HOME MANAGEMENT DEMO

BED MAKING - Proper arrangement of the bed linen.

Folding Laying
Fitted sheet (w/ garter) WSO RSO
Flat sheet RSO WSO
Blanket WSO RSO
Pillow case WSO RSO
Comforter WSO RSO

** WSO - wrong side out // RSO - right side out

Miter - 45°fold corner

 ELDERLY CARE, BED BATHING DEMO

COMPLETE BED BATH MATERIALS:

1. Bath towel – Ideal is 5 – 6 pcs
2. Face towel – 3 pcs. (square)
3. Toothbrush, toothpaste, shampoo, soap, soap dish, deodorant, shaver
4. Adult diaper
5. Surgical gloves – Size is 7 ½ or 8
6. Cotton balls

1 set fitted sheet, flat sheet, pillow case, blanket

DRESSING & UNDRESSING - WITH ONE SIDED PARALYSIS:

*UPPER EXTREMITIES*

DRESSING RULE:
 Start from the affected part and end in unaffected part with the client helping by using unaffected
part.

UNDRESSING RULE:
 Start from the unaffected part and end in the affected part with the client helping by using
unaffected part.

*LOWER EXTREMITIES*

DRESSING RULE:
 With assistance on the affected part insert lower garments into both feet up to the hips.

UNDRESSING RULE:
 Do the reverse. Start from the hips down to the feet.

OCCUPIED BED – A bed with someone laying or occupying it. - Ideal bed for elderly.

LINENS USED:

1. Fitted Sheet
2. Draw Sheet - rubber draw sheet, cotton draw sheet
3. Flat Sheet

BATHING – Washing or cleaning the parts of the body.

3 TYPES OF BATHING:
1. TUB BATH – bathing on a tub.
2. SHOWER BATH – bathing on a shower.
3. BED BATH – complete bed bath – washing the whole-body parts.
Partial / sponge bath – washing only some or specific parts of the body.
INDICATION OF BED BATH
1. Client who is bed ridden or as recommended by doctors due to illnesses.
2. Client in a cast or traction.
3. Recovering from surgery.

COMPLETE BED BATH PURPOSE OF COMPLETE BED BATH

1. It refreshes the body.
2. Body parts can be examined.
3. Promotes good blood circulation.
4. Client & caregiver interaction time (ideal time: at least 15 – 20 minutes)

CAREGIVERS CONCERN BEFORE PERFORMING BED BATH

1. Know what type of bathing to give.
2. Know the limitations or restrictions on the movements of the client.
3. Allow the client to help as safely as possible.
4. Gather necessary materials to be used before starting the activity.
5. Provide privacy.
6. Clean from the cleanest part to the dirtiest part. Start always from the far side or the side away from
you.
7. Always rinse the skin well.
8. Avoid rubbing or scrubbing the skin vigorously.
9. Regulate the room & water temperature.

COMPLETE BED BATH

1. Hair shampooing
2. Clean the eyes
3. Clean the face, nose, ears, and oral care
4. Clean the arms
5. Clean the chest
6. Clean the legs
7. Clean the back
8. Perineal care

BED BATH:
Assess the following
1. Physical and emotional factors
2. Presence of pain and need for the adjunctive measure before the bath
3. Range of motions of joints
4. Any other aspect of health that might affect the client’s bathing process
5. Need for use of gloves during the bath
6. Condition of the skin

EQUIPMENTS:
 Basin with water (3 basins)
 Soap in soap dish
 Linens which include bath blanket
 5 - 6 bath towels
 3 wash cloth
 Gowns / clothes
  Gloves
 Personal hygiene like powder & lotion
 Urinal bed pan
 2 Pitcher of water
 1 kidney basin for oral care
 Toothbrush, toothpaste & shaver

HAIR SHAMPOOING:
Introduce yourself and tell client your identity and explain to the client what you are going to do, why it’s
necessary and if appropriate & how the client can cooperate.
 Bath blanket on top of flat sheet.
 Instruct the client to hold the bath blanket then remove the flat sheet.
 Instruct the client to get the weak arms.
 Instruct the client to scoop the affected leg then diagonal side.
 Put the inflated Kelly pad under the clients head.
 Use tap water & lukewarm water. (use 2 pitcher)
 Bath towel (nape)
 Untangled the hair before rinsing.
 Lukewarm first to open the pores.
 Do not place the shampoo directly to the hair, put it in your hand, then rinse tap water to close the
pores
 Use towel then pat dry.

CLEAN THE EYES:

 Use 2 mitt.
 Canthus – inner to outer canthus.

