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Rules of disability patients care with arms and legs muscles paralysis (paraplegia, quadriplegia)

Rules of disability patients care with arms and legs muscles paralysis (paraplegia, quadriplegia)

In acute stages of patient lower limbs muscle paralysis (paraplegia) paramount importance have secondary prevention of urinary tract infections. Due to areflection bladder with urinary retention, the patient does not feel its filling. This can result damage to the bladder's muscle membrane (m. detrusor) because of its distension. In order to prevent this complication, urologist produce patientís bladder drainage, thereby preventing of urinary tract infections. This is achieved by periodic bladder catheterization performed by qualified personnel. Alternative methods are prolonged bladder drainage via a closed system or suprapubic drainage. However, it can be related with a sufficiently high frequency of infectious complications for the patient with paralysis.

Patients with acute lesions, especially causing spinal shock, often require a special cardiovascular therapy due to attacks of increase and decrease in blood pressure (hypertension or hypotension). At the same time, it must be entered intravenous solutions for correction of deviations in blood volume (CBV). Potential emergency medical condition in patients with complete spinal cord cross-section lesions are stomach and intestines stress ulcers. In such situations, the presence of gastrointestinal tract ulceration is effective therapy with cimetidine and ranitidine.

Rules of disability patients care with arms and legs muscles paralysis (paraplegia, quadriplegia)

Pay attention that when assisting a person lying on the bed is necessary to bend your legs and not your lower back. This will prevent you from pains in it from excessive loads.

Spinal cord injury at a high cervical level cause mechanical respiratory failure of varying severity due to intercostal muscles and diaphragm malfunction. Such respiratory failure requiring assisted ventilation and sanitation of bronchopulmonary tract. With incomplete respiratory failure with rates of forced vital capacity 10-20 ml/kg for patients is advisable physiotherapy (inhalation) and chest massage.

To prevent collapse (atelectasis) and lungs exhaustion, especially when massive damage localization below C5 spinal cord segment can be used corset with negative pressure. For severe respiratory failure intubation (in case of spinal instability intubation performed by using an endoscope), followed by tracheostomy, provides access to the trachea for ventilation and aspiration of sputum. A promising new method seems the phrenic nerve electrostimulation in patients with pathological process localized at the C5 level or higher.

With the stabilization of the clinical manifestations is necessary pay attention to the psychological state of the patient and development of his rehabilitation plan. Vigorous rehabilitation program often gives good results in younger and middle-aged patients, and enables them to return home to continue a normal life.

Some procedures paraplegic patients can perform themselves with others help.

Serious problems that are associated with prolonged immobilization of the patient, create the preconditions for the emergence of pulmonary embolism:

  • infringement of skin integrity over the compression site,
  • urological sepsis,
  • vegetative instability.

Patient's body need frequently change position in bed (every 3 hours), use emollients skin application and soft bed cover, anti-bedsore mattresses. Multifunctional beds is special designed for facilitate patient's body turning and a more even distribution of his body weight, reducing load on the bony prominences.

Rules of disability patients care with arms and legs muscles paralysis (paraplegia, quadriplegia)

Note that in assisting the sitting patient, you need to bend your legs and not your lower back. This will prevent you from the excessive loads pain.

If there is no damage to the spinal cord sacral segments patient can achieve automatic bladder emptying. At first patients urinate reflexively in the interval between catheterization, and later learn to provoke urination using different techniques. Urine residual volume presence can lead to bladder infection; it is necessary urological procedures or an indwelling catheter installation.

Most patients with paralysis need to monitor the bowel function and ensuring of its emptying at least twice a week for the prevention of intestinal tension and obstruction.

Rules of disability patients care with arms and legs muscles paralysis (paraplegia, quadriplegia)

Note that in assisting the standing patient, you need to bend your legs and not your lower back. This will prevent you from the excessive loads pain.

 

Severe arterial hypertension and bradykinesia occur in response to negative stimuli, stretching the bladder or bowel surface, or surgical procedures, especially in patients with damage to the spinal cord cervical or upper thoracic segments. Severe redness and profuse sweating in the areas above the spinal cordís lesion level may accompany arterial hypertension. The mechanism of these vegetative disorders is not clear enough. Due with that requires assignment of antihypertensive agents, particularly during surgical operations, but it is not recommended to use beta-blockers. In some patients with spinal cord injury, severe bradycardia occurs because of tracheal phlegm aspiration. This can be avoided by administration of small doses atropine.

Serious complication in the early period is a pulmonary embolism on the patientís immobilization background. Pulmonary embolism in patients with paralysis occurs in about 30% of cases after acute spinal cord injury.

Rules of disability patients care with arms and legs muscles paralysis (paraplegia, quadriplegia)

Neurotrophic bedsores - are consequences of innervation malfunction after vertebral spine compression fracture with spinal cord compression.

 

Detailed information on physical therapy, rehabilitation and use of orthopedic devices in patients with spinal cord diseases should be checked with the patient's attending physician (neurosurgeon, urologist, rehabilitation therapist and therapist). Vertebral spine orthopedic stabilization in spinal injury case is based on clinical indications.

 

If you have any questions on the disability patients diagnosis or care with arms and legs muscles paralysis (paraplegia, quadriplegia), you can ask them to our neurosurgeon or neurologist: (499) 130–08–09

 
 

 

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