BACK RUB

Definition: A rub or back massage which promotes blood circulation and relaxation.

Purposes:
1. acts as a general body conditioner. 2. relaxes and relieves tension. 3. provides relief from pain and promotes sleep.

4. stimulates blood circulation to the tissues and the muscles. 5. provides an opportunity for the nurse to observe the skin for signs of breakdown. 6. it improves circulation and provides a means of communication with the client through the use of touch.

Gen. Considerations: 1. contraindicated when the

client had back surgery or fracture of ribs or vertebrae, burns, redden areas on skin or open wounds, status post coronary artery bypass.

2. Provide massage following a bath, before sleeping and at other times as necessary to achieve comfort and relaxation. 3. Assess clients vital signs, signs of stress, and reception to therapy.

Preparation:
A. Materials -bath towel -lotion or powder or alcohol or oil -bath blanket (optional)

B. Client and Unit

1. Explain the procedure and desired position to the client. 2. Assemble all materials needed. 3. Provide privacy and reduce noise. 4. Wash hands properly. 5. Assess clients cardiac rate, respiratory rate and blood pressure.

Procedure:
1. Move the client towards the nearside of the bed. Assist the patient to the prone or side lying position with face away from you. The back rub usually follows the clients bath and is given again as part if evening care. The back may be rubbed any other time indicated to reduce skin problem

2. protect bed with towel, see that client is comfortable.

3. Expose the back by separating the gown.

Towel prevents soiling of sheets when solution spills off the hands.
Fold down the bed clothes to the middle area of clients buttocks. This allow exposure of the shoulder and the sacral area.

4. Pour small amount of rubbing alcohol or lotion or powder in palm of the hand and rub palms together. Explain lotion will feel cool n wet. 5. Take your position at side of bed with one foot forward; knees are slightly flexed; arms extended.

Alcohol having astringent effect is good for oily skin, while lotion is good for dry skin.rubbing pal,s together creates friction making it warm before application. This reduces startled response and discomfort due to muscle tension caused by cold application.

7. Effleurage the entire back. Apply palms and fingers to sacral area, massaging in circular motion. Stroke upward from buttocks to neck. Circle your hands over shoulder blades with smooth firm strokes. Continue massage to upper arms and laterally along sides of back down to the iliac

Avoids straining muscles while doing the procedure.

Relaxation promotes rest and sleep. A backrub at the end of the day may alleviate tension and anxiety

Do not allow hands to leave clients skin. Continue massage pattern for at least 3 minutes. 8. Apply friction strokes next to spine. Using the thumbs, massage back, moving form side to side in smooth and strong and tiny circles starting at the neck and ending at the waist.

Gentle firm pressure applied to all muscle groups promotes relaxation. Continuous contact of skins surface is soothing and stimulates circulation to tissue. Penetrates deeper muscles.

9. Petrissage the back and shoulders of the client.Knead skin gently by grasping tissue between thumb and fingers. Knead upward along one side of spine from buttocks to shoulders and around nape of neck.knead or stroke downward toward sacrum. Repeat along other side of back.

Kneading increases circulation. Motion is soothing and relieving.

10.Optional: use tapotement technique at the back. Place both palms together. With the small fingers touching the clients back, tap the back using brisk, vigorous rhythmic and percussive movements.

Invigorates and stimulates tired muscles.

Hands may be used to alternately tap, cup, slap or pummel the muscles.

11. Complete the massage by using light effleurage to entire back for an additional 3 minutes. Tell the client you are ending massage. 12. Wipe excess lubricant from clients nack with bath towel. Retie gown and assist with pajamas.

Excess lotion can be irritant.

13. Help client to comfortable position. Raise side rails as needed. 14. Dispose of soiled towel and wash hands. 15. Record: Time condition of clients back Any areas of muscle pain and tension BP and Pulse

Comfortable position enhances back rubs effect. Promotes infection control. Degree of relief depends on length of massage, clients ability to relax and degree of discomfort before massage. Gentle back massage may increase heart