Slings

Slings are used to support clients being moved with hoists. The sling is attached to hooks or clips on the hoist spreader bar or yoke to provide support for the client while they are being moved. There are several types of sling available that are made from various materials. Becoming familiar with the multiple types of sling is an essential part of using hoists. Training programmes typically spend some time on teaching the correct use of slings. Accidents that occur during the use of hoists often involve incorrect sling use. The table below summarises some of the key features of slings. Choosing the right sling and fitting it correctly improve comfort, dignity and safety for the client. Having a comfortable and secure experience can help to overcome a reluctance to use a hoist, which some clients have. Generally, the more material a sling has the greater the comfort and support it provides

Points to note about slings

Compatibility of slings with hoists

Some hoists are designed to be used with only a specific type of sling. Other hoists can use multiple types of sling. This point should be checked in the hoist instruction manual or with the supplier. When ordering new slings or hoists it is important to know whether the new versions will be compatible or interchangeable with any existing slings or hoists. If they are not compatible, more work will be required to maintain and service different sling and hoist systems. It is possible to use multiple brands of sling on some hoists, but this requires a suitably qualified person to document compatibility, preferably with agreement from the suppliers

Reusable and disposable slings

Most facilities have reusable slings that are washed before use with another client. However, if heavy soiling is likely or infection risk is high, disposable slings may be preferred. Disposable slings are for one‑client use only and should be disposed of when soiled or no longer needed for the client. They must not be washed or cleaned then reused.

Laundry services:

There are several ways to launder slings and each facility needs to have a system in place. These systems include: the facility owns the slings and they are cleaned by its own laundry; the facility owns the slings and its laundry contractor cleans them as an added service; and the contract laundry service provides the slings in agreement (e.g. types, numbers) with the facility and cleans them. Note that some external laundering services provide specific brands of sling only.

Standard labelling

Each sling should be labelled with the following details:

– The name of the sling or its model number

– The names or types of hoist for which the sling is designed

– The size of the sling

– The SWL of the sling

– Any special washing, drying and sterilisation instructions – The manufacturer’s name or logo, or registered trade name

Checking slings

All slings should be checked before they are used:

– Check all loops at connection points for signs of fraying and loose stitching

– Check entire sling body for loose stitching, rips, holes and bleach staining

– Check for signs of fabric weakening, such as heat damage, distorted fabric and staining

– Check all buckles – Size, shape and fitting of slings

Slings are available in multiple sizes to suit the weights and body sizes of clients. Sling sizes can range from very small to extra large. The sling size will be shown on a label attached to the sling. Most slings are now colour coded; the size indicated by each colour should be shown on a sticker attached to the hoist that will be used with the sling. Not all manufacturers use the same colours to indicate sling sizes, so this should be noted if using slings with different hoists. Sling sizes may vary between manufacturers, so carers need to measure the sling for each client to ensure the correct size is used. When ordering slings, ensure each sling is labelled with its size and SWL, which should be in kilograms for use in U.K.

If the sling is too large, there is a risk of the client slipping out of the sling. A sling that is too small can result in the spreader bar coming too close to the client’s face, can be tight in the crotch and cause discomfort, or may not provide enough support for the back. Slings have loops or straps that are attached to spreader bars on hoists. Sometimes these straps are adjustable and can be set for a specific client by being marked with a piece of wool or a pen to identify the setting for the client. This means they can be hoisted in the same position with different carers. The following table summarises the more common types of sling and these are described in more detail below. There are other types of sling, such as amputee slings, that require specialist knowledge for use. Clients with hip replacements, morbid obesity, bilateral amputations or other complications may require specialised transfer assessments and specialty slings.

Standard or divided leg sling

This is a U‑shaped sling and may or may not have upper back and head support. Its advantages are that:

• It is easy to put on when the client is sitting or lying

• It covers a large surface area of the client’s body and is more comfortable than a toilet sling

• When the leg bands are positioned correctly, there is less likelihood of the client slipping or falling out of the sling

• The standard sling can be used to pick up a client off the floor.

Some disadvantages are that standard slings may not be as suitable for bathing and toileting as the access or toilet sling. The leg bands or straps can be uncomfortable for the client if they are not positioned correctly or if the client is left in the sling for too long.

Access or toilet sling (hygiene sling)

Toilet slings provide split leg support and upper‑mid‑back support. Some slings come with waist support instead of upper‑mid‑back support. The advantages of this sling are that it is useful for toileting if the client has some upper limb and trunk control, and it can be put on a client in most positions. It provides good access for washing as well as toileting. Some clients may be able to put this sling on independently. Toilet slings have disadvantages. They do not provide as much support as standard slings, so they should only be used for a short time. A client with reduced muscle tone has an increased risk of slipping through the sling. The client must be able to cooperate fully and not raise their arms over their head.

Hammock sling

This is a rectangular sling. Some have commode openings. It is comfortable to use as the client’s body is supported over a larger area than in a standard sling. There is less likelihood of discomfort or damage to the client’s skin. It is suitable for lifting the client off the floor. Some disadvantages are that it can be difficult to put on and take off when the client is seated or lying in bed, and there is no access to the client’s body for washing, even if the sling has a commode opening

Repositioning sling

This is a specialised full‑body‑length sling used for turning or positioning in bed clients who need to be turned several times a day. Repositioning slings are usually left under the client in their bed. If leaving a sling under a client, care should be taken to remove wrinkles from the material and tuck the straps under the mattress. Flat bed sheets, soaker pads and other items can be placed on top of a repositioning sling to absorb moisture and improve comfort.

Stretcher attachment

A stretcher or ‘flatlifter’ enables the movement of a client in a lying position. The stretcher is a body‑length rigid scoop frame, or a series of flexible batons that are positioned under the client and attached to a frame that is assembled around the client. Some stretcher attachments are made of special material designed for X‑rays. Stretcher attachments are useful for spinal and post‑operative orthopaedic care as the clients can be immobilised during transfers. Some hoists offer three‑way client angle adjustments for the stretcher sling: flat, head down (Trendelenburg) and feet down. Not all hoists can accommodate stretcher attachments.

Walking harness sling

Walking harness slings are designed to provide complete or partial support for clients who can walk. These slings can be used with ceiling hoists, but are also available with some mobile hoists where the booms can be raised high enough for clients to stand directly underneath the sling bars.

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