Post OH Surgery activity advice

meandragonbrett · Jun 24, 2007

we have ours extubated no later than 6 hours post-op and generall OOB around 12 hours and as long as pain is being controlled. Post-ops are sent to stepdown 24-36 hours post-procedure if things are going as planned.

Spatialized · Jun 24, 2007

Besides just getting them OOB, remember to enforce sternal precautions on those sternontomy patients. Y'know, no pushing up with the arms, hanging onto things to pull up, anything that will put undue stress on that now-healing sternum.

My .00002...

Tom

muffie, RN · Jun 24, 2007

we have pt fold arms over chest, bend up knees and turn on their side

then drop the feet and pull against the bed with the feet while digging elbow into the bed while arms remain folded [nurse pulls on pt as needed]

nurseabc123 · Oct 30, 2007

we have pt fold arms over chest, bend up knees and turn on their side
then drop the feet and pull against the bed with the feet while digging elbow into the bed while arms remain folded [nurse pulls on pt as needed]

I don't think I've seen a patient that could move like that.

smileyRn96 · Oct 30, 2007

We give them a heart shaped pillow to hug, this keeps them from using their arms to pull themselves up. We assist them to a sitting position. Hope that helps.

-Smiley

CVICURN2003 · Nov 3, 2007

I say "Hug your bear" 400+ times a day....we teach them to roll onto their side and then to their hip onto their back. same for getting OOB just backwards. :lol2: :lol2:

francis01 · Nov 20, 2007

the quicker they can get OOB and progess to ambulation the quicker they get home. Advancing activity is key to their recovery.

Editorial Team / Admin · Nov 22, 2007

Place bed in lowest position, bottom siderail down on side of bed from which pt will exit.

Leave top rail up, so pt can grasp it if s/he needs it (depending on what type of bed rails you have; if it'll be in the way when the bed is rolled up, lower it before getting pt OOB).

Position footstool (if used) next to bed, and chair right next to footstool (maybe leave a space between so pt can step off footstool onto floor, then pivot into chair).

Have pt turn on side, arms crossed across chest or pillow at chest, pt at edge of bed.

Elevate HOB to close to 90 degrees.

As HOB comes up, drop the legs (in a controlled manner) off the bed, so the pt is lifted by the bed into a sitting position on the edge of the bed, legs hanging off.

Pt may now uncross arms and step down onto footstool, then off footstool onto floor, pivot and sit in chair.

Please do not tug on pt's arms.

Support pt by the shoulders and let him/her help, if possible.

As pt becomes more mobile, steps may be eliminated.

:)

tttaylor · Mar 29, 2012

Great tips! I'm curious though- what if the patient has chest tubes and cannot turn on either side?

Creamsoda, ASN, RN · Mar 31, 2012

Great tips! I'm curious though- what if the patient has chest tubes and cannot turn on either side?

Usually with CT surg patients the chest tubes are mediastinal so they are more anterior anyway.