382 Unit 4 Healthcare Skills Copyright Goodheart-Willcox Co., Inc. Rationale Assisting a patient who is ambulating with a cane reduces the chance of injury and promotes safe ambulation by helping achieve balance and giving support. Preparation 1. Make sure you have a written doctor’s order for ambulation with a cane. 2. Assemble the following equipment: • a robe, if needed to ensure the patient is not exposed • nonslip, properly fi tting, low-heeled footwear • a cane with one, two, three, or four tips for added support (check the cane for fl aws, cracks, bends, or missing parts) • a gait belt (check that it is in good condition and is functional) 3. Wash your hands to ensure infection control. 4. Explain in simple terms what you are going to do before assisting with ambulation with a cane. The Procedure 5. Provide privacy. You can draw the bed curtain or put a screen around the bed, if needed. 6. If the patient is in bed, lower the bed to its lowest position and lock the wheels. 7. If the patient is in bed, assist him or her to a dangling (sitting) position on the side of the bed. The patient may be seated in a chair. 8. Help the patient put on the nonslip, properly fi tting shoes and robe, if needed. 9. Apply the gait belt, if needed. Put the belt around the patient’s waist, over her clothing, with the buckle in the front. Thread the belt through the teeth of the buckle and through the other two loops to lock it. Make it snug, but leave enough room to place your fi ngers under the belt. 10. The patient should hold the cane on her stronger side. 11. While facing the patient, use an underhand grasp on the gait belt for greater safety. Procedure 13.2 Assisting with Ambulation Using a Cane Canes with a single shaft are known as C canes. The C shape resem- bles a candy cane. These are used for temporary walking impairment and are available at local pharmacies. This type of cane usually has a slip-resistant tip. A functional grip cane is another type of single-shaft cane. This type has a straight handle for a steadier grip. While the C and functional grip canes provide support, they do not assist with balance. The quad cane has a base with four prongs, each with a skid-resistant tip. It offers more stability than a single-shaft cane. This cane offers sup- port, provides a functional grip, and assists with balance. To successfully ambulate with a cane, a patient’s cane must be fi t and used properly (Figure 13.12). The top of the cane should be in line with the patient’s wrist crease (the wrinkle that separates the arm from the hand) when she stands up straight and her arms are hanging loosely at her sides. The patient should be able to slightly bend her elbow (approxi- mately 15–20 degrees) while using the cane. The cane should always be held in the hand on the stronger side of the body (opposite the side that needs support). Wards Forest Media, LLC Figure 13.12 Check the cane’s fit before the patient begins using it during ambulation.