coma patients-out of bed

[katmecan]

Are there any benefits to sitting a coma patient up in a chair?

[happthearts]

Not that I have heard . We ussally keep them in bed. I can just see a coma sitting in a recliner .Pt sliding right out of the recliner on to the floor .Not a pretty picture.

Boom ending on the floor.

Maybe stitting up a bit in a fowlers postion in a bed ,to help assist breathing.

I guess or do tube feeding in semi fowlers.

Happy

[CHATSDALE]

usual reasoning is to keep lung fields clear...

[suzanne4, RN]

To prevent pneumonia, to aid with tube feeding. There are chairs that open flat, and you can use a slider board to move the patient over. You can elevate the head as much as tolerated, There is a foot-rest for support, as well as leg support. There are also security straps that prevent them from sliding out.

[LilRedRN1973]

I would think sitting them up from time to time would benefit their lungs....keep secretions from building up. I work ICU and even with our "comatose" patients, we frequently put them in the chair positions in our ICU Hill ROM Total Care beds. They are not all the way up, but almost. It's amazing what comes out of their trachs/ETT's after the've been moved all about!

Melanie = )

[suzanne4, RN]

If you ever go into a neuro ICU, or even stroke unit, you will usually see several "Cadillac" chairs or "Cardiac" chairs, depending on what your facility calls them. You can flatten them put, slide the patient over, and then sit them up. There are side arms, as well as seat belts so that they do not slide out. There are also foot rests there, as well.

It is not the same as lifting the patient up and putting in a regular chair, that would be very hard to do without a special mechanical lift to do it.

[chadash]

and be extra diligent about repositioning and relieving pressure in a timely manner. That's alot of pressure on the posterior....

[steelcityrn, RN]

You betcha! Helps promote circulation, decrease risk of pneumonia, prevent decubes and prevent constipation and UTI. The chair used of course would be one like a reclining wheel chair or a geir chair. Also better for the patient on a vent to sit up.And who knows, do you know that your being cared for better while in a coma as apposed to just left to lay in a bed??? One never knows.....

[KatieBell]

Getting a coma Patient in to a chair or in the sitting position of the HillRom is a Pain in the Neck (and other places), but it is really very good for the patient. Especially for pulmonary toilet. But also for circulation, skin integrity, tube feeds as has been mentioned. Helps to maintain some functionality in the joints etc...

I used to do it daily when I was in NSICU. It was definitely difficult,because of all the tubes and wires, and many a patient has been accidently extubated during the transfer, BUT, if careful, I think the benefits outweigh the hassles.

[P_RN, ADN, RN]

By all means! Short, short anecdote. Kid, head injury, comatose, 2 arms, 2 legs fx.

Every day I got him up in the cadillac and we sat him in the nurse's station for about an hour. Of course "they can always hear you" so as usual I said ______ what would you like to do now?

He OPENED HIS EYES and SAID "whatever Dr. So and So (sitting there) says I can."

Within a week he was talking, walking on platform walker and was out of there in a couple of months.

By all means. Get them up!!

[leslie :-D]

i always make it a point to get my comatose patients oob; not just for the medical benefits but hate treating them as if they were just vegetables. they deserve to get oob just like everyone else.

leslie

[ArmyWife,RN]

Wow!

This is something I've never thought about/been taught/or seen done in my short carreer. Are there articles/web-sites regarding this practice?

Thanks,

A.W.