling manufacturer, sling style, size, serial number, and documents damage to the components of the sling for example has many benefits.
It’s evident that both the visual pre-use sling inspection and the standardized and documented sling audit are important safety strategies. Ensuring slings are available, are appropriate for the patient or resident’s needs, are used correctly, and are clean and in good working order will benefit the patient, resident, caregiver, and organization.
And I think you may agree with the words of Benjamin Franklin, “An ounce of prevention is worth a pound of cure”.
If you are interested in learning more about sling inspections and audits, please feel free to connect with us at Handicare.
In our last blog post we walked you through the basic steps involved in the sling selection process. To recap, the selection of a sling as with all safe patient handling and mobility solutions requires a through clinical assessment, risk assessment, and sound clinical judgement. This month we will guide you through the steps and tips and tricks for the application of a Universal Sling in a chair.
The application of the Universal Sling can be broken down into 5 Basic Steps beginning and ending with safety checks.
The process of applying a Universal Sling in a chair involves performing the pre-use sling inspection to ensure the sling is in good working order. The sling is checked to ensure there are no visible signs of damage; no holes, rips, tears, frays, discoloration, and the stitching should be intact. The pre use sling inspection also includes a visual inspection of the sling label to ensure that it is legible and not compromised. The sling label provides identifying information such as the serial number, the sling style, size, safe working load (SWL), and laundry instructions necessary for safe use.
If the sling does not pass inspection, follow your site or facilities policies, procedures & protocols with regards to removing the sling from circulation.
There are two basic scenarios with the application of the sling body in a seated position.
The first scenario involves the user who can lean forward independently or with caregiver assistance.
With individuals who can lean forward in the chair, place the sling body behind their back with the label facing out. The midline of the sling should be aligned with the spine and the centre arch is aligned with the coccyx.
In the second scenario with individuals who are unable to lean forward due to medical conditions, pain, stiffness, tone, decreased ROM and so on, an alternative solution will be required. The large EasyGlide Ovals, Slider Sheets, or the Comfort Care Sling may be options.
Next the leg bands of the sling are applied under the individual’s thighs. Some individuals may be able to assist with leg band application by creating space under their thighs; by going up on their toes or using their upper body strength to lift the thigh up. If the individual requires assistance to create space under their thighs the FootStool placed under the feet may be an option -remember to remove it post leg band application to prevent slips, trips, or falls.
For individuals who are unable to assist, the small EasyGlide Ovals may be an option. Another leg band application method can be viewed in this video featuring the Universal PolySlip Sling utilizing the low friction, SlipFit material to facilitate the application.
Next, based on your clinical assessment, risk assessment, and your clinical judgement you may choose to criss-cross the leg bands, which is the most used application, or apply the leg bands in a closed or open position.
With the sling in place, the lift’s carry bar is lowered, and the sling’s straps are applied via the loops for this loop style sling. The various loops within the straps allow caregivers to position the individual in a seated to a more reclined position for the lift and transfer.
For a more upright seated position the shortest loop at the shoulder straps and the longest loop at the leg straps are applied to the carry bar, for a more reclined position the longest loops at the shoulder straps and the shortest loop at the leg straps are applied to the carry bar.
Once the sling has been attached to the carry bar the safety checks are performed to ensure the sling is a good fit for the individual. The individual is raised off the chair surface until the straps are tensioned and then checked to ensure they are securely in place. Next the individual is lifted off the surface and checked to ensure they are not migrating through the commode opening. Also ensure the individual is comfortable, well supported, safe, and secure in the sling before proceeding with the lift and transfer.
There you have it, the 5 Steps to Applying a Universal Sling with Safety Checks.
For more information on Universal Sling application consult the user manual and video located on our website or reach out to our Clinical Academy Team.
Sometimes, finding the right sling can feel overwhelming with all the different styles, sizes, and fabrics to choose from. With a fresh start to the year, we thought it would be ideal to revisit the fundamentals for selecting a sling. We hope this simplifies the sling selection process for you to make everyday life easier.
