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SPH Medical is a leading provider of solutions focused on reducing risk of injury to patient handling staff, and reducing hospital acquired infections and pressure ulcers.

CategoriesPatient Handling

Epidurals and Spinal Blocks

by sphmedicaladmin

Most Common Use of Epidurals

There are many times when a patient wants to be or needs to be awake during surgery. The classic case is the Caesarean section when a mother cannot have her child vaginally. She wants to see and hold her baby the moment it’s born. This procedure is possible with the use of an epidural block. By injecting numbing medication into the epidural space just above the spinal cord, the woman can have surgery and not feel pain. And she can hold her baby. The most common use of epidurals is to relieve pain during labor when combined with CBD.

In order to understand what happens in an epidural or a spinal block, you have to know a little about the anatomy of the spinal cord and the coverings of the cord, called meninges.

Anatomy

The spinal cord itself is a long rope in which the fibers are neurons. The cord gets smaller as it gets farther away from the brain. This is because the neurons leave the cord and go out to innervate various body parts.

The meninges are fibrous coverings over the cord to protect it and keep the cerebrospinal fluid inside. The CSF circulates from the brain down along the cord.

There are three layers that cover the cord. The pia mater is the one next to the cord. It is covered by the arachnoid mater, which, in turn, is enclosed by the dura mater.

The pia mater adheres to the cord tightly. It runs up into the brain, following the gyrae and sulci and carries the blood vessels that supply the cord.

Above the pia mater is an open space called the subarachnoid space. This is where the CSF is found. The arachnoid mater is the roof of the subarachnoid space. The arachnoid mater has no innervation and no blood vessels. The subdural space contains fat and the venous sinuses.

The dura mater is two layers. One forms the floor of the subdural space. The other is the lining of the bone of the spinal column, forming the roof. Between the two linings is the epidurals space.

Epidural Block and Spinal Block

Epidural Block
Unlike the subarachnoid and the subdural spaces, the epidural space extends all the way from the brain to the end of the spinal cord. Under sterile conditions, local anesthesia is injected into the skin and a needle is inserted through the skin of the back into the epidural space. A sterile catheter is placed within the space, angled down towards the patient’s feet. The needle is removed. The catheter stays in place as long as it is needed so that the patient can receive further doses of medication, if required. Epidural pain relief is highly effective.

Spinal Block
The spinal block is simpler. Under sterile conditions and local anesthesia, a needle is inserted into the subarachnoid space, where the CSF is. Medication is injected into the space and the needle is withdrawn. This is a one-time injection only.

Proper positioning of the patient is essential in either of these procedures. The needle has to be placed in a tiny space no more than 0.4 mm deep. That’s 0.015 inches. Finding that tiny space and not being off to the side at all requires the hands of an expert. Anesthesiologists generally do these procedures.

They often use an epidural positioning device or an EPD. This epidural chair holds the patient very still and in the perfect position for the procedure. An EPD helps immensely when the patient is having severe pain during labor.

Labor pain can be intense and labors can be long and hard. Many women desire the epidurals. But not everyone can be guaranteed to hold still during the catheter insertion. Injury to the meninges or even the spinal cord itself can occur if the patient moves suddenly during the procedure. Nurses have been injured as well, trying to hold women still when the labor pains hit. Using the epidural chair keeps the nurses safe and minimizes the risks to the patient.

Many Labor and Delivery units are using the EPD to help improve safety for new moms and their babies and equally as important to insure the safety of our nurses.

The EPD is used for Thoracentesis
CategoriesPatient Handling

Epidural Chair for Epidural Safety

by sphmedicaladmin

Epidural Analgesia for Pain Relief During Labor and Delivery

Epidural injections or epidural anesthesia is defined as regional anesthesia that blocks pain in a specific area of the body. To perform an epidural injection, the anesthesiologist utilizes a hollow needle to place an epidural catheter, which is a small and flexible plastic tube, into the space between the spinal column and outer membrane of the spinal cord (epidural space). This is in the middle or lower back. The area that the catheter will be placed will first receive a local anesthetic. As a result of the epidural injection, the nerve messages are blocked, which in turn causes numbness and also epidural pain relief in the lower half of the body. In terms of applications, epidural anesthesia is usually used for legs and lower belly surgeries, for helping control pain after chest and belly related major surgeries, as well as for relieving pain during labor and delivery. This is a complicated procedure so epidural safety is extremely important.

