Try: Where do you need to use this lift if in a home what rooms within the home in a bathroom in a bedroom in a family room between multiple rooms what type of flooring do you have carpet is there space available to operate a rolling patient lift and space to store it when not in use evaluate all potential tight areas does the bed have clearance under it for the legs of a rolling lift if necessary what do you know about your ceiling construction if in a facility in a ward between multiple rooms what is the current injury rate for caregivers information references "patient lift help" 2008 by sherman oaks medical supplies available at www shermanoaksmedical com

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Categories: Sage, Topic, Medical Physical, Mobility, Needs Some Assistance, Needs Much Assistance, Immobile

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References: n/a

Keywords: Mobility transferring needs help getting up needs help sitting down lift

*This information is listed as a Fact Sheet and is not explicitly medically licensed

Try: Consider Care recipient (cr) characteristics what is the cr cr’s weight and height what is their condition — things that might relate to lifting them do they need head support do they need access to a commode do they have sensitive skin any restrictions to bending will cr ever need tobe lowered to or lifted from the floor for therapy or after a fall is cr always assisted consider the caregiver’s characteristics how strong are they do we have a 120 pound caregiver caring for a 200 pound patient they will need to become familiar with the operation of the new lift consider the types of lift movements cr needs to be able to do bed to chair or toilet or tub or floor and back chair to bed or toilet or tub or floor and back to from floor for therapy or in case cr has fallen sit to stand repositioning the patient in their chair or bed consider cr’s special needs restrictions applications gait training rolling or otherwise re-positioning cr in bed cr unable to sit want to use to visit family members or travel using hotels information references "patient lift help" 2008 by sherman oaks medical supplies available at www shermanoaksmedical com

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Categories: Sage, Topic, Medical Physical, Mobility, Needs Some Assistance, Needs Much Assistance, Immobile

Information: n/a

References: n/a

Keywords: Mobility transferring needs help getting up needs help sitting down lift toileting getting in car getting out of car falls fell fall prevention

*This information is listed as a Fact Sheet and is not explicitly medically licensed

Try: Caregiver injury preventing caregiver injury is a driving force in the purchase use of patient lifts even highly skilled facility caregivers can injure themselves by overexertion and strain while the use of manual hydraulic lifts is a step in the direction of caregiver safety they still require caregiver exertion power-assisted patient lifts are the answer to preventing caregiver injury know the types of lifts available there are many types of lifts available the primary classes of lifts are ceiling – ceiling lifts run on tracks installed in the ceiling of your home facility they are the most versatile convenient and least obtrusive types of lifts within the ceiling lift class of lift there are installed lifts and portable lifts floor rolling – floor model lifts roll on casters and are designed to perform different functions slings whether you choose a ceiling or floor lift the patient will be lifted in a sling attached to the lift there are many different slings available for example track ceiling lifts travel from point to point or room to room on a track installed in your ceiling the track can be as short as a 6 foot piece of track over the bed and wheelchair area or as involved as track all over a home or facility this track can be straight or curved and can have a variety of accessories to help your patient get where they need to within your home or facility information references "patient lift help" 2008 by sherman oaks medical supplies available at www shermanoaksmedical com

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Categories: Sage, Topic, Medical Physical, Mobility, Needs Some Assistance, Needs Much Assistance, Immobile

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Keywords: Mobility transferring needs help getting up needs help sitting down lift toileting getting in car getting out of car falls fell fall prevention ceiling lifts floor lifts slings track ceiling lifts

*This information is listed as a Fact Sheet and is not explicitly medically licensed