There are 5 Basic Steps that we found useful when selecting a sling.
Step One in the sling selection process is to conduct a thorough clinical assessment of the individual’s abilities. Identifying the individual’s mobility level, whether they are independent with transfers, require supervision or assistance (minimum, moderate or maximum) is one factor in the selection process which helps narrow down sling style options. Keep in mind that choosing a sling based solely on 1 factor may not ensure the correct sling has been selected.
To ensure the individual is prescribed the correct sling, consideration must also be given to other factors such as medical conditions, medications, pain, behavior, cognition, communication, weight bearing status, height, weight, body shape, skin integrity, range of motion (ROM), strength, endurance, tone, medical devices, and so forth.
Step Two of the sling selection process involves identifying the individual’s needs – the tasks requiring caregiver assistance – transferring from bed to wheelchair, repositioning in bed, lifting a limb for hygiene care, transferring onto a toilet or commode, and so on. Identifying the various task(s) requiring caregiver assistance during the assessment process will help to further narrow down the sling style options.
Consideration for sling selection must also include factors related to the caregiver’s abilities, the environmental conditions, equipment accessibility, and other factors that you may identify during the assessment process.
Ultimately, selecting a sling, as with all safe patient handling and mobility solutions, requires a through clinical assessment, risk assessment and sound clinical judgement. The sling should balance the individual’s need for support and comfort without compromising the individual’s abilities or the caregiver’s safety.
To select the sling style, Step Three in the sling selection process, we’ve created an easy-to use Situations Table which can be found in our Handicare Sling Brochure. Simply, select the task(s) across the top of the table and then choose one of the corresponding slings in the column.
Please see our Sling Brochure for full charts and fabric descriptions for sling selection.
In brief, sling styles can be grouped into Five Styles as seen in the image below.
To help those who may be unfamiliar with the Seated Transfer Slings, we’ll quickly go through some of their key differences to assist you with your selection process.
In a nutshell:
Feel free to connect with us or your Handicare Account Manager if you require an in-depth look at our sling styles.
Now, when selecting a sling size, Step Four of the sling selection process, it’s important that you find a sling that is the right fit for the individual’s height, weight, and body shape. Located in the Handicare Sling Brochure is an easy to use, “Sling Size Guide” that will help with our sling sizing.
Once the sling style and size have been selected, choose a sling fabric, Step Five in the process. In short, mesh slings are durable and breathable. Quilted mesh slings provide increased comfort under the thighs. Mesh/Poly slings have non-absorbent padding on the leg sections and may be used for bathing or swimming pools. Slings with padded polyester leg bands are designed for increased leg comfort. Poly/Slip slings are constructed with a low friction material on the outer leg sections for easier leg band application and removal. Spacer slings may be suitable for individuals with skin integrity issues with its multi-directional stretch, breathability, and ability to wick away moisture. Disposable slings, designed for single patient use, are strong, breathable, and liquid repellent.
Now, where do we go from here you ask?
If you have selected a sling then it’s time to perform a trial sling fitting – this is where you apply the selected sling to the individual – to check and ensure the sling provides a safe, supportive, and comfortable fit before proceeding with the lift and transfer.
If you have not found a sling that meets the needs and abilities of the individual and the situation, then connect with us at Handicare to assist you!
We hope you found this blog post on sling selection helpful.
So, you need a sling. Whether you have a ceiling lift or floor lift, neither do you much good without a sling. A sling is the peanut butter to your lift’s jelly; the mac to its cheese. But nothing is worse than picking the wrong peanut butter (ahem, smooth) to go with your lift.
But with thousands of options, where does one begin?
We’re here to help.
Okay, so I am sure some of you are smooth peanut butter fans, so apologies if I offended anyone. But then you’ll understand how startled you would be to bite into a sandwich that had some crunch. That’s because touch means everything!