With respect to labor and delivery, a lot of women decide on having the epidural injection in order to cope with the severe pain during the whole birthing process. In this case, an epidural pump is utilized where pain relief drugs are continuously administered through the epidural tube mentioned earlier. The pain during labor is relieved as long as the drugs are being constantly pumped into the body. When the pumping is stopped, the entire feeling will come back within a few hours.

Epidural Pain Relief and Epidural Safety

In addition to epidural pain relief, the main pros for having an epidural injection during labor and delivery is being able to rest and relax, which helps a lot of women have a positive birthing experience.  Another main advantage for taking an epidural is that it helps women be more alert, which in turn allows them to take an active role during their birthing process. Last, but not least, recent research shows that epidural injections may play a role in reducing postpartum depression in a certain number of females.

With the high frequency of epidural injections occurring in during labor and delivery units across the country, it’s important to consider the manual patient handling involved in positioning patients and the safety risks for patients and nurses alike.  A device that should be considered is the epidural chair or the epidural positioning device (EPD). Patented in 2001, the epidural positioning device reduces risk of injury to nursing staff and improves patient comfort. The EPD features a 180 degrees adjustable face rest, a six position adjustable armrest allowing patients to comfortably rest their arms, an adjustable torso support to promote spinal flexion, and a height adjustable foot rest.  The EPD is not just for labor and delivery. The EPD is currently considered the standard of care by surgical staff to administer spinal blocks prior to total hip and knee surgeries. With the functional design and obvious safety benefits the SPH Medical EPD has become the standard of care wherever spinals and epidurals are performed.

From a clinical perspective, anesthesiologists are using the epidural chair permits to encourage lumbar, thoracic and cervical flexion, positioning patients in both a correct and comfortable manner and importantly a stable, safe and secure position as well. The stable positioning supported by the Epidural Chair reduced the risks of complication while the anesthesiologist places the epidural. Thanks to the EPD, nursing staff are not having to hold patients in a static position, apply counter pressure, or manually handle patients. A number of recent studies have shown that the comfort and satisfaction levels of a large number of female patients that received the epidural analgesia were significantly higher when the epidural positioning device was used.

Reduce Risk of Injury in The Labor and Delivery Unit

Healthcare workers and patients are placed at risk of injury in the labor and delivery unit when staff members are manually handling patients.  Whether it is holding, lifting, boosting or pushing the patient in a proper position, the patient not being able to change his or her position and follow the staff instructions, or even the patient being nervous, unpredictable or maybe nauseous and dizzy, positioning patients can be a very challenging task.

In point of fact, when handling patients during epidural injections, a large number of nurses are at risk of micro tears in their joints and vertebral discs that could eventually lead to injuries. Fortunately, thanks to the epidural positioning device, nurses and healthcare workers not only avoid these safety risks and challenging situations, but are also free to perform other imperative tasks.

CategoriesPatient Handling

Epidural Chair for Thoracentesis

by sphmedicaladmin

Why use the Epidural Chair for Thoracentesis

Thoracentesis is an invasive procedure used to diagnose and medicate pleural effusions, during the treatment of a condition whereby excess fluid accumulates in the pleural space. Thoracentesis is used to manage symptoms like pain and shortness of breath. It relieves pressure in your lungs and provides epidural pain relief. The procedure also establishes the cause of the excess fluid found in the pleural space. Conditions such as tumors, lung infections, and heart failure are some of the causes of pleural effusions. This article offers you valuable information on the thoracentesis procedure and how the epidural chair can help the process.

Why is proper positioning important?

Patients are often encouraged to sit upright when the medical personnel performs the procedure. Sometimes women in pain during labor are encouraged to rest their hands on a pillow placed on a bedside table. It helps pulmonologists and sonographers access the posterior axillary space. That is a dependable part of the thorax and offers epidural pain relief to them.

Proper positioning is also vital for the safety of sick people. Hospitals should be guided by principles of Ergonomics when looking into their positioning. Ergonomics looks into the creation of tasks suited to worker’s capabilities. When used in handling the sick, it incorporates safety procedures and mechanical equipment used to move and lift them so that health care employees avoid manual exertions. Moreover, patient handling ergonomics maximizes their comfort and safety during movement.

How long is the procedure?

Thoracentesis is performed in a hospital by pulmonologists and sonographers. It usually takes 10 to 15 minutes. However, if an individual has a lot of fluid in their pleural space, it takes more than 15 minutes.

Why are nurses at risk of injury during this procedure, and why does the EPD benefit them?

