a. General. The backrub is usually administered after the patient's bath. It should be offered to the patient because it promotes relaxation, relieves muscular tension, and stimulates circulation. During the backrub, the specialist is able to observe the patient's skin. To give an effective backrub, the specialist will massage the back for 3 to 5 minutes (figure 1-10).
Figure 1-10. Administer a backrub.
b. Important Points.
(1) The backrub is contraindicated if the patient has such conditions as fractures of the ribs or vertebral column, burns, pulmonary embolism, or open wounds.
(2) Monitor pulse and blood pressure of those patients with a history of hypertension or dysrhythmias.
(1) Explain to the patient what you are going to do.
(2) Prepare equipment:
(a) Bath blanket (optional).
(b) Bath towel.
(c) Skin lotion, alcohol, or powder.
(3) Adjust bed height to working level.
(4) Provide privacy and quiet environment.
(5) Lower side rail. Position patient with back toward self. Cover patient so that only parts to massage are exposed.
(6) Wash hands, and warm if necessary. Warm lotion by holding some in hands. Explain that lotion may feel cool.
(7) Begin massage by starting in sacral area using circular motions. Stroke upwards to shoulders. Use firm, smooth strokes to massage over scapulae. Continue to upper arms with one smooth stroke and down along side of back to iliac crests. Do not break contact with patient's skin. Complete massage in 3 to 5 minutes.
(8) Gently but firmly knead skin by grasping area between thumb and fingers. Work across each shoulder and around nape of neck. Continue downward along each side to sacrum.
(9) With long, smooth strokes, end massage. Remove excess lubricant from patient's back with towel, and retie gown. Position for comfort. Lower bed, and raise side rail as needed.
(10) Place soiled laundry in proper receptacle. Wash hands.