no abduction pillow w/ THR

doobiedo, RN · Mar 17, 2005

I just had a bilat THR in October for osteoarthritis. I did not have abductor pillow...just pillows between my legs...worked fine and more comfortable..

However I was not turned at all except when I was assinged a student and then never repositioned on my side and ended up with stage II sacral decub after 4 days

I have been out clinical for awhile and just wondering if you are not suppose to turn bilateral thr pts? Is this something new? We always turned them when I was in the hospital just 5 years ago... I had an epidural block for almost 2 days...so I felt comfortable of course on my back

I also went to rehab and was not encouraged to turn in rehab either either....granted I was out of bed every chance I had but however very surprised I was not encouraged to turn when in bed

Just an honest question as maybe there was a reason for it...not sure and would appreciate any reponses.

meownsmile, BSN, RN · Mar 17, 2005

No,, someone dropped the ball. You should have been turned at least every 2 hours at night while you were recouperating and werent able to make complete turns yourself. Its never acceptable for a patient that is otherwise in good health to lay long enough to get a decub.

But back to the issue at hand. I guess we have dinosaurs doing our hips. 100% of our hips get abductor pillow following surgery. Maybe ill have to ask about that this weekend if i see the orthos.

luvanurse0630 · Mar 21, 2005

I just had a bilat THR in October for osteoarthritis. I did not have abductor pillow...just pillows between my legs...worked fine and more comfortable..
However I was not turned at all except when I was assinged a student and then never repositioned on my side and ended up with stage II sacral decub after 4 days
I have been out clinical for awhile and just wondering if you are not suppose to turn bilateral thr pts? Is this something new? We always turned them when I was in the hospital just 5 years ago... I had an epidural block for almost 2 days...so I felt comfortable of course on my back
I also went to rehab and was not encouraged to turn in rehab either either....granted I was out of bed every chance I had but however very surprised I was not encouraged to turn when in bed
Just an honest question as maybe there was a reason for it...not sure and would appreciate any reponses.

Well, how are your hips now?

LPNer · Mar 21, 2005

We have Docs who do not use the abductor pillow, but they go with regular pillows.

If you also have a lot of knee replacements, you would know that crossing your legs is out of the question with that immobilizer on! I can see how it would be great for the post op hip! Wonder if any of our Docs learned aobut this technique at the big symposium last month? I hope so, those abductor pilows are hated by all!

I've never seen a CPM used on a hip, interesting, but at the same time, if it helps the pt with bending the knee, it would certainly help with bending a hip too. OH please no! We already have too many people to get on and off their machines mid-week! The CNAs can't keep up wth them all and the nurses end up helping at the worst possible time of the morning. (Though one of our surgeons has quit using the CPM on knees, one study indicated they are just not that helpful. I guess that goes with everything else in medicine, for every study proving one thing there is another proving just the opposite.)

minnib · Mar 22, 2005

Hi All,

I work on the Rehab unit and the big foam pillows are used on all THR immediately postop but once they come over to our unit a regular is used, sometimes along with the knee immobilzer. If the PT understands the reasoning as why not to cross the legs then we forego the pillow. Believe some pts are very confused on our unit and we make sure they have them in. When they get tired of laying on their backs we turn them on their nonoperative hip and put them in perfect alignment and put a pillow between their legs, one at the bottom, between their feet and one rolled under their back. Most love this position and it gives them a break from the back!

minnib

LPNer · Mar 22, 2005

Hi All,
I work on the Rehab unit and the big foam pillows are used on all THR immediately postop but once they come over to our unit a regular is used, sometimes along with the knee immobilzer. If the PT understands the reasoning as why not to cross the legs then we forego the pillow. Believe some pts are very confused on our unit and we make sure they have them in. When they get tired of laying on their backs we turn them on their nonoperative hip and put them in perfect alignment and put a pillow between their legs, one at the bottom, between their feet and one rolled under their back. Most love this position and it gives them a break from the back!
minnib

I'm not on a rehab unit, but woulen't it be better to put them on the operative side, thus making it impossible to pop the hip out? When one of our fresh post ops want to turn on their side, that's the way we encourage them to go.

More often than not we "play" turn-over just barely relieveing the pressures from their back and buttocks because either side is very painful. Makes getting OOB so important. Our PT has everybody up and walking pot op 1. (Except the few who simply can not do it, they aren't ogres!)

sunlovin35 · Mar 29, 2005

I have found that a knee immobilizer is used in confused patients as well. There is a proven theory that if the knee cannot bend then in fact the 90 degrees flexion is harder to obtain therefore decreasing the risk of dislocation

ask23 · Apr 4, 2005

When I worked on an ortho/neuro floor not every doctor would order an abductor pillow post op THR. I think they based it on if the patient was alert and oriented enough to understand not to cross their legs.