Most of them lie flat on the hard ground caused by trauma, so don't move easily. Call the emergency number 120 1, and the position of the bedsore cannot be turned at will. Skin and subcutaneous tissue are easy to be compressed, bed sheets are wet, malnutrition, poor skin elasticity and poor tolerance to crush injuries can all lead to bedsores. 2. It is prone to urinary system infection and urinary incontinence caused by stones or urinary retention. Symptomatic treatment is catheterization, which is easy to cause infection. The urine in the drainage bottle or tube flows back into the bladder or the drainage is not smooth, and the residual urine accumulated in the bladder can cause urinary system infection and stones. 3. Fecal incontinence or constipation is related to gastrointestinal nerve function damage, long-term bed rest and less activity after spinal cord injury. Incontinence of stool will pollute the bed, and if it is not replaced in time, it will easily lead to bedsore or local infection. 4. Patients who are prone to lung infection are afraid to cough and take a deep breath because of the pain after injury. The supine position is not conducive to breathing, and the secretions in the lungs and trachea are not easy to discharge, which is prone to pneumonia. Especially in patients with cervical spine fractures, intercostal muscles and abdominal muscles are paralyzed, leaving only diaphragm, so the lungs are not fully inflated and pneumonia is more likely to occur. Nursing 1. Psychological nursing patients bear great mental pain, which may lead to anxiety, tension, fear, depression, pessimism and other adverse psychological reactions. We should do a good job in the ideological work of patients and their families in time, and increase patients' sense of security and trust with warm, kind, caring and sympathetic listening attitude and skilled nursing technology. Introduce the treatment plan and the available treatment effect to patients. We can consciously organize the exchange of successful cases of similar patients and enhance the confidence of patients. Carefully observe whether patients have abnormal emotions and strengthen preventive measures to prevent patients from committing suicide. 2. Appropriate lying position and correct turning method should be given to patients in the early stage to avoid further injury. It takes at least 2 people to turn over for patients with lumbar fracture and at least 3 people for patients with cervical fracture. Four weeks after the injury, he entered the late stage of paraplegia and the fracture was locally stable. Only 1 nurses can help patients lying on their side turn over. When lying on your back, your legs can be placed parallel, and your hips and knees are bent. The thigh should be placed under the pillow, the feet should be supported by leather pads or sandbags to keep the ankle joint functional, and the ankle joint of the calf should be padded with cotton rings or sponge pads. When patients with lower limb spasms adopt this sleeping position, their legs should be separated. When lying on your side, bend your thighs and knees, and put the pillow under your legs. Legs stretch hips and knees, feet rest on sandbags, and the back must be supported by pillows. Patients with high paraplegia due to cervical spine fracture should use skull traction, so when they turn over, they should protect their heads, and the skull traction device should not slide down, keeping their heads and trunks in a straight line. In supine or lateral position, the head should be slightly extended backward, and the cervical vertebra should be kept at a horizontal line with the trunk. 3, to prevent the occurrence of bedsore regularly change position, it is forbidden to drag patients in bed, keep the sheets flat, clean, dry, soft and wrinkle-free, for patients who stay in bed or in wheelchairs for a long time, put balloons and cotton balls in the compressed parts of the bony process to reduce the long-term oppression of local tissues and keep the skin clean and dry. 4. Prevention and nursing of urinary tract infection In the early stage of injury, usually within 2 weeks after injury, the patient is inserted with an indwelling catheter, and the catheter is kept unobstructed continuously, so that urine does not accumulate in the bladder and the chance of injury is reduced. Opening the catheter regularly after 2 to 3 weeks will help to establish reflective bladder urination; When inserting catheter, we should choose the appropriate catheter type, strictly abide by aseptic operation technology, encourage or help patients to drink more water to prevent urinary calculi. 5. Treatment of digestive dysfunction after spinal cord injury, impaired somatic nerve function and autonomic nerve function disorder. Intestinal paralysis may occur after injury or operation, which is manifested by vomiting, bloating, not defecating for several days, abdominal distension, limited diaphragm activity and dyspnea. Fasting, gastrointestinal decompression, anal exhaust and intramuscular injection of neostigmine should be given. After injury, patients often suffer from stress ulcer, hematemesis and melena due to hormone use or internal stress reaction. We closely observe the condition and give timely treatment and care. 6. Prevention and care of pneumonia patients can be given appropriate painkillers to relieve pain at the early stage of injury, and encourage patients to cough and expectorate effectively. The method is to let the patient take a deep breath, cough hard at 2/3 of the exhalation, and repeat it, so that the sputum enters the airway around the alveoli and coughs up; Turn over more and change your position. Every time you turn over, pat your chest and back to help eliminate phlegm. You can also improve alveolar function by blowing water bottles. The problem of expectoration in patients with high paraplegia caused by cervical spine fracture is even more important. Such patients are prone to pneumonia complications, and even suffocate because they can't discharge respiratory secretions. Early tracheotomy is one of the important measures to reduce the complications and mortality of pneumonia. Good drainage of sputum after tracheotomy is closely related to the quality of nursing work. When nursing tracheotomy patients, aseptic operation must be emphasized, and atomization inhalation can be done to help expectorate. When the liquid medicine is dripped through tracheotomy and intubation, it should be dripped slowly along the tube wall to avoid choking. 7. Prevent deep venous thrombosis of lower limbs, guide the active and passive activities of both lower limbs to pressurize regularly to promote blood circulation, turn over frequently, take anticoagulants such as aspirin, often raise both lower limbs to facilitate venous return, supplemented by manual massage, and get out of bed as soon as possible. 8. Prevent disuse atrophy of limbs and joint stiffness. After the vital signs are stable, help to carry out functional exercise, so that paralyzed muscles, joints and soft tissues will not shrink and joints will not be stiff, promote blood circulation and prevent deformity. For muscles that are not paralyzed, especially the muscles of upper limbs and back, we should exercise seriously and actively to lay a good foundation and prepare for the future. We should carefully and patiently explain the importance of exercise to patients and get their cooperation. To sum up, paraplegic patients are prone to bedsore, pneumonia, urinary system infection and other complications due to long-term passive bed rest and poor physical function. Due to our predictive countermeasures and patient health education and guidance to patients and their families, the occurrence of complications during hospitalization was minimized.
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