Buzz
The Hoyer Lift serves as a mechanical apparatus crafted to safely elevate patients. While Hoyer represents a brand name, it's commonly utilized as a generic term encompassing various types of mechanical patient lifts. Although most patient lifts operate similarly, there exists a plethora of models. It's imperative to consult the owner's manual, manufacturer, or expert user to determine if your model possesses unique features. Prioritize familiarizing yourself with the lift and conducting practice sessions with empty slings and fully mobile volunteers before assisting individuals with limited mobility, such as paraplegics and surgical patients.
Procedures
Getting Acquainted with the Lift and Sling
Recognize the base, legs, and wheels. The lift typically comprises 2 'legs' aligned parallel to the floor, supported by 4 wheels. It's crucial to maintain stability at all times by ensuring the wheels are securely fastened. Avoid operating the Hoyer lift on uneven surfaces.
Adjust the Lift Legs Using the Spreader Handle. Utilize the vertical spreader handle located adjacent to the main column of the lift to widen or narrow the legs. Ensure the handle securely locks into place to prevent leg movement during operation.
- Some models may feature a foot pedal instead of a spreader handle.
- Always widen the legs to their maximum position before lifting a patient and maintain this position throughout the lift operation. Failure to do so may compromise stability.
Take Note of the Boom and Sling Bars. Positioned at the lift's apex is a lengthy, angled bar known as the boom. Attached to the end of this boom is a 4-pronged sling bar, also referred to as a swivel bar, equipped with hooks for securing the sling that supports the patient.
Learn How to Operate the Boom's Elevation. Hoyer lifts come in two variants: manual (or hydraulic) and powered (or electric). The distinction lies in the method employed to elevate or lower the boom. Manual lifts necessitate the use of a pump handle, while battery-powered lifts offer simple 'Up' and 'Down' controls.
- Locate the control valve near the base of the pump handle on manual lifts. When the valve is positioned toward the handle, it is closed, enabling the pump's operation for boom elevation. Continue pumping until the boom locks into place.
- For manual lifts, adjusting the control valve away from the handle opens it, regulating the speed of boom descent.
- Practice operating the boom's elevation before attempting to lift a patient. Familiarize yourself thoroughly with the lift's functionality beforehand.
Locate the Emergency Release on Electric Lifts. Electric patient lifts typically feature an emergency release mechanism for use during power outages, allowing manual lowering of the patient. Identify its location and familiarize yourself with its operation.
- Manual lifts lack emergency release mechanisms, as they are human-powered and not reliant on batteries.
- Some models may include multiple emergency releases. Know which release is primary and which serves as a backup.
Identify the Appropriate Sling Type. U-slings are convenient for users capable of sitting upright to some extent, while full-body or hammock slings are necessary for those unable to sit independently.
- U-slings resemble the letter U, featuring two parallel extensions often padded for comfort.
- A full-body or hammock sling is a single piece, sometimes equipped with a commode hole.
- Choose a sling that offers adequate head and neck support for users incapable of supporting their necks.
- Ensure compatibility between the sling and your lift model. Contact the manufacturer for guidance if needed.
- Consult a physician to select the appropriate sling size and type for each user, making it their dedicated sling. Slings are available in small, medium, and large sizes. Familiarize yourself with their dimensions to make the correct selection.
Inspect the sling for any signs of damage. Look for tears, loose stitching, or worn loops that could compromise the sling's integrity and potentially lead to accidents during transfers. While these slings are generally durable, it's essential to conduct a thorough inspection before each use to ensure safety.
Master the technique of attaching the sling to the lift's hooks. Different slings feature various attachment methods such as chains, straps, or loops. Familiarize yourself with these attachment points by referring to the owner's manual or seeking guidance from experienced users. Ensure that the open side of the hook faces away from the user to prevent injuries.
Adopt proper lifting practices. Although the Hoyer lift assists with most of the lifting, you still need to maneuver the user into and out of the sling. Follow safe lifting techniques to minimize the risk of injury, applying principles similar to lifting heavy objects.
Thoroughly practice each transfer method before executing it. Repeat the steps multiple times using an empty Hoyer lift, then practice with a volunteer who has full mobility. Ensure familiarity with each step before attempting a transfer on the intended user, especially when alone.