Try: Pressure ulcers are localized areas of tissue ischemia or skin breakdown they are caused when soft tissue the skin is compressed between a bony prominence like a hip and an external surface like a mattress for a prolonged period of time if left untreated these ulcers progress through increasingly destructive stages eventually producing necrosis or tissue death a staging system measures destruction by classifying wounds according to the tissue layers involved to carefully evaluate the amount of tissue damage other factors such as undermining slough eschar and sinus tract development must be considered definitions by the national pressure ulcer advisory panel npuap stage i an observable pressure related alteration of intact skin whose indicators as compared to the adjacent or opposite area on the body may include changes in one or more of the following skin temperature warmth or coolness tissue consistency firm or boggy feel and or sensation pain itching the ulcer appears as a defined area of persistent redness in lightly pigmented skin whereas in darker skin tones the ulcer may appear with persistent red blue or purple hues stage ii partial loss of skin thickness involving epidermis and or dermis the ulcer is superficial and presents clinically appears as an abrasion blister or shallow crater stage iii full thickness skin loss involving damage or necrosis of subcutaneous tissue that may extend down to but not through the underlying fascia the ulcer presents clinically as a deep crater with or without undermining adjacent tissue stage iv full thickness skin loss with extensive destruction; tissue necrosis; or damage to muscle bone or supporting structures e g tendon joint capsule note undermining and sinus tracts may also be associated with stage iv pressure ulcers a healing wound is in the process of reconstruction the base of a healing stage iii or stage iv wound is filled with granulation tissue so as a stage iii pressure ulcer heals it must be carefully observed and protected to prevent re-occurrence primary causes and effects of skin breakdown pressure unrelieved pressure is the primary cause of pressure ulcers and skin breakdown the effects of excessive pressure on soft tissue depend on the intensity of the pressure how heavy the patient is for example how long pressure is applied how well the tissues tolerate pressure a key variable is capillary closing pressure the pressure at which small blood vessels close this level of pressure can vary dramatically from patient to patient shear is caused by tissue layers sliding against each other this can cause disruption or angulation of blood vessels usually at the fascia level shearing forces account for the high incidence of sacral ulcers when a patient patient’s head is elevated the skeletal frame slides toward the foot of the bed while the sacral skin adhere by friction to the bed linen sliding produces stretching and angulation of the arteries that supply the skin f riction is surface skin damage caused by skin rubbing against another surface an example is sliding a patient up in bed the skin rubbing against the sheet causes friction and the resulting burn or abrasion exposes the skin to bacterial invasion and infection treatment planning and intervention recognizing and relieving pressure will help prevent skin breakdown reduce the healing time of existing ulcers lower the cost of treatment reduce pain and discomfort to the patient pressure reducing devices these devices offer an effective way to reduce interface pressure below what is encountered with a standard mattress they cannot provide pressures consistently less than 25-32 mm hg so they may have to be used with a turning schedule examples of such devices include foam mattresses gel water mattresses static air mattresses foam overlays pressure relief devices these consistently reduce pressure below 25-32 mm hg examples include low air-loss therapy beds alternating pressure mattresses dynamic mattress systems air fluidized therapy systems corrective steps to reduce the effects of shearing the plan of care should include the following specific nursing steps do not elevate the head of the bed for prolonged periods use care in placing and removing bed pans use patient handling techniques and tools to reduce friction such as heel protectors an over-bed trapeze transparent dressings and a mattress with a low friction covering methods to protect the skin from excessive moisture should also be included in the plan of care some helpful supplies include skin cleansers moisturizers lubricating sprays and ointments ointment barriers skin sealants incontinence devices information references "wound care help" 2008 by sherman oaks medical supplies available at www shermanoaksmedical com

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Categories: Sage, Topic, Medical Physical, Mobility, Needs Some Assistance, Needs Much Assistance, Immobile

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Keywords: Wound pressure ulcers pressure sores skin sheering mattress skin breakdown

*This information is listed as a Fact Sheet and is not explicitly medically licensed

Try: A person with ad may have other medical problems over time as we all do these problems can cause more confusion and behavior changes the person may not be able to tell you what is wrong you need to watch for signs of illness and tell the doctor about what you see these diseases spread quickly from one person to another and people with ad are more likely to get them make sure that the person gets a flu shot each year and a pneumonia vaccine shot every 5 years the shots lower the chances that the person will get flu or pneumonia for more information on these illnesses visit the centers for disease control and prevention website at www cdc gov flu and pneumonia may cause fever chills aches pains vomiting coughing breathing trouble note that not everyone with pneumonia has a fever fever having a fever means that the person’s temperature is 2 degrees above his or her normal temperature a fever may be a sign of infection caused by germs dehydration caused by a lack of fluids heat stroke constipation discussed later in this section don’t use a glass thermometer to check the temperature of a person with ad because the person might bite down on the glass use a digital thermometer which you can buy at a grocery or drugstore information references "caring for a person with alzheimer’s disease your easy-to-use guide from the national institute on aging" by national institute on aging 2011 available at www nia nih gov

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Categories: Sage, Topic, Medical Physical

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Keywords: Flu and pneumonia fever chills vomiting heat stroke constipation

*This information is listed as a Fact Sheet and is not explicitly medically licensed