CLEAN THE FACE, NOSE, EARS & ORAL CARE:

CLEAN THE FACE

 “3” count stroke technique.
 Start from the forehead to the cheek, to the cheek then to the chin then pat dry. Then next is to the
other side of the face. Same procedure.

CLEAN THE NOSE

ONE STROKE ON THE AFFECTED PART

ANOTHER STROKE ON THE UNAFFECTED PART

ONE DOWNWARD STROKE ON THE BRIDGE OF THE NOSE

ANOTHER STROKE UNDER THE NOSE

CLEAN THE EARS

 With soapy water clean the ears far side give basic considerations from the folds, cartilages & back of
the ear then rinse with tap water & pat dry.
 With soapy water clean the strong side same procedure as the far side also.

ORAL CARE
 Do the fowler’s position.
  Get the toothbrush and put toothpaste on it. If the client can able to do it then let the client do it. Then
every time the client will spit give the kidney basin.
 If the client is unable to brush his/her teeth then let the caregiver brush the teeth of the client.
 Get a basin and toothbrush with toothpaste on ask the patient to gargle by giving him water then
brush the teeth in circular motion.
 Ask the patient to gargle again
 For client with dentures use gloves, remove it & soak in a glass of water with special solution
appropriate for dentures
 Use clean soft cloth to clean the gums & tongue scraper for tongue gargle then pat dry with clean
towel.
 For the LAST PART ADMINISTER SHAVING IF MALE far side stroke downward 2-3x then upward for last
stroke (For TESDA USE SOAK,SHAVE & SOAK SHAVE DOWNWARD METHOD 3X THEN SOAK SHAVE
UPWARD)

CLEAN THE ARMS

 Undress the client.
 Put towel.
 Use soapy water, far side first, squeeze from wrist going up, and concentrate on folds, going up long
stroke up to the armpit. Rinse off with tap water then pat dry. Then do it again to the other side of the
arms.
 Then by using the 3rd basin, soak both hands for 3 – 5 minutes to soften the nails then clean the inter-
digital spaces in water.
 Trim nails
 Ask client if he/she wants to use deodorant.

CLEAN THE CHEST

 Use bath towel and put it on the top of the chest.
 Remove the bath towel up to her waist.

Start at the neck first use mitt with soapy water. Far side of the neck first going down around the breast
areola over the nipple.
 Raise the breast with your non-dominant hand then clean the under fold of the breast.
 Then downward stroke until the navel.
 Rinse with tap water (same technique, same stroke) TESDA – use “8” stroke technique on the
breast.
 For the male client use downward stroke. Pat dry – instruct the client to pat dry.

*Half body*
 Place the bath blanket then remove the towel doesn’t expose any part of the body.

CLEAN THE LEGS

 Place the bath towel on the one side of the leg then expose the other leg.
 Use soapy water, far side first, start to ankle upward to the folds pay attention to folds make sure that
it is clean then up to the inguinal / groin area.
 Rinse with tap water.
 Then clean the affected part, use soapy water upward folds up to inguinal / groin area. Bend the knee
then pat dry. (upward to promote blood circulation)
  Soak the foot to soften the nails then clean the inter-digital spaces then pat dry. After that trim the
nails.

CLEAN THE BACK

 Put the client into side laying position then loosen the diaper if there is feces use surgical gloves to
clean it then throw the diaper.
 Clean the sphincter / anus of the client using wet wipes.
 Bath towel at the back use soapy water, start on nape downward to the waist.
 Rinse with tap water. Clean the butt area but make sure that the stroke you make in cleaning the butt
is away or outside the sphincter / anus area to avoid bacteria going inside it. 
 Pat dry.

PERINEAL CARE
 Wear gloves.
 Place bath blanket into a diamond shape, bend your client knees (LITHOTOMY OR DORSAL
RECUMBENT)

For male uncircumcised client – remove the skin using soft cloth.
 Give consideration on side of the glans of the penis (smegma) to the balls
 Smegma – remove their glands circular retract motion from the opening.
 Retract the skin, clean it suing soft cloth or tong with cotton balls.
 Then in circular motion clean from the opening of the scrotum going outward then release the skin use
soft cloth paying attention to the folds.

For male circumcised client - clean it using soft cloth inward then to the shaft to the scrotum (paying
attention to the folds). Then pat dry

For female - clean from labia majora using 7 stroke on both sides.
 Using the non-dominant hand open the labia minora then clean it using 7 strokes again on both sides.
 Then last one clean it in straight downward stroke. Pat dry.
 @ LAST PART turn on strong side clean the back and butt area also.

