Skin Care
Pressure!
Name 3 things that are done differently in patients with a spinal cord injuries personal care/daily activities.
-cathing
-bowel program
-skin inspection
-hydration/diet to help with bowel management and skin health
Describe what you would pack to be out in the community.
cathing supplies, wipes, extra attends, slide board, extra clothes, water
Describe the first signs of experiencing AD.
Flushed face and chest
sweating above the level of injury
severe headache
high blood pressure
Anxious
Anxiety
Name 3 preventative measures you can take to prevent skin injury.
- Clean, dry skin
- Daily skin inspection
- Pressure relief
Name 5 pieces of adaptive equipment that you might use to help with personal care
-reacher
-long handled sponge
-foot funnel
-extended mirror
-dil stick/suppository inserter
-slide board
-gloves for wheelchair
-lift
For planning your first few outings after discharge, what might you want to consider as you adapt to your change in physical needs?
- time of day (before or after bowel program/cathing schedule)
- time of day (crowded environments)
- accessibility of desired location
What should you do FIRST if you think your patient is experiencing AD?
sit-upright, loosen all clothing, check blood pressure
Name 3 possible causes of skin injury
pressure
friction/shearing
cut/scrape
What should a new injury patient participate in prior to leaving the hospital?
TLA
SCI training/education
In room TLA
At home TLA
Describe how you would access the following:
- elevator
- curb without a cut out or single step
- parking lot without accessible parking
Answer evaluated by RT/OT
What are the possible causes of autonomic dysreflexia?
bladder is full, bowel is full, shoes/clothes are too tight, pressure somewhere below level of injury, wound/injury, sexual activity
Name 5 things you will look for in daily skin inspection
- redness
- cuts/scrapes
- bruising
- color/texture change
- rash
Describe how you would educate your patient to prepare for a shower and how they should direct someone to assist them.
Answer evaluated by RT/OT
(putting all supplies in bathroom; having plenty of towels available; slide board; long handled sponge; bench set-up where you need; things within reach. Help should be available for checking for breakthrough stool and helping with pericare)
What questions would you ask when calling a location to determine accessibility?
Are there any steps?
Do you have a private/family restroom?
Do you have an elevator?
Are there ramps to access the entrance/exit?
Will I be able to pull my wheelchair up to the table/will I be able to stay in my WC?
Do you have accessible parking?
What should you train your patient to do if they think they are having AD and their blood pressure does not go down/symptoms do not improve?
CALL 911, Go to the hospital if at home. If in the hospital call nurse for assistance.
What steps will you take if you find a red spot on the skin of the buttocks?
- See if the redness is blanchable
- Avoid putting pressure on that spot
-Document and alert wound care nurse
- continue avoiding pressure to the area and monitor the spot.
Why is a bowel program important and why should it be completed even if the patient has a bowel accident throughout the day.
patient needs to be on a schedule to prevent further bowel accidents.
Describe how you would plan an outing to a high school football game?
Answer evaluated by OT/TR.
What level of injury is most at risk of AD?
T6 and above