Respiratory Management Following Spinal Cord Injury - 29
CLINICAL PRACTICE GUIDELINE
29
Incorporating fun and diversion into the life of the patient who is dependent on a ventilator is essential. A therapeutic recreation specialist can provide leisure resources for the patient and family in the home community. Technology and adaptive equipment might be required for some recreational activities. The benefits of socializing outside the home and being diverted from medical issues may inspire the patient to advance his or her own interests and activities.
Transition Resources
46. Identify medical and other transition resources in the home community, including: Local specialists. Respiratory services. Home supply and durable medical equipment vendors. Pharmacies.
Vocational Pursuits
45. Arrange a vocational evaluation to determine special aptitudes, interests, and physical abilities; factor in the need for transportation and attendant services.
(Scientific evidence–NA; Grade of recommendation–NA; Strength of panel opinion–Strong)
Home health-care services. Advocacy groups.
(Scientific evidence–NA; Grade of recommendation–NA; Strength of panel opinion–Strong)
Patients who are ventilator dependent should be encouraged to pursue their vocational interests. Chapin and Kewman (2001) found many key psychological factors associated with employment, including self-esteem, optimism, pride in personal achievement, and the positive influence of role models. State and private vocational rehabilitation agencies can provide a vocational evaluation to guide the patient to appropriate vocational choices. Schooling or other training might be necessary before employment can be secured. Transportation, manageable scheduling, support services, and accessibility in the vocational setting are essential to success.
Before discharge from an institutional setting, it is essential to identify the community resources that are available to provide services for the patient at home. A list of telephone numbers for key contacts is particularly helpful. A safe and efficient transition can help to alleviate the anxiety of leaving a stocked and staffed inpatient setting for life in the home setting. The successful transitional experience will empower the patient and family to manage care needs at home and to start to normalize the life of the patient.
Respiratory Management Following Spinal Cord Injury
Table of Contents for the Digital Edition of Respiratory Management Following Spinal Cord Injury
Respiratory Management Following Spinal Cord Injury
Contents
Preface
Acknowledgments
Panel Members
Contributors
Summary of Recommendations
The Consortium for Spinal Cord Medicine
Recommendations
Recommendations for Future Research
Appendix A: Respiratory Care Protocol
Appendix B: Protocol for Ventilator-Dependent Quadriplegic Patients
Appendix C: Wean Protocol for Ventilator-Dependent Quadriplegic Patients
Appendix D: Wean Discontinuation Protocol
Appendix E: Cuff Deflation Protocol for Ventilator-Dependent Quadriplegic Patients
Appendix F: Cuff Deflation Discontinuation Protocol
Appendix G: High Cuff Pressures Protocol
Appendix H: Post-Tracheoplasty/Post-Extubation Protocol
Appendix I: Criteria for Decannulation of Trach Patients
Appendix J: Evaluation of High Peak Pressure on Mechanically Ventilated Patients
References
Index
Respiratory Management Following Spinal Cord Injury - Respiratory Management Following Spinal Cord Injury
Respiratory Management Following Spinal Cord Injury - Cover2
Respiratory Management Following Spinal Cord Injury - ii
Respiratory Management Following Spinal Cord Injury - Contents
Respiratory Management Following Spinal Cord Injury - iv
Respiratory Management Following Spinal Cord Injury - Preface
Respiratory Management Following Spinal Cord Injury - Acknowledgments
Respiratory Management Following Spinal Cord Injury - Panel Members
Respiratory Management Following Spinal Cord Injury - Contributors
Respiratory Management Following Spinal Cord Injury - ix
Respiratory Management Following Spinal Cord Injury - Summary of Recommendations
Respiratory Management Following Spinal Cord Injury - 2
Respiratory Management Following Spinal Cord Injury - 3
Respiratory Management Following Spinal Cord Injury - 4
Respiratory Management Following Spinal Cord Injury - The Consortium for Spinal Cord Medicine
Respiratory Management Following Spinal Cord Injury - 6
Respiratory Management Following Spinal Cord Injury - 7
Respiratory Management Following Spinal Cord Injury - Recommendations
Respiratory Management Following Spinal Cord Injury - 9
Respiratory Management Following Spinal Cord Injury - 10
Respiratory Management Following Spinal Cord Injury - 11
Respiratory Management Following Spinal Cord Injury - 12
Respiratory Management Following Spinal Cord Injury - 13
Respiratory Management Following Spinal Cord Injury - 14
Respiratory Management Following Spinal Cord Injury - 15
Respiratory Management Following Spinal Cord Injury - 16
Respiratory Management Following Spinal Cord Injury - 17
Respiratory Management Following Spinal Cord Injury - 18
Respiratory Management Following Spinal Cord Injury - 19
Respiratory Management Following Spinal Cord Injury - 20
Respiratory Management Following Spinal Cord Injury - 21
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Respiratory Management Following Spinal Cord Injury - 25
Respiratory Management Following Spinal Cord Injury - 26
Respiratory Management Following Spinal Cord Injury - 27
Respiratory Management Following Spinal Cord Injury - 28
Respiratory Management Following Spinal Cord Injury - 29
Respiratory Management Following Spinal Cord Injury - Recommendations for Future Research
Respiratory Management Following Spinal Cord Injury - Appendix A: Respiratory Care Protocol
Respiratory Management Following Spinal Cord Injury - 32
Respiratory Management Following Spinal Cord Injury - 33
Respiratory Management Following Spinal Cord Injury - Appendix B: Protocol for Ventilator-Dependent Quadriplegic Patients
Respiratory Management Following Spinal Cord Injury - 35
Respiratory Management Following Spinal Cord Injury - Appendix C: Wean Protocol for Ventilator-Dependent Quadriplegic Patients
Respiratory Management Following Spinal Cord Injury - Appendix D: Wean Discontinuation Protocol
Respiratory Management Following Spinal Cord Injury - Appendix E: Cuff Deflation Protocol for Ventilator-Dependent Quadriplegic Patients
Respiratory Management Following Spinal Cord Injury - 39
Respiratory Management Following Spinal Cord Injury - Appendix F: Cuff Deflation Discontinuation Protocol
Respiratory Management Following Spinal Cord Injury - Appendix G: High Cuff Pressures Protocol
Respiratory Management Following Spinal Cord Injury - Appendix H: Post-Tracheoplasty/Post-Extubation Protocol
Respiratory Management Following Spinal Cord Injury - Appendix I: Criteria for Decannulation of Trach Patients
Respiratory Management Following Spinal Cord Injury - Appendix J: Evaluation of High Peak Pressure on Mechanically Ventilated Patients
Respiratory Management Following Spinal Cord Injury - References
Respiratory Management Following Spinal Cord Injury - 46
Respiratory Management Following Spinal Cord Injury - 47
Respiratory Management Following Spinal Cord Injury - 48
Respiratory Management Following Spinal Cord Injury - Index
Respiratory Management Following Spinal Cord Injury - Cover3
Respiratory Management Following Spinal Cord Injury - Cover4
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