OCCUPIED BED – change bed covers

1. Fitted Sheet / Bottom Sheet
2. Rubber Draw Sheet
3. Cotton Draw Sheet
4. Side Laying Position – repeat 1 to 3
5. Flat Sheet over the client (do not miter it)
6. Blanket over the flat sheet

OPEN BED - Open only where the door faces (use miter on the one side of the bed)

CLOSE BED - Close pillow, miter, miter open one side.

ELDERLY CARE, WALKING AIDS DEMO

DEMO: CRUTCHES

TRIPOD POSITION
 4 inches lateral : 4 inches anterior / forward
 Elbow flex / Bend 20º - 30º
 2 inches (axilla axillary bar)
 Hand grip should be at the level of greater trochanter.

4 POINTGAIT
1. Good Crutch
 2 POINTGAIT
1. Good Crutch /
2. Bad Leg Bad Leg
3. Bad Crutch 2. Bad Crutch /
4. Good Leg Good Leg

3 POINTGAIT SWINGGAIT
1. Partial Weight 1. Swing To (Level of the crutch)
Bearing  Swing to: WEAKNESS: advance both crutches forward then swing to
 Toe Touch the level of crutch.
 Heel Touch AMPUTATION: advance both crutches forward, swing to up to the level of the
(Advance both crutches.
crutches forward then
Bad Leg, toe touch / 2. Swing Thru (Beyond the crutch)
heel touch then  Swing thru: WEAKNESS: advance both crutches forward then swing
followed by Good Leg) thru beyond the crutches.

AMPUTATION: advance both crutch forward then swing thru beyond the
CANE
crutches.
 Opposite side of
affected extremity
 6 inches lateral
 Elbow flex / Bend 20º - 30º
 Hand grip should be at the level of greater trochanter.

CANE LEVEL WALKING

1. Advance cane forward.
2. Shift weight to the cane.
3. Bad leg.
4. Good leg.

WALKER
 1 foot / 12 inches (foot – anterior foot of the walker)
 Elbow flex / Bend 20º - 30º
 Hand grip should be at the level of greater trochanter

WALKER LEVEL WALKING

1. Advance walker forward.
2. Shift weight in front.
3. Bad leg.
4. Good leg.

UPSTAIRS: Good Leg: Bad Leg & the Crutch / Cane

DOWNSTAIRS: Bad Leg & the Crutch / Cane: then Good Leg
ELDERLY CARE, TRANSFER DEMO
TRANSFER – it is a pattern of movement by which the client is move from one place to another.
CONSIDERATIONS BEFORE TRANSFERING:

FOR THE CLIENT

1. He / She should rehearse the transfer on both sides.
2. Move towards the edge of the sitting surface.
3. Shift body weight forward.
4. Make use of all possible functions.

FOR THE CAREGIVER

1. Explain & demonstrate the procedure to the client.
2. Stand where the client can be protected from falling (weak side always)
3. Place hands on hips, shoulder or upper thorax (upper torso) or a combination of all.
4. Allow the client to see the direction you are moving.

THE SURFACE ON WHICH THE CLIENT TRANSFER SHOULD BE

1. Immobilize – not moving
2. Firm to give support.
3. The same level high as the wheelchair.

WHEELCHAIR
1. It should be locked.
2. Foot rest / Foot blade should be raised.
3. Should be positioned on the uninvolved side (strong side) of the client closes to the surface he / she is
transferring too.

TRANSFERRING DEMO
1. Sit Client Up A Low Bed
2. Supine – long sitting – towards the headboard
3. Stand Client Up
 4. Supine – long sitting – edge of bed
5. Bed to Wheelchair – wheelchair on foot part
6. Wheelchair to Bed – wheelchair on head part
7. Bed to Commode
8. Commode to Bed
9. Wheelchair to Commode
10. Commode to Wheelchair
11. Assist to Walk

TRANSFERRING SEQUENCE:

A. SIT UP CLIENT IN A LOW BED

1. Ma’am / Sir I’m [name] I’m here to sit you up in a low bed
2. Ma’am / Sir please kindly grab your weak hand using your strong hand and put it above your tummy.
 (Kneel your inner knee above the edge of the bed and grab your client’s scapula.)
3. Ma’am / Sir I’m going to grab your scapula and at the count of three I will sit you up.
4. 1, 2, 3
 (Sit on your heal when you grab your client for proper body mechanics.)
5. Ma’am / Sir do you feel dizzy? (Dizzy – because of the POSTURAL HYPOTENSION – inability of
your cardio – vascular system to adjust in upright position)
 (If yes, lay him / her again in the bed and do the ankle pumping or place a pillow at his / her ankle to
elevate his / her extremities.)
 (After sitting your client always support her back by holding his / her shoulder.)
6. Ma’am / Sir please kindly support your elbow.
7. Ma’am / Sir kindly bend your strong leg and press your foot against the mattress and raised your
buttocks as I pull you backward at the count of three.
 (Position yourself at the back of your client, kneel your one knee at the mattress while the other foot is
at the floor.)
8. 1, 2, 3
9. After bringing your client at the head board of the bed place a pillow at his / her back.