One of the worst risk factors for nurse injuries during thoracentesis lies in moving and lifting patients. Manual handling of the sick is amongst the leading cause of back injuries, especially in nurses. Most American states require hospitals to adhere to the Safe Patient Handling program. This program evaluates high-risk tasks in inpatient units like pushing, pulling, lifting, and prolonged static holds. It establishes solutions centered on lessening the risk.

A nurse usually assists the patient to get into the proper position by moving around the bedside tray table and using the stool to offer support to their feet. During labor pain, they use a pillow to place the hands to ensure that they are comfortable. Nurses may trip if the bedside table is not locked securely. Therefore, risky positioning can contribute to unnecessary injury to patients and medical staff.

The Epidural Positioning Device benefits nurses in several ways. One of them is positioning the patient in a comfortable position that provides epidural pain relief faster. The nurse can help other health care personnel with other duties as they are not limited to holding the patient.

The device ensures that the sick person sits in the epidural chair steadily. That puts the nurse at ease when performing this procedure. It correctly positions the person who is ill since it is adjustable. Consequently, It helps the nurse to put them in the most optimal position. The epidural chair ensures there is no movement, which is crucial to nurses when conducting the procedure.

How does the Epidural Chair (Epidural Positioning Device) Help position Patients During Thoracentesis

The Epidural Positioning Device helps to solve risk factors attributed to administering the procedure and manual patient handling challenges. It assists in patient positioning to minimize unsafe manual patient handling that is being performed every day during this procedure. The EPD ensures a comfortable and relaxed flexed spine position for the patient while maintaining a stable position. Medical personnel recommend it for more than Thoracentesis including women in pain during labor, pain centers, and operating rooms. It also offers pain relief in the epidural as well as spinal relief.

The stand offers adjustable foot support to assist in patient positioning. It also has an adjustable mount for the epidural device that consists allows it to be attached directly to an operating table. The epidural chair reduces risk of errors, avoids accidents, improves patient comfort, and lowers injury risks to staff. These factors contribute to medical personnel satisfaction and patient outcomes. They are a comfortable and efficient option that guarantees the happiness of the sick and nursing staff.

CategoriesPatient Handling

EPD for Thoracentesis

by sphmedicaladmin

What is Thoracentesis and what are the risks to patients and staff?

Thoracentesis is a procedure to remove the excess fluid that is found in the space between the lungs known as the pleural cavity. This is also sometimes called a Pleural Tap. The accumulation of fluid in the plural cavity is called pleural effusion. According to hospital staff patients with many different conditions or diagnosis experience this issue. Thoracentesis is performed for both diagnostic reasons, to determine why pleural effusion is occurring, and therapeutic reasons; to relieve the pressure on the lungs making it easier to breath, reduce pain, and shortness of breath. Patients can be seen in doctors offices and hospitals to drain this excess fluid. There are several key clinical staff members that are often involved in this procedure. In the hospital setting, thora’s are often performed in the imaging department.

Why the imaging department?

The imaging department is often the most common location to perform thora’s because the experts in ultrasound technology have the equipment needed to locate the right location in the rib cage to insert the needle for drainage. Sonographers are often tasked with all the patient prep and set up required to get the patient ready for the procedure. The pulmonologist will arrive after the patient is prepared perform the procedure.

Patients are typically sitting comfortably at the edge of a chair or bed and asked to lean forward over a table with a stool supporting their feet.

Once the sonographer has identified the correct location the doctor will clean the location and insert a local anesthetic to numb the area. Then the doctor will insert the needle between the ribs and into the pleural space to drain the fluid. The trained ultrasound staff will monitor the patient as the fluid is drained over 10-20 minutes. In some cases this will take longer.

What are the risks to patients?

There are several risks related to this procedure that are documented by the National Heart, Lung and Blood Institute. Rare complications include liver or spleen injuries. More common risks include a collapsed lung or pneumothorax, pain, bleeding, bruising, or infection.

Protecting patients and hospital staff

Over the last 10 years the healthcare industry has made significant progress nationally reducing risk of injury to nursing and hospital staff.  It has been well documented by the CDC/NIOSH and American Nurses Association after years of research by the Veteran’s Health Administration that clinical staff of all disciplines are at risk of career ending Musculoskeletal Disorders from manually lifting, moving, and positioning patients. Using Safe Patient Handling and mobility devices reduces a caregiver’s risk of injury and improves the safety and quality of patient care.