Understand the lifting and sling's weight limits. Refer to the owner's manual or contact the manufacturer to determine the maximum weight capacity of your lift and sling. Never exceed these limits and always use the appropriate sling for the user's requirements.
Assisting Someone from a Horizontal Position
Clearly communicate each step to the individual. Inform them of your actions beforehand and involve them in the process, fostering mutual respect and cooperation. Engage them throughout the procedure, enabling their assistance when feasible.
Maintain raised guard rails on a hospital bed whenever feasible. Ensure the guard rails are raised and locked when not impeding access. While moving from side to side, consistently raise and secure the guard rail. Temporarily lower the rail if it facilitates better access to the user during sling assistance.
Elevate the bed to its maximum flat height if achievable. Utilize beds with adjustable heights to their maximum extent, reducing strain on your back during user assistance.
Instruct the individual to lie on their back near the side of transfer. On single or twin beds, positioning in the center is optimal, while on larger beds like queen-sized ones, lying closer to the transfer side is recommended.
- Avoid positioning the individual at the extreme edge of the bed.
Clear any extra blankets or sheets from the patient's upper body. Remove any items that could obstruct the transfer and adjust the patient's attire or gown as needed.
- If the patient feels exposed, such as during preparation for a shower, leave a single sheet for privacy.
Instruct the user to lift the leg closest to you. Have them raise the knee nearest to you and place the foot flat on the bed to facilitate the rolling process.
Guide the user onto the opposite side. Support the raised knee and the opposite shoulder of the user, then gently maneuver them onto their side facing away from you.
- If the user requires additional support to remain on their side, place a rolled-up towel behind their back or enlist the assistance of another person.
Fold the sling lengthwise and position it beside the user. Ensure that the bottom end aligns with the user's knees and the top end reaches their armpits. Orient the loops and tabs inward when folding.
- Place the folded sling adjacent to the user with the open side facing away from them.
- You can either fold the sling neatly, roll it onto the user's back, or gently position it in place.
Roll the user onto their back and then onto the opposite side. Utilize the same rolling technique to transition the user onto their other side, positioning them atop the folded sling.
- If unable to comfortably roll the user from the current side, move to the opposite side of the bed.
- If using a wedge, remove it before rolling the user onto their back to prevent discomfort.
Gently unfurl the top layer of the folded sling. Carefully extend the sling to ensure it lays flat on the bed surface, taking care to avoid positioning it too close to the patient's underarms or breasts, especially if they have a larger bust.
Rotate the user onto their back, positioning them over the unfolded sling. Arrange the user's limbs in accordance with the sling's design and the user's preferences. Their arms should either be kept straight alongside the body or placed outside the sling if desired, while their legs should be flat and positioned either together or slightly apart, depending on the sling's configuration.
Secure the lift beneath the user's bed. Ensure there are no obstructions under the bed that could hinder the positioning of the lift. If necessary, adjust the width of the lift's legs using the shifter handle or foot pedal, but always extend them fully once beneath the bed.
- Position the sling bar directly above and parallel to the user's shoulders.
- Always engage the lift's wheel locks before proceeding.
Gradually lower the boom until the sling bar is positioned above the user. Lower it sufficiently for the sling loops to reach the sling hooks, ensuring it does not make contact with the user.
- If unfamiliar with lowering the boom, familiarize yourself with this operation before using the lift with a user. It's crucial to understand the lift's functions before assisting someone with limited mobility.
Attach the loops of the U-sling to the cradle. Choose the most comfortable loops behind the user's shoulders, consulting the user if feasible. Utilize straps, chains, or extended sling loops to connect each corner of the sling to the corresponding hook on the sling bar.
- For slings equipped with leg loops, cross them beneath the user's legs, ensuring the left loop connects to the right hook and vice versa. This criss-cross arrangement helps maintain leg alignment and prevents the user from slipping out of the sling.
- Some slings feature a detachable flap to support the neck and head, although it may not be suitable for users capable of head control.
- Ensure the open ends of the hooks face away from the user to prevent injury.
Elevate the boom gradually. Ensure the loops are securely attached, then raise the boom until the patient is lifted slightly above the bed. Confirm that everything is stable and comfortable before proceeding.
- If the lift feels unstable or uncomfortable for the patient, lower it slowly, make any necessary adjustments, and try again.