B. STAND CLIENT UP
1. Do procedure 1 – 5 of sit client up a low bed. (but the position is stand you up)
2. Ma’am / Sir please kindly scoop your weak leg using your strong leg.
 (While holding your client’s shoulders use your other free hand and scoop the lower extremities of
your client.)
3. Ma’am / Sir on the count of three I will turn you to the side of the bed.
4. 1, 2, 3
5. Ma’am / Sir using your strong hand press it against the mattress and please scoot forward.
6. Ma’am / Sir advance your weak leg by putting your strong leg posteriorly.
7. Please clasp your hand and finger interlock weak over the strong hand and put it on my nape.
 (Support your client by putting your foot outside his / her weak foot, your foot and your client’s foot
must be parallel to each other and your knee must be touching together (knee to knee contact).)
8. Ma’am / Sir I’ll insert the towel behind your buttocks.
9. Ma’am / Sir in the count of three I will stand you up.
10. 1, 2, 3
C. BED TO WHEELCHAIR
 Position the wheelchair 45º from the foot part of the bed.
 The wheelchair should be locked.
 Foot plate should be raised.
 Do procedure 1 – 5 of sit client up a low bed, then 6 – 14 of stand client up
 From standing position instruct your client to PIVOT going to wheelchair.
15. Ma’am / Sir using your strong foot please PIVOT going to the wheelchair.
 (While the client is pivoting himself / herself going to the wheelchair drag his / her affected foot by your foot.)
16. Ma’am / Sir is the back of your knee touching the wheelchair?
17. Ok ma’am / sir using your strong hand support it to the arm rest.
18. In the count of three I will sit you down.
19. 1, 2, 3
20. Ma’am / Sir please scoot backward.
21. Ma’am / Sir using your strong foot can you please bring down the foot rest on the weak side.
22. Ma’am / Sir kindly scoop your weak leg and put it in the foot rest.
23. And then bring down the other foot rest.

D. WHEELCHAIR TO BED
 Position the wheelchair 45º from the head part of the bed.
 The wheelchair should be locked.
1. Ma’am / Sir I’m [name] I’m here to transfer you from wheelchair to bed.
2. Please kindly raise the foot rest of your strong side first.
3. Ma’am / Sir kindly scoop your weak leg and put it on the floor.
4. Ma’am / Sir kindly raised the other foot rest.
5. Ma’am / Sir can you please scoot forward.
6. Ma’am / Sir please clasp your hand and finger interlock and put it on my nape.
 (Knee to knee)
7. (Insert the towel on his / her buttocks.)
8. Ma’am / Sir on the count of three I will stand you up.
9. 1, 2, 3.
10. Ma’am / Sir using your strong foot please PIVOT going to bed.
11. Ma’am / Sir is the back of your knee touching the bed?
12. In the count of three I will you down.
13. 1, 2, 3
 (While supporting your client back ask him / her to …)
14. Ma’am / Sir can you please scoop your weak leg by your strong leg.
15. Ma’am / Sir using your strong hand please press it on the mattress and scoot yourself backward.
16. Kindly grab your weak hand by your strong hand and put it above your tummy.
17. In the count of three ma’am / sir I will take you back of the bed.
18. 1, 2, 3
 Kneel your knee at the edge of the bed, grab your client’s shoulder and lay him / her on the bed.