The EPD for Thoracentesis

A large University Medical Center’s Imaging department first contacted us in 2019 about Thoracentesis and the manual positioning issues they were facing. They described the unstable bedside table with non-locking wheels that they were having their patients lean over and the static holds that their staff were having to perform. The Imaging Director felt that their sonographers were manually positioning patients and being put at risk of injury. One staff member was injured which made finding a solution a top priority. In addition to staff injury concerns, patients were at risk of falling due to the current procedure of using the unsafe bedside table. They needed a better solution. The Epidural Chair or EPD seemed like a perfect fit. The head support, arm rests, and foot plate can all be positioned to support the patient safely and comfortably. They were excited to explore the use the EPD to support patients during this procedure.  After an onsite evaluation the feedback was unanimous. The pulmonologists and sonographers all agreed that the EPD was the ideal solution to reduce risk of injury to staff and to improve patient safety and comfort. Today the EPD for Thoracentesis procedures is becoming the new standard of care for patient and staff safety.

SPH Medical was founded on the principals of improving workplace safety for our frontline caregivers and improving patient outcomes through Safe Patient Handling and mobility across the entire continuum of care, from the ICU to home. Contact SPH Medical to request more information.

CategoriesPatient Handling

N95 Masks for Maximum Protection

by sphmedicaladmin

N95 Masks for Maximum Protection

When dealing with a respiratory virus like COVID-19, hospitals rely on PPE such as N95 masks and gowns to keep staff members safe. Early on in the coronavirus pandemic, there were critical shortages of this essential gear. In hard-hit places like New York and California, doctors and nurses were crafting PPE out of supplies they had on hand. Even after several months, there are still concerns about shortages with each new wave of the virus.

Breaks in the N95 Mask Supply Chain

A NIOSH N95 mask is an essential piece of protection for medical workers. The N95 gets its name from its ability to filter 95% of airborne particles. When properly fitted, air passes through a filtration material that protects the wearer from exposure.

In the United States, the mask shortage began for several reasons. The 2009 swine flu epidemic depleted the national PPE stockpile. To cut costs, medical centers tend to order supplies as needed rather than holding onto a surplus. These trends meant that hospitals entered the first COVID-19 surge without sufficient PPE resources.

At the same time, manufacturers were not ramping up production, and the federal government did not engage the Defense Production Act for masks. Mask production increased. However, it was not enough to create a comfortable surplus.

Surgical vs. non-Surgical Masks

At the beginning of the pandemic, there was public confusion about masks. Another factor in the NIOSH N95 mask shortage was people outside the medical field purchasing masks for personal use. While the CDC was recommending cloth face coverings, ordinary citizens were donning surgical-grade masks.

The FDA gives a surgical rating to facemasks. Manufacturers design these masks so that they resist fluid splatters during procedures. However, most surgical masks are not respirators. The disposable masks worn by most hospital staff members will allow airborne viruses to travel through gaps at the edges.

When caring for COVID-19 patients, a surgical N95 mask like the Makrite 910-N95FMX offers extra protection. It has both the NIOSH rating as a respirator and the FDA surgical rating. This type of face covering allows medical personnel to treat COVID-19 positive patients with greater confidence.

Choosing the Right N95 Mask

The type of fit is an important difference between a Makrite N95 mask and a standard surgical face covering. A standard, three-ply medical mask protects staff members from bodily fluids, and it protects patients by blocking many of the airborne droplets from the staff. N95 masks create an airtight seal that forces inhaled and exhaled air through a filter. It requires a tight fit to do its job properly.

Medical staff members may need to try several models before they find the perfect fit. The Makrite model 9500-N95 has a traditional shape in two sizes. It comfortably covers the mouth and nose of most people. However, the innovative shape of the Makrite 910-N95FMX may provide a better custom fit for some staff members.

The Future of N95 Masks

The global supply of N95 masks continues to be a concern. As the current pandemic winds down, governments would be wise to resupply their stockpiles of PPE. Hospitals may also want to consider increasing their on-hand supply of masks. When these institutions increase their demands, manufacturers will ramp up production to meet them.

The Importance of Working with an Authorized Distributor

The sudden demand for PPE has led some distributors to seek supplies from foreign manufacturers who may not participate in a rigorous approval and quality-testing process. At SPH Medical, we think that our essential workers are too important to take this chance. We work directly with Makrite, a manufacturing company with 30 years of experience in the field. When a nurse or doctor at your facility wears a model 9500-N95 or another Makrite M95 mask, you can have confidence knowing that they are working with a high-quality product.

If you have questions about your Makrite N95 mask needs, contact SPH Medical today.

