Figure 1-6. Turning in a wheelchair
a. Crutches are used to promote ambulation and independence in patients with
affected lower extremities. The use of crutches is a complicated procedure that is
routinely taught by the physical therapy department. There are occasions, however,
when the nursing staff will have this responsibility. The physician will prescribe the use
of crutches and the gait (crutch-walking method) to be used. The prescribed gait
depends upon the amount of weight bearing permitted on the affected leg(s). The
crutches must be "fitted" to the patient and instructions given for the prescribed
b. Standard axillary crutches need two adjustments--the length of the crutch
and the position of the handgrip. Prior to adjusting, prepare the crutches with padding
on the axillary bar and a rubber tip on the end of each crutch.
(1) Have the patient lie supine, arms at sides, wearing a shoe on the
(2) Using a tape measure, measure from the axilla to the heel of the shoe
and add two inches. Adjust the crutch shaft to this measurement. Or . . .
(3) Place the crutch along the patient's unaffected side with the axillary pad
at the axilla and the crutch tip 6 to 8 inches to the side of the heel. Adjust the crutch to
fit this length.