Try: A legrest which can be elevated placing the leg in an extended knee straight position most have some type of calf pad which may be padded or hard footplate and calf pad can be readjusted for improved alignment and placement some have an articulating feature which allows the legrest to be extended and become longer as the rest is elevated this item is most commonly ordered for edema swelling control advantages maintains the leg in an extended position this works well for those users who have limited knee flexion knee is fixed in a straight position or for those who require this position post operatively on a chair with a powered recline system powered elevating legrests are useful in helping a user obtain a supine laying on back or reclined position independently the ability to change leg position is sometimes helpful in resolving discomfort or pain issues in the lower extremities disadvantages elevating legrests will add a considerable amount of weight to the wheelchair they have a number of moving parts that may lock up or become difficult to deal with it requires a certain amount of coordination and strength to work this item independently the user must bend over to one side depress a lever and lift the leg and device weight all at once the extent of edema swelling control is questionable in the most elevated position the extremity is nowhere near the level of the user user’s heart depending on the length of the legrest elevating the leg may result in flexing the knee when the legrest is elevated it makes the chair longer resulting in the need for increased turning space after a period of time the legrest hanger attachments become warped or worn from the weight of supporting the legs and the legrests take on an abducted away from each other position when loaded this results in poor positioning of the legs and hips legrest pads may push against the user user’s calfs and pull the user forward on the seat resulting in a sacral sitting slouched posture the joint at the highest point of the legrest may rub on the outside of the user user’s leg elevating legrests increase the cost of the wheelchair adding a legrest may make your nice wheelchair suddenly look bad information references "elevating legrests help" 2008 by sherman oaks medical supplies available at www shermanoaksmedical com

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Categories: Sage, Topic, Medical Physical, Mobility, Mobile, Needs Some Assistance, Needs Much Assistance

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Keywords: Power wheelchairs wheelchair legrests reclining in wheelchair knee fixed mobility aides getting around the home

*This information is listed as a Fact Sheet and is not explicitly medically licensed

Try: Continuous positive airway pressure cpap is an effective treatment for obstructive sleep apnea osa at first cpap patients should be monitored in a sleep lab to determine the appropriate amount of air pressure for them the first few nights on cpap tend to be difficult with patients experiencing less sleep many people at first find the mask uncomfortable claustrophobic or embarrassing cpap is not a cure and must be used every night for life non-compliant people experience a full return of obstructive sleep apnea and related symptoms during cpap therapy the person sleeps wearing a face mask connected to a pump that forces air into the nasal passages at pressures high enough to overcome obstructions in the airway and stimulate normal breathing the airway pressure delivered into the upper airway is continuous during both inspiration and expiration types of cpap therapy nasal cpap is currently the best treatment for severe obstructive sleep apnea cpap is safe and effective even in children tissues are prevented from collapsing during sleep and apnea is effectively prevented without surgical intervention daytime sleepiness improves or resolves heart function and hypertension also improve and importantly the quality of life improves continuous positive airway pressure cpap provides one constant air pressure all through the night automatic positive airway pressure apap therapy automatically varies the pressure all through the night and from night to night it actively responds to the continuous changes in the upper airway bilevel therapy vpap bipap provides a higher pressure when the person inhales and a lower pressure when they exhale information references "respiratory care help" 2008 by sherman oaks medical supplies available at www shermanoaksmedical com

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Categories: Sage, Topic, Medical Physical, Mobility, Mobile, Needs Some Assistance, Needs Much Assistance

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Keywords: Respiratory care sleep problems sleep therapy problems breathing at night snoring nasal cpap continuous positive airway pressure cpap automatic positive airway pressure apap bilevel therapy vpap bipap

*This information is listed as a Fact Sheet and is not explicitly medically licensed