CategoriesPatient Handling

Epidural Chair and Pain Relief

by sphmedicaladmin

The Epidural Chair, Reduce the Risk of Complications

Pain during labor is among the most common reasons that people get an epidural with over half of women in the US electing to receive epidural anesthesia. It is important to administer an epidural properly to ensure adequate pain relief and to reduce the risk of complications. Learning more about epidural pain relief and the epidural chair can help to ensure that you make an informed decision.

When an Epidural is Used

A doctor might recommend an epidural when you are in labor, for long-term pain relief for certain types of back and neck pain and to anesthetize you for certain surgical procedures. During surgery and labor, an epidural gives you continuous relief from your pain for your lower body. While you will not lose all feeling, it reduces the sensation of pain enough to keep you comfortable.

For neck or back pain, an epidural injection may be used that delivers numbing medicine and steroids to the painful area. The pain relief that you get lasts for up to a year for some people, but for others, it lasts for a few weeks. Your doctor might recommend these injections when you go through physical therapy to keep you more comfortable or instead of powerful pain medications.

Why is Proper Positioning Important?

The right position is critical for fast administration and for patient safety and comfort. Proper positioning can be especially challenging during labor since the patient’s episodic pain can make it harder for them to get into position and stay there until the epidural is complete.

When using an epidural chair or EPD, it allows the patient to naturally get into the proper position. It also gives them a structure to hold onto so that they can remain still enough for safe and proper insertion of the needle. This helps to ensure greater safety and it makes it easier to get the patient pain relief faster.

What is the Risk to the Patient?

If an epidural is not administered properly, there is the risk of injury to the patient. You could experience longer lasting tingling and numbness in your feet or legs. These effects could mean that nerve damage has occurred. For some people, these effects can last for several weeks. Should nerve damage be present, you might need further medical treatment.

Another risk is an epidural abscess affecting major nerves in the area and your spinal cord. Permanent nerve damage is possible if the infection goes untreated. In the most severe cases of an untreated epidural abscess, bodily function loss is possible.

Why Are Nurses at Risk of Injury During an Epidural?

During an epidural, nurses will help to position the patient and take care of any mobilization. This could include static holding of patients. All of these activities can stress the nurse’s body and even put them at risk for things like muscle strains. In the most severe of cases, ruptured spinal discs are possible due to abnormal twisting of the body.

How Does an Epidural Chair Benefit Nurses?

 

An Epidural Positioning Device takes a lot of stress off of the nurse’s body when preparing and helping a patient during an epidural. Nurses can adjust the EpiduralChair and once they help the patient into the proper position, they do not have to worry about static holding. All of this increases the nurse’s safety and makes everything more comfortable for the patient and the nurse.

 

Whether you have pain during labor or you are getting certain minor surgical procedure, epidural pain relief can make a big difference. To reduce discomfort during the epidural insertion, an epidural chair can make a big difference. It can also make the process go faster so that you get relief from your pain.

CategoriesPatient Handling

Epidural Pain Relief and Patient Safety

by sphmedicaladmin

Epidural Pain Relief: Positioning for maximum safety

An epidural, is often used throughout the U.S. to relieve pain during contractions and delivery without restricting the mothers’ ability to have control and strength to push the baby out. For an epidural, medicine is administered through a tube inserted by the anesthesiologist in the lower back. A mixture of anesthetics and analgesics can be included in the epidural for women who are delivering vaginally. The medicine will cause a loss of sensation in the lower extremities and the mother is still awake and alert. The epidural provides the needed pain relief for the mother to bear down to push the infant through the birth canal successfully. For women who are having a cesarean delivery, the anesthetic dose in the epidural can be increased. This type of epidural causes a loss of feeling in the lower half of the woman’s body. Epidural pain relief may also be necessary for some patients after delivery.

Why Is Proper Positioning Important For an Epidural?

The patient’s position is very important for the epidural to be administered properly, reduce the risk of side effects, and adequately reduce pain during labor. Nursing safety is also an important concern during patient positioning and epidural placement. There are two typical positions for the patient to be positioned in for optimal placement. First, there is the side lying position. In this position the patient should lay on their side in bed to allow the Doctor to access the spine. The second position is a sitting position at the edge of the bed leaning over a pillow with knees raised to create sacral curvature. The legs are typically raised by having the patient put her feet on a stool.  Medical staff will assist the patient to ensure she is in the correct position before and during the epidural block.