E. BED TO COMMODE
 (Position the commode 45º from the foot part of the bed.)
 (The commode cover should be opened.)
1. Ma’am / Sir I’m [name] I’m here to transfer you from bed to commode.
 2. Ma’am / Sir please kindly grab your weak hand using your strong hand and put it above your tummy.
 (Kneel your inner knee above the edge of the bed and grab your client scapula.)
3. Ma’am / Sir I’m going to grab your scapula and at the count of three I will sit you up.
4. 1, 2, 3
 (Sit on your heal when you grab your client for proper body mechanics.)
5. Ma’am / Sir do you feel dizzy?
 (If yes, lay him / her again in the bed and do the ankle pumping or place a pillow at his / her ankle to
elevate his / her extremities.)
 (After sitting your client always support her back by holding his / her shoulder.)
6. Ma’am / Sir please kindly scoop your weak leg using your strong leg.
 (While holding your client’s shoulders use your other free hand and scoop the lower extremities of
your client.)
7. Ma’am / Sir on the count of three I will turn you to the side of the bed.
8. 1, 2, 3
9. Ma’am / Sir using your strong hand press it against the mattress and please scoot forward.
10. Ma’am / Sir advance your weak leg by putting your strong leg posteriorly.
11. Please clasp your hand and finger interlock weak over the strong hand and put it on my nape.
 (Support your client by putting your foot outside his / her weak foot, your foot and your client’s foot
must be parallel to each other and your knee must be touching together (knee to knee contact).)
12. Ma’am / Sir I’ll insert the towel behind your buttocks.
13. Ma’am / Sir in the count of three I will stand you up.
14. 1, 2, 3
 (From standing position instruct your client to PIVOT going to commode.)
15. Ma’am / Sir using your strong foot please PIVOT going to the commode.
 (While the client is pivoting himself / herself going to the commode drag his / her affected foot using
your foot.)
16. Ma’am / Sir is the back of your knee touching the commode?
17. Ok ma’am / sir using your strong hand support it to the arm rest.
18. In the count of three I will sit you down.
19. 1, 2, 3

F. COMMODE TO BED
1. Ma’am / Sir I’m [name] I’m here to transfer you from commode to bed.
2. Ma’am / Sir please clasp your hand and finger interlock and put it on my nape.
 (Knee to knee)
 (Insert the towel on his / her buttocks.)
3. Ma’am / Sir on the count of three I will stand you up
4. 1, 2, 3
5. Ma’am / Sir using your strong foot please PIVOT going to bed.
6. Ma’am / Sir is the back of your knee touching the bed?
7. In the count of three I will sit you down.
8. 1, 2, 3
 (While supporting your client’s back, ask him / her to…)
9. Ma’am / Sir can you please scoop your weak leg by your strong leg.
10. Ma’am / Sir using your strong hand please press it on the mattress and scoot yourself backward.
11. Kindly grab your weak hand by your strong hand and put it above your tummy.
12. In the count of three ma’am / sir I will take you back at the bed.
 13. 1, 2, 3
 (Kneel your knee at the edge of the bed, grab your client’s shoulders and lay him / her on the bed.)

G. COMMODE TO WHEELCHAIR
Position the commode 45º from the foot part of the bed and the wheelchair 45º from the head part of the
bed.
 The commode cover should be opened.
 Wheelchair should be locked and the foot rest must be raised.
 Always remember if you are transferring your client from commode to wheelchair always consider the
weak leg of your client, the wheelchair must be near at the strong leg of your client.
1. Ma’am / Sir I’m [name] I’m here to transfer you from commode to wheelchair.
2. Please clasp your hand and finger interlock weak over the strong hand and put it on my nape.
 (Support your client by putting your foot outside his / her weak foot, your foot and your client’s foot
must be parallel to each other and your knee must be touching together (knee to knee contact).)
3. Ma’am / Sir I’ll insert the towel behind your buttocks.
4. Ma’am / Sir in the count of three I will stand you up.
5. 1, 2, 3
 (From standing position instruct your client to PIVOT going to commode.)
6. Ma’am / Sir using your strong foot please PIVOT going to the commode.
 (While the client is pivoting himself / herself going to the commode drag his / her affected foot using
your foot.)
7. Ma’am / Sir is the back of your knee touching the wheelchair?
8. Ok ma’am / sir using your strong hand support it to the arm rest.
9. In the count of three I will sit you down.
10. 1, 2, 3
11. Ma’am / Sir please scoot backward.
12. Ma’am / Sir using your strong foot can you please bring down the foot rest on the weak side.
13. Ma’am / Sir kindly scoop your weak leg and put it in the foot rest.
14. And then bring down the other foot rest.

