Arm
and hand problems include: limitations that have resulted
in decreased strength or function due to finger amputations;
hand amputations; weakness; below-elbow or above-elbow amputations;
or tendon, muscle, nerve, or joint damage. There are often
risks of further injury due to: decreased padding or scar
tissue around a stump that may not tolerate usual bumping
or brushing around objects such as farm machinery or buildings;
prosthetic entanglements; using the other arm or hand to break
a fall or perform a hazardous task; using the non-affected
and less coordinated hand; susceptibility to frostbite and
areas where there has been nerve damage or decreased circulation.
The following is a list of safety tips that have been provided
by farmers with upper extremity impairments:
- For
finger and hand injuries with decreased tissue or padding
around bony prominence, wear a custom-made padded glove
to prevent skin from breaking and potential infection from
bumping into objects.
- Pocket
hand warmers can be used for finger and hand injuries that
have decreased circulation to prevent possible frostbite.
- Although
nails can be started using one hand, you risk smashing a
finger or receiving a blood-blister. One-handed nail starters
might be considered.
- When
climbing with a prosthetic device, it is important not to
rely on the terminal device when grasping an overhead rung
on a ladder. it may be safer to wrap the forearm of your
prosthesis around the outside of the ladder.
- When
working around livestock be careful not to catch onto chains,
collars, ropes, halters, or other materials attached to
livestock. If you use a Prehensile hand, use the farmost
grip on this terminal device when grasping a cow's chain
so that you can let go more easily.
- A
quick-release chest harness might be useful for those situations
in which a prosthetic device may get caught onto something.
A chest harness allows you to pull a velcro strap to release
the prosthesis quickly from the stump. A chest harness may
not be appropriate for everyone. A prosthetist should be
consulted.
- When
using an upper-extremity prosthetic device with an internal
elbow lock, be cautious in lifting and carrying objects
that exceed the strength of the elbow lock. Consult with
a prosthetist on appropriate weight that could be carried.
An external elbow lock made out of durable material such
as stainless steel might be considered for heavier lifting
and carrying. Keep in mind that a heavy-duty external elbow
lock will add more weight to the prosthesis.
- Do
not touch electric fences with the terminal device of a
prosthesis. The electrical current may travel the terminal
device through the metal cable and you will experience a
shock to the back or shoulder.
- To
prevent frostbite to the stump of a below-elbow amputation,
the following are some tips that might help: Add additional
stump socks to provide more insulation. Obtain stump socks
that lift perspiration away from the skin. Tube socks can
be added to the outside of the socket to provide more insulation.
Frequent work breaks should be considered so that you can
warm up the stump. A heater or electric hair dryer may be
useful in the farm shop to warm the stump in emergencies.
Caution should be taken to ensure that not too much heat
is applied due to the potential of burns resulting from
decreased sensation in the stump. A muff might also be used
to keep the stump warm while performing tasks in which the
arm is not needed.
- Be
careful to compensate for lost gripping ability when performing
tasks with your nonaffected hand. Jigs, fixtures, clamps,
and vice grips should be used to compensate for the loss
of strength or ability.
- Use
one-handed tools and other labor-saving devices to help
prevent additional injuries to the affected limb as well
as potential injuries to your other hand or arm.
- For
bilateral arm amputations additional steps made out of non-slip
material, wider steps, and hand-holds could be added to
farm machinery to make mounting and dismounting safer due
to decreased balance and grasping ability.
- Special
caution should be taken when performing tasks that could
result in your prosthesis getting caught. These tasks include
throwing bales of hay, climbing, catching livestock, and
working around power machinery.
- Any
adaptations or modifications intended for use by an individual
with a disability should be used by that individual only.
Use of a modification or adaptation by another individual
could result in an injury.
The information shared is based on data gathered by the
Easter Seal Society of Iowa's Farm Family Rehabilitation Management
(FaRM) Program through financial support from the Injury Prevention
Research Center at the University of Iowa Grant #R49\CCR703640-02
funded by the Center for Disease Control. No scientific research
has been conducted to determine if the above tips or suggestions
are safe or effective. The information shared is simply ideas
shared by farmers affected by disabilities of the staff at
the FaRM Program. For more information or clarification contact
the FaRM Program at (515) 289-1933 or submit comments or questions
to P. 0. Box 4002, Des Moines, Iowa, 50333.
Disclaimer and Reproduction Information: Information in
NASD does not represent NIOSH policy. Information included in
NASD appears by permission of the author and/or copyright holder.
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