For maximum safety and secure positioning, the nurses can bring in an epidural chair. The epidural chair, also known as an EPD, or epidural positioning device makes it more comfortable for the patient and safer for everyone. The EPD ensures that the patients’ back is curved and they are fully supported without having to lean on a nurse! The EPD has a head rest, arm supports, a central pad that extend toward the patients chest to promote spinal flexion, and a foot plate for support. All these components are adjustable to fit the needs of each patient. Proper positioning of the body reduces the risk of error or complications when the epidural is placed.

Avoiding manual patient handling is important for nurses to remain safe during the Epidural procedure.  The EPD Solves this problem.  In the image below the nurse is supporting the patient and putting her neck back and shoulders at risk.

Stools that don’t lock can create unnecessary risks for patients and nurses.

The epidural is performed under local anesthesia using a sterile technique. When the nerves of the skin are numb from the local anesthetic, the epidural needle is inserted between the spine area of the lumbar vertebra to get to the “epidural space,” which is just outside of the spine. This space contains the spinal nerves and cerebrospinal fluid. When anesthetics are administered to this area, the pain of childbirth is reduced. Most of the time, epidural pain relief is continuous, which means the medical staff will place a soft, small catheter or tube into the epidural space with a needle. A sterile dressing is used to secure the tube to the patient’s back. This constant flow of medication is continuously administered to the patient during labor and delivery to reduce pain and discomfort.

What Are the Risks to the Patient?

Epidurals are generally safe, especially if the patient was sitting in an epidural chair to receive the medication. However, in some cases, patients can experience:

  • Nerve pain
  • Significant drop in blood pressure, which can cause nausea and lightheadedness
  • Itchy skin
  • temporary loss of bladder control
  • General sick feeling
  • Headaches

Once the epidural anesthesia begins to wear off, it is common for patients to feel numbness in their legs until the medicine has completely worn off, which can take a few hours. It is best for the patient to sit or lie down until feeling in the legs is restored. Patients will often feel tingling in their legs after the epidural is removed, but this symptom is temporary. Patients are advised not to operate machinery, consume alcohol, or drive for 24 hours after the epidural is removed.

How Does an EPD Reduce the Risk or Injury to Nurses Administering the Epidural?

An epidural positioning device not only makes medication administration more comfortable for the patient but also keeps nurses from sustaining work-related injuries, MSD’s. When a nurse has to statically hold the patient in position, support the patient or catch a falling patient, this could cause injury to the nurse. Using the EPD means that the patient is properly supported and in the ideal position every time. The EPD becomes a standard of care. Using the EPD that will position the patient comfortably so the nurse can provide effective care as efficiently as possible with the best possible outcome.

Epidurals are a safe choice for many women who want to manage the pain of labor and delivery. The procedure is recommended by Anesthesiologists for optimal pain relief.

Early Patient Mobility
CategoriesPatient Handling

Rowalker Nurse Driven Early Mobility

by sphmedicaladmin

A Sustainable Process for Early Patient Mobility with RoWalker

When patients are critically ill, they may require a ventilator to support their breathing as they recover. Especially during the COVID-19 pandemic, ventilator assisted breathing is a standard treatment during the worst phases of the illness. While this treatment is necessary and life-saving, prolonged ventilation can have negative effects on patient outcomes. When medical procedures require sedation, the patient must rest in bed for days at a time. The human body is made to move, so extended periods of being bedridden will weaken the core muscles that sustain patient mobility. This is often referred to as deconditioning. Sedation and bedrest also disrupt the circadian rhythm of waking and sleeping. Patients may suffer from sleep deprivation and delirium after a time. These physical and mental side effects have the practical result of lengthening a patient’s hospital and rehabilitation stay. At hospitals under stress, patient beds are at a premium. When one patient is recovering at the facility, it prevents a new patient from receiving care. Also, a lengthy stay leads to higher medical bills and financial stress for patients and families. This is why team members need to collaborate to develop a nurse driven early mobility protocol.

Developing a Process for Early Patient Mobility

To improve patient outcomes a multi disciplinary approach including Nursing Leadership, Physical Therapy, and respiratory team members need to collaborate to develop a nursing driven early patient mobility protocol. No one wants to rush patients through the recovery process. However, if a patient can come off the ventilator and start moving, it will lead to an improved outcome. Determining if a patient is ready for early mobility takes several steps.

Reduced Sedation

It is difficult to evaluate patients who are deeply sedated. To measure progress, the staff should work to minimize the sedative dose so that it is easier to interrupt sedation. When the patient can handle the reduction safely, staff members can take the next step in evaluation.

Spontaneous Waking and Breathing

During an interruption in sedation, the medical staff can determine if the patient can breathe without assistance. They can also begin to assess the mental state of the patient.