Try: If you need oxygen therapy at home it is important to learn how to use it and take care of your equipment this information will help you get the most from your oxygen therapy key points breathing extra oxygen can help you feel better and lead a more active life you can travel even though you use oxygen but you will need to plan ahead oxygen is a fire hazard it is important to follow safety measures to keep you and your family safe oxygen therapy is a way to increase the amount of oxygen in the lungs and the bloodstream it is sometimes used for people with diseases that make it hard to breathe such as chronic obstructive pulmonary disease copd cystic fibrosis or heart failure oxygen therapy can make it easier to breathe and reduce the heart’s workload some people need extra oxygen all the time others need it from time to time throughout the day or overnight a doctor will prescribe how much oxygen you need based on blood tests he or she will tell you how much oxygen to use per minute flow rate and how often to use it to breathe the oxygen most people use a nasal cannula say kan-yuh-luh a thin tube with two prongs that fit inside your nostrils children and people who need high levels of oxygen may need to use a mask that fits over the nose and mouth oxygen can be delivered to your home in tanks or cylinders or it can be produced in your home by a machine called an oxygen concentrator your doctor will help you choose the source that fits your needs a combination of methods may be the best choice some people use an oxygen concentrator at home keep a large oxygen tank on hand as a backup and have small tanks for use outside the home oxygen tanks oxygen in tanks comes in two forms compressed oxygen gas tanks of oxygen gas come in several sizes small tanks can be carried when you leave home large tanks are heavy and are usually not moved after they are placed in the home liquid oxygen oxygen takes up less space in liquid form than as a gas compared to tanks of oxygen gas tanks of liquid oxygen weigh less and hold more oxygen so they may be a good choice for people who are active oxygen concentrators oxygen concentrators are machines that take in regular air which is about 21 oxygen remove the other gases and produce oxygen that is up to 95 pure most oxygen concentrators are about the size of a kitchen garbage can and weigh from 30 lb to 50 lb oxygen concentrators don’t need to be refilled like oxygen tanks do so they may cost less and be more convenient but unlike an oxygen tank an oxygen concentrator runs on electricity so you will need an oxygen tank as a backup in case the power goes out portable oxygen concentrators are oxygen concentrators which have rechargeable internal batteries portable oxygen concentrators are lightweight and can be charged at home or in the car with the car charger option after charging portable oxygen concentrators can be used depending on setting for up to about 8 hours when traveling contact your airline and make sure that portable oxygen concentrators are allowed on the flight some airlines accept certain manufacturer’s oxygen concentrators and not others information references "respiratory care help" 2008 by sherman oaks medical supplies available at www shermanoaksmedical com

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Categories: Sage, Topic, Medical Physical, Mobility, Mobile, Needs Some Assistance, Needs Much Assistance

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References: n/a

Keywords: Respiratory care oxygen oxygen concentration oxygen mask oxygen therapy portable oxygen

*This information is listed as a Fact Sheet and is not explicitly medically licensed

Try: A nebulizer is a device used to administer medication to people in forms of a liquid mist to the airways it is commonly used in treating cystic fibrosis asthma and other respiratory diseases the nebulizer pumps air or oxygen through a liquid medicine to turn it into a vapor which is then inhaled by the patient as a general rule doctors generally prefer to prescribe inhalers for their patients not only because these are cheaper and more portable but are often less potent and carry less risk of side effects nebulizers for that reason are usually reserved only for serious cases of respiratory disease or severe attacks newer compact ultrasonic nebulizers are also available these nebulizers use vibrating micro-mesh to produce the vapor nebulizers of this variety are rather expensive and the micro-mesh is very delicate and sensitive to dust and debris use and attachments nebulizers usually accept their medicine in the form of a concentrated liquid sometimes viscous these medicines are frequently steroids and the reason they are inhaled instead of ingested is to limit their effect to the lungs and respiratory system only otherwise that amount of steroid saturated throughout the body would be toxic this liquid is loaded into the machine for use bronchodilators such as salbutamol albuterol usan are often used and sometimes additionally ipratropium usually the vaporized medicine is inhaled through a tube-like mouthpiece similar to that of an inhaler this has the added benefit of increasing portability as well as allowing surrounding air to mix with the medicine decreasing the unpleasantness of the vapor the inhaling apparatus however is sometimes replaced with a standard rubber face mask similar to that used for inhaled anaesthesia for ease of use with young children or the elderly after use with steroids the person who used the nebulizer must rinse his or her mouth because those steroids can cause yeast infection of the mouth thrush this is not true for bronchodilators; however patients may still wish to rinse their mouths due to the unpleasant taste of many bronchdilating drugs information references "respiratory care help" 2008 by sherman oaks medical supplies available at www shermanoaksmedical com

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Categories: Sage, Topic, Medical Physical

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Keywords: Oxygen therapy aerosol therapy oxygen nebulizers bronchodilators salbutamol albuterol usan

*This information is listed as a Fact Sheet and is not explicitly medically licensed

