Acute Neuro Treatments Flashcards
Cardiovascular stability before movement
HR, BP (if this drops=clammy, dizzy, nausea, vacant look), RR, pulse Ox to monitor sats, consciousness
Getting a patient for lying to sitting
orientate head in direction, position arm under body away, reach other arm over body, bend legs, then roll onto side, patient may be able to assist, then side flex spine to lift head and shoulders, put hand under shoulder (or scap), one person swings legs out and other person brings upper body up, need to help with balance when sitting up
what to do with patient when they’re sitting up
place a cushion in between your legs and patients back, then lean into anterior and posterior pelvic tilt
considerations when getting a SCI injury patient sitting up
impairment of vasomotor control- BP/HR/RR, postural hypertension- BP drops, autonomic dysreflexia- BP and HR raises,
sitting on the edge of the bed- lower half- start with
run fingers down SP
symmetry/muscle activity/ curves- look for rotation (can also look at shoulders and leg positions)- feel landmarks (ASIS and PSIS), look at level of pelvis, skin crease= shows amount of flexion between the thorax and pelvis
sitting on the edge of the bed- upper half
level of scapulae- inferior angle, level of shoulders, arm position- look to see if level, head position (important role in balance)- ensure neutral position
observation of movement of trunk in sitting (AROM)
Anterior pelvic tilt= sit up from here (whilst holding SI joints), posterior pelvic tilt- instruct to slumped and sit back, lateral pelvic tilt with side flex of trunk, combine with arm reaching to encourage righting reactions
passive trunk movements
passive movement of trunk/pelvis with one or 2 people, repeat AROM but do as passive as possible,
think about- speed, range, hand position, support, resistance
outcome measures for trunk
postural assessment scale for strokes, trunk impairment scale
what is an acute neurological patient
an acute illness is an illness with rapid or abrupt onset generally with short, severe course requiring prompt treatment
aims of acute neuro rehabilitation
begin rehab, identify means of communication, preven secondary respiraotry complications & provide respiratory care, prevent development of pressure areas, identify means of nutrition/hydration, maintain muscle length and joint ROM, prevent secondary MSK problems (contractures and deformities)
problem and treatment- means of communication, prevent secondary respiratory complications, prevent development of pressure areas
communication- discuss with SALT/family, respiratory= positioning/ sputum clearing techniques/ mobs, pressure= positioning/splinting
problem and treatment- identify needs of nutrition/hydration, maintain muscle length and joint ROM, prevent contractures and deformity, maintain of continence
hydration- liaise with nurse and dietitian, muscle and contractures= PROM/Soft tissue mobs/ positioning/ splinting, continence= liaise with nurse
aims of acute neurorehabilitation
facilitate sensory feedback, promote alignment, prevent/maange tone, facilitate muscle activity/movement, pain relief, provide advice to MDT and family, identify transfer method, laying foundation for rehab
problem and treatment- facilitate sensory feedback, promote alignment, muscle activity, encourage movement
sensory= AROM/PROM/soft tissue mobs/joint mobs, alignment- PROM/soft tissue mobs/joint mobs/positioning/splinting, muscle=AROM, movement= bed mobility/transfer out of bed/sitting balance
