Physical assistance and monitoring

Physical assistance and monitoring

Exam category: Patient Care → Ergonomics and Monitoring
Why it matters: This section tests whether you can physically keep a patient safe while doing your job — body mechanics, safe handling equipment, tubes/lines, and recognizing when vital signs are abnormal.

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The big picture (plain English)

Radiographers move, transfer, and monitor people who are often sick, injured, sedated, or unstable — sometimes while those patients are attached to medical equipment. This section is about doing that safely, for both the patient and yourself.

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1. Body mechanics and transfer

Wide base of support, bend at the knees (not the waist), keep the load close to your body, pivot your feet instead of twisting your spine. Always explain a transfer before starting, and lock wheels/brakes on stretchers, wheelchairs, and beds before every transfer.

2. Medical equipment during positioning

• Infusion lines — keep IV bags above the insertion site for proper gravity flow; watch for tension on tubing during movement, which can cause infiltration or dislodgement.
• Oxygen — never turn off supplemental oxygen without a physician's order, even briefly; hypoxia can develop quickly in an oxygen-dependent patient.
• Urinary (Foley) catheters — the drainage bag must stay below the level of the bladder to prevent backflow/reflux.
• Tracheostomy tubes — never occlude, pressure, or disconnect during positioning.
• Nasogastric (NG) tubes — passed through the nose into the stomach. Four purposes: feeding, decompression (suctioning off gas and secretions), medication, and radiographic contrast administration. Support the tube as you move the patient so nothing pulls on it, and don't turn off the suction or reposition the tube yourself — that's a nursing decision. A nasoenteric / nasointestinal tube is the same idea passed further, into the small intestine.

3. Vital signs

Tachycardia = pulse >100. Bradycardia = pulse <60. Tachypnea = respiration >20. Bradypnea = respiration <12. Abnormal vitals should be reported promptly to the care team — not silently documented and left.

4. Fall prevention and patient comfort

Never leave a confused, sedated, pediatric, or unsteady patient unattended on a table or stretcher, even briefly. Keep side rails up when appropriate, lock wheels during transfers. Provide appropriate draping — expose only the anatomy being imaged — and keep the patient warm; a cold, exposed patient is both a comfort and a dignity issue.

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Registry must-know facts

• Gait belt (patient assists) vs. transfer board (can't bear weight, can be slid) vs. Hoyer lift (can't assist at all) — matched to the patient's capability, not interchangeable.
• IV bags above the insertion site; catheter drainage bags below the bladder.
• Never discontinue oxygen or occlude a trach without authorization.
• NG tube = nose to stomach, for feeding, decompression, medication, and contrast. A nasoenteric/nasointestinal tube goes on into the small intestine. Don't stop the suction or move the tube yourself. Dobbhoff = feeding (small-bore, flexible); Levin = single-lumen and Salem Sump = double-lumen with an air vent, both for decompression.
• Tachy- = fast, brady- = slow, for both pulse and respiration.
• Abnormal vitals get reported, not just recorded.

Common trap

A scenario describes briefly lifting a urinary drainage bag above bed level "just to reposition the patient." This is incorrect regardless of how brief — it risks backflow of contaminated urine into the bladder, and there's no exception for a short duration.

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Source: Ehrlich, Patient Care in Radiography, 10th ed. Vital sign ranges cross-checked directly against the ingested text (respiration 12-20/min, pulse 60-100 bpm confirmed). The nasogastric material is from that text's bedside-radiography chapter: NG tubes passed through the nose into the stomach and the four listed purposes (feeding, decompression, radiographic examination, medication); decompression defined there as suction used to clear gas and secretions; the Dobbhoff as a feeding tube of smaller lumen and greater flexibility than the drainage tubes; the Levin as single-lumen and the Salem Sump as a radiopaque double-lumen tube whose second lumen serves as an air vent; and nasoenteric/nasointestinal tubes as the variant placed into the small intestine.