H. WHEELCHAIR TO COMMODE
Position the commode 45º from the head part of the bed and the wheelchair 45º from the foot part of the
bed.
 The commode cover should be opened.
 Wheelchair should be locked and the foot rest must be raised.
 Always remember if you are transferring your client from wheelchair to commode; always consider the
weak leg of your client, the commode must be near at the strong leg of your client.
1. Ma’am / Sir I’m [name] I’m here to transfer you from wheelchair to commode.
2. Please kindly raise the foot rest of your strong side first.
3. Ma’am / Sir kindly scoop your weak leg and put it on the floor.
4. Ma’am / Sir kindly raise the other foot rest.
5. Ma’am / Sir can you please scoot forward.
6. Please clasp your hand and finger interlock weak over the strong hand and put it on my nape.
 (Support your client by putting your foot outside his / her weak foot, your foot and your client’s foot
must be parallel to each other and your knee must be touching together (knee to knee contact).)
7. Ma’am / Sir I’ll insert the towel behind your buttocks.
 8. Ma’am / Sir in the count of three I will stand you up.
9. 1, 2, 3
 (From standing position instruct your client to PIVOT going to commode.)
10. Ma’am / Sir using your strong foot please PIVOT going to the commode.
 (While the client is pivoting himself / herself going to the commode drag his / her affected foot using
your foot.)
11. Ma’am / Sir is the back of your knee touching the commode?
12. Ok ma’am / sir using your strong hand support it to the arm rest.
13. In the count of three I will sit you down.
14. 1, 2, 3

I. ASSIST TO WALK
1. Ma’am / Sir I’m [name] I’m here to assist you to walk.
2. Ma’am / Sir please clasp your hand and finger interlock weak over the strong hand and put it on my
nape.
 (Support your client by putting your foot outside his / her weak foot, your foot and your client’s foot
must be parallel to each other and your knee must be touching together (knee to knee contact).)
3. Ma’am / Sir I’ll insert the towel behind your buttocks.
4. Ma’am / Sir in the count of three I will stand you up.
5. 1, 2, 3
 (From standing position grab your client’s strong hand and put it at his / her side and then grab his /
her weak forehand and turn around at his / her side and support his / her back by putting your hand on
the client’s waist.)
 (Your one foot must be a few inches away in front of your client’s weak foot for support. Ask you
client to grab the cane.)
6. Ma’am / Sir using your strong hand please grab the cane.
 (Instruct your client how to walk using the cane.)
 Cane forward, shift weight on the cane, and forward the bad leg up to the caregiver’s foot and then
forward the good leg.

VITAL SIGNS DEMO

VITAL SIGNS (Body temperature, Pulse Rate, Respiratory Rate & Blood Pressure)
 The objective is to obtain the accurate measurement of the body temperature, pulse rate,
respiratory rate & blood pressure.
 The equipment needed are: cotton balls, a watch w/ a second hand, stethoscope,
sphygmomanometer & thermometer.

1. Hi Ma’am, I am your name & I’m going to take your vital signs. I washed my hands.
 Get the thermometer, rinse it in cool water.
 Get a cotton ball, wipe it from bulb to stem in a circular motion.
 Then turn it on.
 Place it on the axilla for 3-5 minutes.

 Get the Pulse Rate.

 Look for client radial pulse on the palm side of the wrist, on the base of the thumb using your 2
fingers & time it in 1 full minute.
2. Ma’am I will start now…
3. You have ______ BPM (Beats per minute).
 Any irregularities & abnormalities below 60 BPM & above 100 BPM should be reported.

 Then get the Respiratory Rate.

 Get your client arms & put it in her chest & observe the rise & fall of her chest in 1 full minute.
4. Ma’am I will start now.
5. I got _____ CPM (Cycles per minute).
 Any irregularities or abnormalities below 12 CPM & above 20 CPM should be reported.

 Now get the Blood Pressure.

A. Make sure the client is sitting or lying in a comfortable position.
B. Arms should be at heart level.
C. Put the inflatable cuff 1 inch above the arm fold, make sure it’s not too tight or not too loose.
D. Insert your finger & look for the brachial pulse.
E. Inflate slowly.
F. Your Palpatory rate is _______ + 30_____.
G. Place the chest piece on the brachial pulse.
H. The ear piece on the ear.
I. Inflate the cuff up to _____ slowly.
J. Breath slowly & evenly.
K. Your blood pressure is _______.
L. Then get the thermometer
M. Wipe it from stem to bulb.
N. Your body temperature is __________.
O. Then place the thermometer in the container.

MEMORIZE THE PARTS

 INFANT BATHING DEMO

PROCEDURE IN BATHING AN INFANT

4 major considerations before bathing an infant: Memorize this part also

1. Check the temperature of the baby – it should be normal b/w 36.5 C – 37.5 C.
2. Control the environment – close all the windows & doors & turn off the air conditioning unit in the
bathing area to prevent the baby from having common colds.
3. Availability of materials – to save time & energy & avoid inconvenience
4. Readiness of the caregiver
• should know the bathing procedure
• should not be sick
• should remove the jewelries & trim nails to avoid harming the baby
• should wear an apron to avoid from getting soaked

STEPS:
1. Remove the soiled diaper, discard it properly - clean the buttocks, using cotton ball, soak in water.