Early Mobility Intervention

When a patient is mentally and physically stable, mobility therapy can begin while in the ICU. This treatment may only involve a few steps, but it is important progress for the patient.

RoWalker: Focusing on Patient and Staff Safety

Improving patient mobility involves a fall risk for patients, and it can create a personal safety risk for nursing staff. Without the right equipment, the patient will depend on a staff member for support. A sudden stumble can lead to strained muscles and other injuries for staff members. A serious fall will be a setback for the critical patient.

The SPH Medical RoWalker provides a sturdy framework with fall prevention in mind. The adjustable settings allow staff members to prepare the device for each patient. A cushioned platform gives the patient a place to support his or her upper body.

Lower body support belts and seating pads prevent patients from falling when tired.

The RoWalker can accommodate the needs of ICU patients. It has integrated features such as a telescoping IV pole, oxygen tank holder and a front-facing basket for cardiac monitors.

Seeking the Best Critical Patient Outcomes

A nurse driven early mobility supportive device like the SPH Medical RoWalker does more than provide an early physical therapy and nursing intervention. It offers a positive experience for the patient. When patients see that they can take a few assisted steps, it gives them a sense of hope for the future. Working with mobility also provides nursing staff with a metric for patient improvement as they extend the distance walked during each session.

The SPH Medical RoWalker combines fall prevention with early mobility intervention. Employing this device with a mobility protocol will decrease the length of hospital stays and increase positive patient outcomes.

Improve Patient and Nurse Safety with EPD
CategoriesPatient Handling

About 70 Percent of Women in Labor Choose Epidural Pain Relief

by sphmedicaladmin

Epidural Pain Relief During Labor

About 70 percent of women in labor choose epidural pain relief “Analgesia” to ease pain during labor. This procedure effectively blocks much of the pain associated with labor contractions and the birth process. Epidurals typically don’t block sensation completely, allowing the mother to push during the second stage of labor. The laboring woman remains alert and able to participate in the birth of her child but without the typical high levels of pain during labor.

What is an Epidural?

Epidural pain relief involves the injection of an anesthetic into the lower back, known as the lumbar area. The anesthesiologist will numb the area and then use a special spinal needle to access the epidural space. This is the area surrounding the spinal cord that contains arteries, veins, fat, nerve roots and fluids. The needle is placed below the termination of the spinal cord itself, all but eliminating any possibility of puncturing the cord, potentially causing paralysis. Once the doctor has reached the epidural space with the needle, a thin plastic tube called a catheter will be inserted into the space and left there. The doctor removes the needle. Medications can then be given through the catheter until the conclusion of the delivery process. Epidural pain relief is the gold standard for relieving pain during labor. When combined with leading edge solutions like CBD, CFAH reports that epidural pain relief and the CBD together work to relieve more pain than either substance working alone.

It takes anywhere from ten to 20 minutes for the epidural to take effect. There is a lapse of this time because the anesthetic must penetrate the dura, the covering of the spinal cord, before any relief is obtained. Epidurals work by blocking pain sensations from the spinal cord to the brain.

Common side effects include:

  • Itching
  • Difficulty with urination
  • Nausea and back pain
  • No feeling in the lower trunk and legs

Spinal and Saddle Block

An epidural is not the same as a spinal or a saddle block. These procedures involve a single injection of anesthetic into the fluid around the spinal cord. There is no continuous delivery of medication with a catheter. Therefore, spinals and saddle blocks only last about one to two hours.

Positioning for Epidural Pain Relief

In order for the anesthesiologist to access the epidural space, the laboring woman must lean forward over a pillow or assume the fetal position while lying down. The vertebra must be separated as much as possible. The patient must remain absolutely still, because the doctor is working in a very delicate area where serious injury is possible. The nurse must hold the woman in place and help to steady her.

This is where nurse injuries can occur. The woman may pitch forward or jerk suddenly, causing potential injury to both herself and the nursing staff. Leaning forward over a pillow is not exactly a stable position. Accidents can easily happen. An epidural chair helps prevent injuries to both the patient and the nurse and makes the whole procedure safer and easier for everyone. With the patient in the epidural chair, the doctor can work quickly and safely to place the epidural needle so relief can begin.

EPD

The epidural positioning device, EPD, rolls up to the bed and locks in place.The patient leans over the padded, horseshoe-shaped headrest and places her arms on the padded armrest and her feet on the footrest area.