Move the lift with the user and sling to the new destination at a slow pace. Unlock the lift's wheels and maneuver it carefully to the desired location. Adjust the width of the legs if needed, but avoid doing so while raising or lowering the boom. Do not adjust the boom while moving the lift.
- If relocating to another room, pivot the swivel bar gradually so the user faces you during transportation.
- Position the user precisely over the center of the new location, such as a chair, toilet, or another bed.
Gradually lower the boom until the user is comfortably positioned. When transferring to a chair or wheelchair, ensure the user's hips are positioned as far back as possible.
Detach the sling loops and remove the sling. Only do this when the user is fully seated or lying in the new location. Carefully remove the sling from beneath the user and store it safely.
- If the user is on a bed or stretcher, roll them from side to side and fold the sling before removal, using the same technique employed during initial placement.
- If the user is in a wheelchair or car, gently tug upward to slide the sling out from behind them. For instance, when transferring to a wheelchair, gently tug on the top sling while assisting the user into a seated position, then remove the sling from behind their back and legs.
Using a Hoyer Lift from a Seated Position
Narrate each step as you proceed. Ensure the user is aware of the transfer destination and your actions. Explain each stage so they can assist to the best of their ability.
Position the U-sling behind the user. Orient the loops forward with the arch of the 'U' at the top. The ends of the 'U' should cross under the legs, positioning them lower.
- If transferring from a wheelchair, secure the wheels first.
Guide the slings down behind the user. Maneuver the slings between the user's back and the chair with short, pulling movements. Ensure the fabric extends sufficiently to cover the user's hips.
- If the user is in a wheelchair, lower the straps to mid-thighs and cross the leg straps before proceeding with the lift.
Position the lift apparatus near the chair and adjust the leg width. Maneuver the base, widening it as needed to align the cradle directly above the user. Use the foot pedal or lever to adjust the leg width.
- Always widen the legs fully before lifting.
- Secure the wheelchair's wheels before lifting. You can also stabilize the chair against a wall or have an assistant assist from behind.
Attach the U-sling loops to the cradle. Adjust the loops behind the user's shoulders for comfort. Connect these loops to the hooks on the swivel bar at the boom's end.
- Criss-cross the leg loops beneath the user's legs unless they are in a wheelchair. Ensure the loops are properly positioned to avoid interference with the boom's movement. This crossing prevents the user's legs from separating and slipping out of the sling.
- If necessary, attach the neck support flap for users unable to support their heads. Leave it unattached for users capable of head support.
Elevate the cradle gradually. Ensure the loops are firmly secured. Lift until the user is clear of the chair, verifying that everything is safe and comfortable before proceeding.
Move the lift with the user and sling slowly to the desired location. Release the wheel locks and steer the lift to its destination. Adjust the wheel width if needed, but only after raising the boom to the correct height.
- The user should face the lift's mast during transport.
Secure the wheels in place at their widest setting over the new location. Carefully position the user to ensure comfort and safety when lowering them into position.
Gradually lower the boom into place. Utilize the pump lever for manual lifts or electronic controls for powered lifts. Ensure the user's comfort, positioning their hips as far back as possible if transferring to another chair.
Remove the sling once the user is safely positioned. Gently tug upward to slide the sling out if the user is in a chair. If they are lying down, gently roll them to one side, fold the sling, then roll them to the other side to remove the folded sling.
Helpful Tips
- If you encounter any discomfort, insecurity with the slings, or instability with the Hoyer lift during a transfer, pause and return the patient to their original position. Make necessary adjustments before retrying. Ensure the patient's safety before moving them from their bed or wheelchair.
- While the patient is lifted, attend to their hygiene needs such as cleaning, suggesting the use of a bedpan, or adjusting clothing, if needed.
- Keep the owner's manual for your lift on hand to address any mechanical issues and to replace dead batteries in electric lifts.
Important Warnings
- Ensure all beds, stretchers, wheelchairs, and lift apparatuses are locked when not in motion during the transfer process. Movement between these items could pose a risk of injury to the patient.
- Avoid pulling directly on the boom bar to raise or lower it while a patient is in the sling.
Essential Supplies
- Hoyer Lift
- Sling prescribed by a physician for the patient
- Appropriate bed, chair, or other destination for receiving the patient
- Assistant (recommended for enhanced safety, though not mandatory)