2. Check the temperature of the baby - using the anal method in temp. Taking, if the temp., is within
normal range proceed to bathing, it its above render tepid sponge bath only.

3. Undress the baby- use swaddling cloth to cover the body.

4. Check the water temperature- using your hand or elbow, the temperature should be optimal.

5. Hold the baby in Football hold position- cover the ears with use of thumb and middle finger, to avoid
water into the ears.

6. Clean the head

 by splashing water on it,
 lather your hand with mild shampoo and apply on the baby’s head in gentle circular motion from top
of the head to the back paying attention particularly the back of the ears.
 Rinse off
 Pat it dry

7. Bring the baby back to the rubber mat and start cleaning the face
 Use a cotton cloth formed into a mitten dip into the water, do not use soap on the face because it is
sensitive.
 Use the Z, A or 3 technique

8. Clean the eyes - Using your thumb, dip it in water and start cleaning from inner part near the nose
bridge to the outer part gently in one stroke only, then pat it dry
9. Expose upper extremities
 Splash with water
 Apply mild soap to the body paying attention to the neck, armpit, the creases and folds of the arm &
forearm & the interdigital spaces of the fingers.
 Rinse hands immediately to avoid soap getting into the mouth once the baby start sucking on them.

10. Cover the umbilical cord - using a sterile gauze

11. Expose the lower extremities

 Splash with water
 Lather your hand with mild soap, apply it on the groin, the thigh, back of the knees ang legs and the
interdigital spaces of toes

12. Put the baby in a side lying position to clean the back
 Splash with water
 Apply mild soap on the back, from the nape, the middle part of the back down to the buttocks Bring
the baby back to original position

13. Clean the genital area

 If baby boy o Splash w/water o Get a cotton ball, soak in water
o Start cleaning from tip, down to the shaft then scrotum
 If baby girl o Get a cotton ball, soak in water
o Do the 7-stroke (1 stroke from the upper part of vagina to the right side, to the left, to the
middle) use many cotton balls as much as you want until the area is already clean.
14. Final rinse
a. Hold the baby in a football hold position
b. Cover the ears
c. Make sure the upper extremity is lower than the foot to avoid wetting the umbilical cord
d. Splash with water
e. Immerse the lower extremity
f. Then the back
15. Get a clean towel then pat dry the body
a. Now this is the ideal time to do some massage
b. Ask your employer if you’re going to use lotion, powder or oil
o Powder– apply away from the baby’s face to avoid some allergic reaction on it
o Lotion/Oil– direction should be against the pores for better absorption
o Do twist & turn massage– start with both hands, legs, for the chest (do I love u massage) for
stomach (sadden moon)

16. Dress the baby

 Clean the umbilical area.
o Get a cotton ball
o Soak in alcohol, betadine solution from inner to outer part o Then cover, close the diaper &
dress

17. Put on the diaper- fold the diaper using butterfly fold technique
 18. Clean the mouth, nose & ears
a) Mouth
o Get a clean cloth, put into smallest finger in an inverted J-stroke (from inner to outer), clean
also the palate & massage gums
b) Nose (extern part only)
o Get a cotton bud, one tip of the cotton bud to each side
c) Ears (external part only)
o Get a cotton bud, one tip of the cotton bud to each side

19. Remove your apron and feed the baby

 Check the temperature of the milk formula before feeding.
 Maintain eye to eye contact to promote bonding and to make sure that the baby is sucking on the
nipple correctly

20. Burp the baby midway and after feeding

 When the baby fall asleep put him in a side lying position inside the crib to prevent aspiration,
suffocation and SIDS

Warnings:
 After bathing the baby, you can clean your mess and do other chores but don’t forget to check the
baby from time to time.

 Never leave a baby unattended in the bath, even for a few seconds. Infants can drown in very shallow
water.
 CPR SCRIPT (ADULT, CHILD and INFANT)

1. Survey the scene.

 “THE SCENE IS SAFE, I HAVE ONE POSSIBLE VICTIM, I HAVE MY BSIP ON, I’M your name, A TRAINED
FIRST AIDER, CAN I HELP?!”