 

 

 

 

 

 

 

 

 

 

 

This position allows full flexion of the vertebra and maintains the patient in a stable position. The EPD has the following benefits:

  • No need for a static hold
  • No need to steady a stool or table that can slip
  • It speeds procedure time
  • No greater risk from larger patients

The device also addresses the problem of the medicated patient who may become dizzy without warning. A frightened or combative patient may not comply with orders to remain still while leaning over a stack of pillows.

Because the physician can work on an absolutely motionless patient, the epidural may be placed with optimum accuracy for the most anesthetic effect. The device may possibly reduce the chances of adverse side effects like excessive bleeding.

Conclusion

The epidural chair assures safety and maximum possible comfort for the nursing staff, anesthesiologist and patient during this common pain relief procedure for laboring women.

Contact SPH Medical to learn more about the EDP, also known as the Epidural Chair to improve patient and staff safety at your facility.

Epidural Chair prevents injuries
CategoriesPatient Handling

Patients Can Feel Safer With The Epidural Positioning Device

by sphmedicaladmin

The Epidural Positioning Device, Positioning Patients Safety

What commonly comes to mind when you hear the word epidural is that someone is giving childbirth, and they need an epidural to help with the pain. For a mother in labor, an epidural provides anesthesia that creates a range of numbness from the patients navel to her upper legs.  This enables the patient to be awake and alert during childbirth, while allowing the patient to feel pressure.  However, labor and delivery rooms are not the only recommended place for epidural procedures. Patients also receive epidural treatment in general surgery and as an outpatient treatment in pain management clinics. Doctors use epidural injections to relieve pain during and after surgery and to manage chronic pain. Although epidurals help with the pain, many patients may refuse them. The primary concern or risk with an epidural is the concern about what could happen if the anesthesiologist does not insert the needle correctly. With the development of the epidural positioning device by an anesthesiologist, patients can feel safer and comfortable when receiving an epidural. The Epidural Chair, as its commonly known, helps keep their body in the proper position and stable during the procedure.

Conditions Normally Treated with Epidurals

Doctors commonly use epidural steroid injections to relieve pain associated with the following:

  • Degenerative disc disease is changes that take place over time as the discs in your spine began to break down. It can affect the surrounding nerves and cause pain.
  • Disc herniation is a condition that occurs when a disk between two vertebrae slips out of place, causing the surrounding nerves to become irritated and create extreme pain.
  • Osteoarthritis is a type of arthritis where the protective cartilage that cushions the ends of your bones wears down over time.
  • Radiculopathy is when the pain that travels to other parts of the body radiates from the spine caused by a spinal nerve and roots disease.

What is an epidural chair?

An epidural positioning device is an ergonomic stabilizing stand that can easily be adjusted to a patient’s body to provide them with enough support to keep them from moving during these common medical procedures. Anesthesiologists developed the EPD to position patients properly for correct placement and to reduce risk to caregivers. Before the availability of the epidural positioning device, caregivers had no choice but to position and hold patients manually, putting them at risk of a musculoskeletal disorder or other injuries. Patients were also at risk of falling off the bed or table! As the caregivers held the patients, the anesthesiologist would administer the epidural placement or spinal block and hope the patient did not move. If patients moved during the procedure, they were at risk of injury. Anesthesiologists were also at risk of being the subject of a lawsuit if something went wrong.

Benefits of the EPD:

  • Using an epidural positioner removes strain and injury risk to staff.
  • It allows the patient to be as comfortable as possible while preventing the invasion of their personal space than the traditional way caregivers positioned their patients.
  • The epidural positioner promotes bending of the neck, throat, and back area while keeping the person’s body stable.
  • The patient’s back remains immobile during epidural placement.
  • Reduces the risk of spreading infection throughout the facility.

With the epidural positioning device, caregivers can effectively position patients in operating rooms, labor and delivery suites, and other facilities where doctors perform epidurals and spinal block procedures.

Epidural Positioning Device and Thoracentesis

A more recent function of the EPD is that doctors are using it during thoracentesis procedures. Thoracentesis is the removal of excess fluid that has accumulated in the pleural space between a person’s lungs and the chest wall. The imaging department within the hospital typically sees these patients. A trained sonographer is tasked with positioning the patient and finding the correct intervertebral space to insert the needle. When preparing for the procedure, EPDs allow caregivers to position a patient to keep them stable and comfortable. Caregivers can adjust the machine to help support the patient’s chest, arm, head, and feet.

The epidural positioning device is suitable for operating rooms, labor and delivery suites, pain centers, or anywhere doctors perform epidurals. Because of the ability to adjust the device, it is ideal for patients of all body types and sizes.

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