Try: Often lost in the ongoing conversation about how best to treat pressure ulcers is a very important concept prevention there are many factors that make up a complete pressure ulcer prevention plan including proper skin treatment and good nutrition but if pressure is the major cause of pressure ulcers it makes sense that any prevention plan would address the relief of that pressure one way to achieve that is by constantly rotating or repositioning the patient equally important however is the actual support surface on which the patient is sitting or lying an effective pressure reducing support surface will allow your body to sink into it in doing so the pressure between your body and the surface is distributed over a wider area in general the more of your body that is in contact with the support surface the better the following overview will give you a good idea of the surfaces available today and highlight some of their advantages and disadvantages how advanced a system you need will depend on your particular medical situation will an overlay surface that rests on top of a standard mattress be sufficient or will you need an entire mattress replacement is cost an issue are you in a home care environment those are all considerations for your health care professional working together you should be able to fond the right system overlays and mattresses one decision you and your care provider will have to make is whether to purchase an overlay system or pursue a mattress replacement solution overlays do exactly what their name suggests; they lay over a standard mattress to provide increased pressure reduction and protect the bony areas of your body which are most vulnerable to pressure ulcers in general they are more portable and less expensive than other options but there can be issues with bottoming out or sinking in so far that your body surface rests against the firmer standard mattress underneath in some cases your nurse or doctor may recommend a replacement mattress made of a pressure reducing material or an actual support system that replaces the mattress and frame and may include other components while replacement mattresses tend to provide greater pressure reduction they are pricier and bulkier most of the materials below can function as either an overlay or a complete mattress solution types of support surfaces foam the most portable surface type foam can also be cut into numerous shapes which makes it a possible solution for wheelchairs or other smaller areas foam can also be used as a mattress material it is very important that the height density and firmness of the overlay be sufficient to support the weight of the patient while preventing them from bottoming out for example softer foams will envelop a patient patient’s body better but must be made thicker some foam products are even combined with gel to make them conform even better some consider foam overlays a safety concern in that it raises the mattress height even further viscoelastic visco viscoelastic is a type of foam support surface that is temperature sensitive as such it becomes softer conforms better and distributes pressure more evenly when in contact with a warm body surface this is an advantage over traditional stiffer foam surfaces in addition viscoelastic support surfaces gradually mold to the shape of the body lying on the surface rather than returning to its original shape this increases the amount of foam in contact with the body further reducing pressure low-air loss low-air loss surfaces are composed of interlocking air pockets or cells that conform to your shape and help take pressure off of the bony areas of your body an air pump pushes a steady flow of air throughout the device and replaces any air that may leak out through the surface it is critical that the overlay is inflated with the right amount of air which will vary based on the weight of the patient some systems will allow different section of the mattress or overlay to be inflated to different pressure levels too much air in any one are will only increase the pressure felt by the patient and too little air put the patient at risk of bottoming out dynamic or alternating pressure dynamic or alternating pressure support surfaces consist of longer air cells arranged side-by-side in columns the overlay or bed is hooked up to an air pump that alternately inflates certain rows of the overlay the theory behind the alternating motion is that it shifts pressure to different parts of the body thereby not allowing any one body area to remain under pressure for a prolonged period it is also believed that the alternating pressure helps improve lymphatic flow some patients find the alternating motion makes them feel uneasy fluid-filled gel or water these overlays or mattresses are made up of large and small compartments filled with gel or water the fluid helps disperse the pressure around the bony areas of the patient patient’s body both materials are meant to provide pressure reduction for the patient while not allowing them to bottom out most are covered in a vinyl shell which makes them relatively easy to clean one concern that occasionally rises for water and gel overlays built without compartments is that when the head of the bed is raised gravity will cause the water to move down and pool under the patients back and backside air-fluidized these beds have been available for over 40 years they consist of about one ton of glass beads sealed in a sheet made of a synthetic material like polyester or gore-tex warm high-pressure air is then forced through the beads causing them take on a fluid state air-fluidized beds allow the greatest level of immersion of any surface currentlt available as much as two-thirds of your body can sink into the bed which takes pressure off of the bony parts of your body and distributes it adjacent areas because of the high cost of air-fluidized systems you should check with your health care provider to be sure their use is covered under your plan information references "chronic wound care a clinical source book for healthcare professionals" 1997 by krasner and kane "managing pressure sore prevention" 1997 by carol dealy "nursing management of chronic wounds" 1997 by morrison moffat bridel-nixon and bale "advances in skin and wound care 2000 by brienza geyer

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Categories: Sage, Topic, Medical Physical, Mobility, Needs Some Assistance, Needs Much Assistance, Immobile

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Keywords: Pressure sores repositioning mattresses support surfaces foam mattress air mattress gel filled mattresses

*This information is listed as a Fact Sheet and is not explicitly medically licensed