2. Check responsiveness by tapping victim’s shoulder 2 times.

 “HEY SIR/ MA’AM ARE YOU OKAY? (2X)”

3. If the victim is unresponsive. Call for help! Activate Medical Assistance.

 “THE VICTIM IS UNRESPONSIVE! HELP!... CALL 911 AND REPORT BACK TO ME AS I ASSESS THE VICTIM”

4. Open the airway (HTCL), check mouth for any obstruction

 “MOUTH & NOSE ARE CLEAR NO OBSTRUCTION SEEN”

5. Check pulse for 10 seconds (CAROTID – ADULT & CHILD; BRACHIAL- INFANT)
 1, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010

6. The victim has no pulse and not breathing (PERFORM CPR); PERFORM WITHIN 1:95mins or 2:05mins.
 “THE VICTIM IS BREATHLESS AND PULSELESS FOLLOW UP 911 AND REPORT BACK TO ME AS I DO CPR”
 30 COMPRESSION 2 VENTILATION FOR 5 CYCLES (Adult, child, infant)

7. Recheck Breathing & pulse for 10 seconds. (LLF position)

 CHECK PULSE (1, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010)

8. The victim has pulse but still not breathing (PERFORM RB); PERFORM WITHIN 1:95mins or 2:05mins.
 “THE VICTIM IS BREATHLESS BUT WITH PULSE FOLLOW UP 911 AND REPORT BACK TO ME AS I DO
RESCUE BREATHING”
 24 BREATHS (ADULT) - PINCH NOSE, VENT(ONCE), 1, 1002, 1003, 1001; PINCH NOSE, VENT,
RELEASE, LFF 1, 1002, 1003, 1002… up to 1024.
 40 BREATHS (CHILD) - PINCH NOSE, VENT(ONCE)1, 1001; PINCH NOSE, VENT, RELEASE, LFF
1, 1002; PINCH NOSE, VENT, RELEASE, LFF 1, 1003…up to 1040.
 40 BREATHS (INFANT) – (MOUTH AND NOSE OF INFANT COVERED BY MOUTH OF FIRST AIDER)
BLOW, 1, 1001; BLOW 1, 1002; BLOW1, 1003…up to 1040.

9. Recheck breathing and pulse for 10 seconds.

 CHECK PULSE (1, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010)

10. The victim is breathing and with pulse

 “THE VICTIM IS BREATHING AND WITH PULSE. THE VICTIM HAS REVIVED.”

11. Put the victim in recovery position. Adult & Child (Side Lying Position); Infant (Burping Position)
 Do secondary survey.
 No DCAPBTLS.
 Monitor vital signs.
 Care for shock.
 Transport and endorse the victim.
 FBAO or CHOKING (ADULT, CHILD and INFANT)

FBAO – FOREIGN BODY AIRWAY OBSTRUCTION (CHOKING)

Classification of Airway Obstruction:

1. Mild Airway Obstruction (Partial Airway Obstruction)

 The victim can speak, cough, breath but with difficulty.
First Aid:
a) Determine if the victim is choking ask “Are you choking?”
b) If yes, ask the victim to cough forcefully to dislodge the object.
c) Stand by to assist beside or behind the victim.

2. Severe Airway Obstruction (Complete/ total Airway Obstruction)

 Poor air exchanged and increased breathing difficulty, inability to speak and cough.
First Aid:
Heimlich Maneuver (Abdominal Thrust)
a) Stand behind the victim with one foot forward
b) Wrap your arms around the victim’s waist
c) Locate the navel using your index finger
d) Make a fist with one hand with thumb tucked inside
e) Place thumb side of fist above the index finger
f) Cover the closed fist with the other hand
g) Do 5 inward and upward thrust in scooping motion until the object is dislodged.
h) Each thrust must have a distinction.

 Victim is pregnant or obese:

a) Do the “Chest Thrust” for5 times at armpit level
b) Each thrust must have a distinction

 Conscious to Unconscious Victim:

a) Place the victim is supine position
b) Ask for help
c) Begin CPR starting with chest compression (30 compressions)
d) Check the mouth for any obstruction
 If obstruction is seen, do finger sweep
 If obstruction is not seen, do not perform blind finger sweep
e) Open the airway
f) Give 2 ventilations
 1st vent- air bounces back, re-tilt the head
 2nd vent-air bounces back again, give 30 compressions
g) Repeat the cycle as needed (step c to f)
h) Recheck the mouth for any obstruction
i) Check breathing and pulse
j) Do RB or CPR if necessary
k) Place the victim in recovery position
Choking Management for Infant:

a) Determine if the baby is choking (bluish discoloration or pale, inability to cry or gasping
for breath).
b) Check the mouth for any obstruction
c) Hold the victim facedown, with your forearm resting on your thigh, head should be
lower than the body.
d) Using the other hand do 5 light blows between the shoulder blades.
e) If the object is not dislodged, turn the infant on his back and head should be lower than
the body.
f) Give 5 chest thrust
g) Do this until the object is dislodged
h) Check the mouth, and check for breathing
i) Do RB or CPR if necessary
j) Place the victim in recovery position (Burping Position)