Cleaning Pts with Broken Backs

[Jackfackmasta, ASN, RN]

I was sitting in my car thinking about critical care nursing and I was wondering this.

If you had a pt admitted to the ICU for say a broken back or some other traumatic injury in which the patient has orders to not turn or move to prevent further injury to the site how would clean a patient if they have a BM and you need to clean them? Is there a special way to move them?

Thanks

[CanadaEh]

I have never had a pt who was not to be moved. I have had pts on C-spine precautions and head injuries that we would minimize activity to avoid an increase in ICP.

[TX RN]

Log roll.

[Biffbradford]

In CVICU you will some times have a patient with an open chest (OPEN, as in the retractor is still in holding the ribs apart, but covered with a sterile dressing)(they are paralyzed and heavily sedated). These patients cannot be turned (you don't want anything to fall out!) so you do the best you can. Some times you can shove clean linens under the legs, head, butt - depending on how stable they are, but you cannot roll them. If they poo, you can get it from the front, between the legs. In a real pinch (perhaps, they are laying in a pool of blood and you know that they will not be closed up anytime soon) you could (perhaps) levitate them if you have 6 to 8 people to help. Get everything ready, so then it's 1-2-3 UP! Quickly swap out the linens, wipe the skin briefly, grab your stethoscope for a 5 second listen, and DOWN! she comes.

I don't know if I would levitate someone with a broken back. Depends on what kind of bracing they have, I guess.

[umcRN, BSN, RN]

In CVICU you will some times have a patient with an open chest (OPEN, as in the retractor is still in holding the ribs apart, but covered with a sterile dressing)(they are paralyzed and heavily sedated). These patients cannot be turned (you don't want anything to fall out!) so you do the best you can. Some times you can shove clean linens under the legs, head, butt - depending on how stable they are, but you cannot roll them. If they poo, you can get it from the front, between the legs. In a real pinch (perhaps, they are laying in a pool of blood and you know that they will not be closed up anytime soon) you could (perhaps) levitate them if you have 6 to 8 people to help. Get everything ready, so then it's 1-2-3 UP! Quickly swap out the linens, wipe the skin briefly, grab your stethoscope for a 5 second listen, and DOWN! she comes.

I don't know if I would levitate someone with a broken back. Depends on what kind of bracing they have, I guess.

I've done this! But with babies! haha it's a little easier but no less risky. Last one I had the wound nurse was insistent we lift her and put a protective dressing on her butt. Well she arrested shortly after the lift and had already been on ECMO. Got her back but her parents took her off support a few days later as she was never able to wean from ECMO.

btw even though she was only a 3kg infant it still took 6 nurses to safely manage the lift, wipe, slap on dressing, change out sheets maneuver. I couldn't imagine trying to do that to an adult