Spinal Cord Injury and the Bariatric PatientBy Ardanowski, Carol; Pasch, Patti; Rehab Management,
Publication Date: July 2011
Article explores the barriers to treating a bariatric patient with spinal cord injury (SCI) and the innovative solutions required to overcome these obstacles. An illustrative case study is presented of a 6 foot 5 inch, 38-year-old male SCI patient weighing about 478 pounds. Treatment solutions discussed include (1) a bariatric bed with a specialty mattress; (2) a Guldmann repositioning sling used with an overhead lift in lieu of a draw sheet to position the patient in bed; (3) a sling for lower limb support fashioned from two pillow cases sown together and fitted with webbing loops to connect it to the overhead lift, with a foam egg crate placed inside for structure and comfort; (4) a foam cushion used to protect the groin during transfer to a wheelchair via a sling and overhead lift; (5) the achievement of pressure relief by suspending the patient using the overhead lift rather than using the wheelchair tilt mechanism, which was limited to 400 pounds; (6) use of a high profile wheelchair cushion; (7) proning achieved with two height adjustable mats, a platform fashioned on one mat using wedges, pillows, and a head support, and a positioning sling on the other mat for returning the patient to his original position; and (8) upright sitting accomplished by using an overhead lift and sling to position the patient on a large, weight accommodating therapy ball and serve as a safety net, and the use of a combination of tables and additional therapy balls to achieve weight bearing. Over the course of rehabilitation, the patient lost 130 pounds and began to meet weight and width limits of additional equipment.
Published by: Ascend Media LLC (Website:http://www.ascendmedia.com)
Link to text: http://www.rehabpub.com/issues/articles/2011-07_03.asp