Similarly, you want to make sure you understand how fabric plays a role in keeping your patient comfortable and safe.
Padded materials are ideal for patients who have sensitive skin. As the name implies, these types of slings help pad the patient during the transfer, heightening their comfort level. However, keep in mind these are not ideal for situations in which the sling may get wet – whether it’s being used in a bathroom setting or for incontinence issues.
What does work well when water comes into play is a polyester mesh. The mesh material breathes easily and dries quickly.
An institutional go-to is the disposable sling. Great for single use and patient specific solutions, the disposable deters the spread of infection or cross-contamination between patients.
Handicare has engineered the spacer fabric that is the best of all worlds. Spacer is the perfect blend of padding and smooth fabric for comfortable positioning. Soft and breathable, spacer prevents the risk of pressure sores making it the perfect solution for patients who may be sitting for extended periods of time or to reduce the need to repeatedly remove and place a sling each time you are transferring a patient. What’s more is that spacer material has an antimicrobial coating to help control infection.
Okay, so now that you understand what type of material to look for, what about the sling’s shape? Hammock, universal, divided legs, non-divided legs… they all look so different!
Let’s start with hammock slings, which are sometimes also referred to as full-body slings. These types of slings fully envelop the patient. His or her entire body is supported within the sling, including supporting the head. Arms are also tucked comfortably within the sling, but the patient’s legs will hang down. As a result, you can select to use in a divided leg or cross-over position. This type is best used with patients who have limited body strength.
Universal slings are pretty much just as they sound. They are the most commonly supplied patient lift sling for general transfer purposes. Easy to use and easy to fit, universal slings can be used for just about any transfer type, whether seated, reclined or supine. Universal slings can be used in a divided leg or closed leg position. Some even include a commode aperture for use in toileting situations.
Which brings us to our next type of sling – hygiene. Specifically designed for use with a commode or toilet, these types of slings have an open bottom for easier access. These slings are also designed to allow the caregiver to easily remove/lower the patient’s clothing while they are still being supported by the sling.
Sometimes, patients have enough body strength that a sit-to-stand lift may be more appropriate for hygiene purposes. As such, stand assist slings are used in conjunction with a sit-to-stand floor lift to gently assist the user into a standing position. The belt/sling supports the lower back and connects to the lift to raise a patient from a seated to standing position. These lifts and slings can are also quite useful outside the bathroom.
Taken one step further is the category of walking slings. Walking slings offer upper body support and freedom of movement to assist in ambulation, gait training and fall prevention.
Conversely, sometimes you need a sling that assists a patient who is lying down. Supine and lateral transfers call for positioning slings. These slings include several straps and loops for optimal head support and can often be used in conjunction with bedsheets , so you’re always ready to go.
Then there is this little special category for niche purposes. Specialty slings are the catchall of everything else you may need – from slings that support limbs to innovative tools that help users get around independently, eliminating the need for a caregiver (check out the Independent Lifter).
Size Matters
Now that you have the type of sling you need in which material, what about the fit?
While you wouldn’t be comfortable wearing a t-shirt that was too big or too small, neither would a patient. Besides comfort, choosing a sling that doesn’t fit presents the risk of having the patient fall out, thereby worsening their condition.
Thankfully, each manufacturer will provide a size chart based on the user’s height and weight. While weight is extremely important to ensure that the sling can safely support and lift the patient, height also must be taken into consideration to ensure there the sling is fitting the user correctly. Think about it: someone who is 150 pounds and 5 feet tall has a much different body shape from someone who is 6 feet and the same weight. Thus, it is imperative both measurements be taken into account.
Thankfully, sling manufacturers understand this and offer a wide gamut of sizes to choose from. Pediatric, bariatric, amputees can all receive the same level of care.
If you would like to set up your free sling consultation, call us at 888-637-8155 or email sales.us@handicare.com to set up an appointment today!
